Breast Reconstruction Procedure

Description of Procedure

Breast reconstructive surgery has evolved with time. New medical procedures are available to help reconstruct breast tissue lost to breast cancer operations (mastectomy), congenital abnormalities or trauma. Your breast tissue can be reconstructed with your own tissue, for example, a rectus flap from your abdomen can be used to reconstruct your breast or in many cases, a prosthesis or breast implant can be used. If you are a women about to undergo a mastectomy you should consult with your general surgeon about your tumor surgery and investigate if you have the option to have your reconstructive procedure immediately following your mastectomy. Dr. Majzoub will work with your general surgeon to help determine if you are a candidate for breast reconstructive surgery using your own body tissue or a breast prosthesis (implant).

Your surgical reconstructive options will vary depending on the preferred method you and your surgeon choose to follow. Two examples are given below as possible reconstructive options.

1. You may choose to have your breast reconstructed with a breast prosthesis. If you choose this route, you may have the option of immediate breast reconstruction in which Dr. Majzoub would place a tissue expander at your mastectomy site immediately following your mastectomy and begin gradual skin expansion of your chest skin in preparation for your implant at a later date. Dr. Majzoub and his staff will follow your progress in the office along with your general surgeon. Expansion of your chest skin will be coordinated around your chemotherapy or radiation therapy (if needed).

   Your implant would be placed after your breast skin is fully expanded, often
   Dr. Majzoub needs to perform a mastopexy (breast lift) on the opposite breast to better match both breast shapes. Nipple recreation generally takes place on a later date when you have fully recovered from your implant placement.

2. You may choose to have your breast reconstructed with your own body tissue. This is accomplished with a tissue flap, usually using the abdominal skin and fat. The flap most commonly used by plastic surgeons is the transverse rectus abdominis myocutaneous flap or (TRAM) flap. With this procedure the abdominal tissue is rotated to the chest using the rectus abdominis as a pedicle to supply the blood to the flap so it can survive. The abdominal tissue removed (rotated to the chest) is somewhat similar to the tissue removed during a tummy tuck (abdominoplasty). Because the rectus muscle is rotated toward the chest, you will no longer have this muscle running longitudinally up and down your abdomen (often called a six pack when referring to both rectus muscles). This procedure can be performed immediately following your mastectomy or you and your surgeons may choose to delay the procedure pending the need for chemotherapy and radiation to your operative site. In some cases where the TRAM flap may not be available, Dr. Majzoub will present you with other muscles that can be rotated into the area to achieve a similar result.

Each reconstructive surgical procedure has its advantages and disadvantages. Some important considerations to think about include: the breath of the operation with its inherent surgical risks, the amount of time you want to spend reconstructing your breast, the donor site deficit and the impact it may have on your body, your physical health, the impact that chemotherapy and radiation may have on your healing at the reconstructive site or donor site, your surgical scars, the quality of your reconstruction with regard to its appearance.

Dr. Majzoub and the staff of Louisville Plastic Surgery Consultants will discuss all of the above concerns with you at the time of your consultation. Our office will work with your general surgeon to coordinate your reconstructive plan, if immediate breast reconstructive surgery is desired, Dr. Majzoub may begin this process on the same day as your mastectomy. Operative times vary depending on the reconstructive procedure. A TRAM flap generally requires 3-5 hours of operative time. Tissue expander placement generally requires 1 hour to complete.

For more information on whether you may be a candidate for a breast reconstructive procedure, contact Louisville Plastic Surgery Consultants at 502.899.9996. Your insurance may cover some or all of the procedural cost if you are mastectomy patient. Dr. Majzoub and his staff will be able to give you a better idea after your consultation. At Louisville Plastic Surgery Consultants our goal is complete patient satisfaction.

Medical Disclaimer: All medical procedures are associated with some degree of anesthetic and operative risks. Surgical results may vary from person to person.Your specific anesthetic and operative risks will be outlined at the time of your consultation.