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Breast reconstruction
Breast reconstruction is the rebuilding of a breast, usually in women.
It involves using existing flesh or prosthetic material to contruct a
natural-looking breast. Often this even includes the reformation of a
natural-looking areola and nipple. This procedure may involve the use
of implants.
Overview
Though this procedure was recently out of the question after surgical
procedures such as mastectomy, this type of cosmetic surgery is
becoming more common. Though most health plans cover the cost for this
operation in the US, some do not, considering it be cosmetic; paying
for this procedure oneself may be very costly. However, as noted, most
plans do cover this procedure as the cost may outweigh the converse
cost of counseling for the individual as they try to cope with the
emotional adjustment of losing a breast.
For individuals who have undergone a mastectomy due to cancer, they
are only eligible for this procedure if the disease was eliminated due
to the breast removal. It is possible for this procedure takes place
immediately following the mastectomy, so the individual awakes with
the newly formed breast already in place. As with many other
procedures, those with high blood pressure, obese individuals or those
who smoke are poor candidates for this operation.
Breast reconstruction is a large undertaking. Most procedures take
several operations. Sometimes these follow-up surgeries are spread out
over weeks or months. If an implant is used, the individual runs the
same risks and complications as those who use them for breast
augmentation.
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Techniques
There are many methods for breast reconstruction. The two most common
are:
Skin expansion By far the most common method, the surgeon inserts a
small balloon expander beneath the skin and periodically, over weeks
or months, injects a saline solution to slowly expand the overlaying
skin. Once the expander has reached an acceptable size, it may be
removed and replaced with a more permanent implant. Reconstruction of
the areola and nipple are performed in a seperate operation after the
skin has stretched to its final size.
Flap reconstruction The second most common procedure uses tissue from
other parts of the patient's body, such as the back, buttocks, thigh
or abdomen. This procedure may be performed by leaving the donor
tissue connected to the original site to retain its blood supply (the
veins are tunnelled beneath the skin surface to the new site) or it
may be cut off and new blood supply may be connected. This procedure
has the downside of leaving scar tissue in both the donor and breast
area, but, since the donor is the recipient, tissue rejection is not
an issue. Also, the patient may end up with a better contoured abdomen
if that was the selected donor area.
Follow-up
Recovery from skin expansion is generally faster than with flap
reconstruction, but both take three to six weeks to recover from and
both require follow-up surgeries in order to construct new areola and
nipple. Most scars will not disappear completely, but the better the
quality of the reconstruction, the less noticeable and distracting the
scars will be. All recipients of these operations should refrain from
strenuous sports, overhead lifting and sexual activity during the
recovery period (three to six weeks).
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