Breast reconstruction is a form of surgery that involves the creation of new breast shape or mound. It is done after the removal of the whole breast (known as mastectomy) or part of the breast (known as breast-conserving surgery). The reconstruction is done at the time of breast cancer surgery or months later as per the condition. The process involves several operations to give the patient the best outcome. There are different options available for breast reconstructions and the surgeon suggests the best form of reconstruction that suits the body.
The 3 breast reconstruction options are as follows –
- Implants/Expanders
- Flaps
- Brava+AFT
The breast reconstruction process aims at creating a breast shape that looks as natural as possible. It is tried to match the breast on the other side in shape, size, and position. With the best possible results, there remains a difference between the remaining breast and the reconstructed one. Surgery is suggested on the other side to helps meet the difference between the two breasts. It is done at the same time as the reconstruction, but one can also wait for the reconstruction to heal and settle into position. A specialist team is always at work to help patients with the best suggestion and breast reconstruction results.
TYPES OF BREAST RECONSTRUCTION
Implants/Expanders
A surgeon inserts silicone or saline implants underneath the skin or muscle while reconstructing a breast with implants. It is mainly a 2 stage procedure for most people. First, a surgeon places a tissue expander underneath the remaining breast skin or pectoralis muscle. The expander works as a temporary saline implant that gradually stretches the remaining tissue.
After proper healing, the surgeon injects sterile saline or saltwater through the skin into the tissue expander on a weekly basis. The process results in the growth of the balloon gradually that stretches the overlying skin and muscle until the breast reaches a comfortable size. As the chest tissue heals and the surgeon adds enough saline to the tissue expander in preparation, it will perform the second procedure for implant insertion.
The surgeon then removes the tissue expanders and replace it with a silicone implant. They usually open the original scar which means that the procedure leaves no scars on the chest. In some cases, the surgeon without using a tissue expander may place a permanent saline or silicone implant at the time of the mastectomy.
Flaps
It this reconstruction process, the flaps of your own tissues, including the skin, fat and sometimes a muscle is used. It is taken from the back or lower abdomen, or from the inner thigh and then reshaped to form a new breast. It might be slightly different shade or texture to the rest of the breast because of the skin used from other areas of the body. The process is particularly helpful for women with moderate to large size breasts that have a natural droop.
This particular reconstruction process is used in delayed reconstruction, especially in the case of radiotherapy. For immediate reconstruction, flaps without implants can be used. An ultrasound or CT scan needs to be done before the flap reconstruction to look at the blood supply to the tissue that is used to create new breasts. The reconstruction of own tissue might involve a longer operation and the recovery time is more. The reconstructed breast using a tissue provides a better match in the long term.
BRAVA + AFT
It is the technique of fat grafting and more specifically fat micrografting. It is the process where fat is harvested as gently as possible, cleansed of oil and blood, and then reinjected in small parcels to spread throughout the tissue.
BRAVA + AFT (Autologous Fat Grafting) is the process of fat grafting to the breast and it combines the use of an external expansion device (known as BRAVA) to expand the breast tissues prior to grafting. The BRAVA is completely different from expanders used in traditional surgery as it is designed to stretch the breast skin to create a space for breast implants. The BRAVA device is known to enhance the blood flow and improves the thickness & quality of the tissue allowing more fat to be injected into the tissues permanently. This approach has shown the most predictable results published so far with fat grafting to the breasts for reconstruction.
Conclusion
Breast reconstruction is one of the major surgeries and one needs to spend several days in the hospital after both flap reconstruction and implant. Patients might need more than one surgery to fully reconstruct the breast, whereas, skin flap surgery has more longevity than using implants. The women will be unable to perform most daily activities for up to 2 months after the surgery. Consult with us surgeon to know the best process that suits one’s physical condition.
