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| Following mastectomy, women
now have the opportunity to regain a breast of size and shape
resembling their own. Breast reconstruction may be performed
immediately following breast removal, or in a delayed fashion
depending upon the patient's preference and health condition.
Most often, breast reconstruction is performed in conjunction
with and immediately following mastectomy, giving the patient
the opportunity to awaken from surgery with a newly reconstructed
breast. There are many forms of breast reconstruction
including implant reconstruction, reconstruction with your own
tissues (autologous breast reconstruction), or a combination
thereof. The choice of reconstruction is dependent on physical
factors, adjuvant therapy requirements and your personal preference. |
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| Before the mastectomy procedure, Dr. Kolker will
carefully discuss with you all surgical options, enabling you
to make the most informed decision. He will thoroughly review
your medical history, carefully examine you, and make appropriate
measurements. He will discuss the benefits, risks and alternatives
of each surgical option. |
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Implant Reconstruction
Following mastectomy, implant reconstruction
often requires a period of tissue expansion. The tissue expander
is placed beneath the pectoralis muscle and remaining breast
skin. It is then sequentially inflated in the office with saline
beginning two weeks following surgery. The expansion process
lasts two to three months. After a three month waiting period
for maturation of a capsule around the expander, the expander
is replaced with a permanent implant at a second operation.
Nipple areolar reconstruction at a third operation completes
the process.
Latissimus Flap Reconstruction
Breast reconstruction may be performed
with the transfer of muscle, fat, and skin from the back to
the chest, creating a breast mound. Occasionally, enough of
your own tissue may be present to complete this reconstruction.
More often, an implant is placed beneath the muscle and skin
from the back. The nipple areolar reconstruction is performed
at a second operation, approximately three months after surgery.
TRAM Flap Reconstruction
The TRAM (transverse rectus abdominus
musculotaneous) flap is a procedure that involves the transfer
of skin, fat, and muscle from the lower abdomen to the chest
to create a new breast. The blood supply is derived from the
rectus abdominus muscle. The benefit of this procedure is
the slimming and toning effect on the abdomen, (tummy tuck),
and that the reconstructed breast is completely of your own
tissue. Nipple areolar reconstruction is performed as a second
operation approximately three months following surgery.
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| As there are many considerations for the various
types of reconstruction, careful and extensive discussion between
you, Dr. Kolker and your breast oncologist will be required. |
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