The diagnosis of breast cancer is one of the most devastating in all medicine. One day life is normal and then the next day patients are being asked to make critical decisions about surgery, chemotherapy, radiation and reconstruction. Reconstructive surgery of the breast has always been an area of special interest to Dr. Gumucio. The work is gratifying and the changes in patients' and their families' lives are often dramatic.
During the preoperative process, Dr. Gumucio spends a great deal of time discussing the suitability, timing, techniques and staging of breast reconstruction. Please ask Dr. Gumucio if there is anything you don't understand about the procedure.
Time in surgery: Varies
Time off from work: Varies
Are you a candidate?
The goal of breast reconstruction is to restore the breast(s) to near normal shape, appearance, symmetry and size following mastectomy, lumpectomy, or other trauma. It may be a good option for you if you have realistic goals for restoring your breast/body image.
How are breast reconstruction procedures performed?
Breast reconstruction typically involves several stages, and can either begin at the time of mastectomy or be delayed at a later date.
Tissue Expander is the most common technique used and is a modified saline implant with a valve that is inserted beneath a pocket under the pectoralis major muscle of the chest wall. In a process that can take weeks to months, saline solution is injected to progressively expand the overlaying tissue. Once the expander has reached an acceptable size, it may be removed and replaced with a saline or silicone implant. (Figure 1)
Flap reconstruction is the second most common procedure and uses tissue from other parts of the patient's body, such as the back, buttocks, thigh or abdomen. A TRAM flap, for example, uses donor muscle, fat and skin from a woman’s abdomen to reconstruct the breast. A Latissimus flap use the muscle, skin and fat of the back along with an implant to form the breast mound. These flaps may either remain attached to the original blood supply and be tunneled up through the chest wall, or be completely detached, and formed into a breast mound. (Figure 2)
Reconstruction of the areola and nipple are usually performed in a separate operation.