Breast Reconstruction
- Introduction to Breast Reconstruction
- Is Breast Reconstruction Right for Me?
- Breast Reconstruction Procedure Overview
- Dr. Ditesheim’s Approach to Breast Reconstruction
- Immediate Breast Reconstruction
- Delayed Breast Reconstruction
- LatissimusDorsi Flap Reconstruction
- TRAM Flap Reconstruction
- Tissue Expansion
- Breast Reconstruction Pre-Operative Overview
- Breast Reconstruction Post-Operative Overview
- Breast Reconstruction Recovery
- Breast Reconstruction Cost
Introduction to Breast Reconstruction
Each year more than 240,000 women are diagnosed with breast cancer. Breast cancer is a serious disease that can leave a woman with a long road to recovery. Lumpectomies and mastectomies are often a medical necessity when it comes to breast cancer treatment, and both may leave a woman with a very different body than before the surgery. Whether or not to have breast reconstruction surgery is a decision that many women find hard to make. New advances in reconstructive surgery give breast cancer survivors more options today than they ever have before.
Is Breast Reconstruction Right for Me?
Most women who have had a mastectomy or lumpectomy are eligible for reconstructive surgery. Breast reconstruction can be an improvement in your appearance, but will not replace your original form completely. However, most patients experience improved self-confidence and state of well-being.
- This may be an extremely difficult decision for you while you are coping with a breast cancer diagnosis, and the decision to have reconstructive surgery should be done for yourself.
- Dr. Ditesheim may advise against a reconstructive procedure if you have a history of obesity, are too thin, have a history of circulatory problems or are undergoing radiation and/or chemotherapy.
- It is important to quit smoking well in advance of a reconstructive procedure to allow for proper healing.
- Once you have had a mastectomy or lumpectomy, you may have to undergo additional surgeries for revision of breast reconstruction.
Breast Reconstruction Procedure Overview
Breast reconstruction is a surgical procedure to help restore the appearance of breasts following a mastectomy or lumpectomy. A patient may choose to have reconstructive surgery performed at the same time as a mastectomy or lumpectomy. By doing so, the patient may only have to recover from one surgery, instead of two. In other cases, women choose to wait until after the cancer treatment has finished. Dr. Ditesheim works with many breast cancer survivors and knows the emotional toll that the disease can take on one’s sense of self. Because this is a very personal procedure that varies with each individual situation, we encourage you to call our office for further information, (704) 754-8351
Dr. Ditesheim’s Approach to Breast Reconstruction
Over the past decade, Dr. Ditesheim has been working in the Charlotte area with breast cancer survivors on their personal quest to regain control of their lives. In one article, “The Next Question for Breast Cancer Survivors: Breast Reconstruction?” Dr. Ditesheim discusses his unique experience with patients. “People often hear, read and talk about the physical aspects of breast cancer. But, only survivors and their loved ones know the emotional toll that this disease can take on one’s sense of self,” says Dr. Ditesheim. “I believe that empowerment is all about how you feel… about yourself. I see many breast cancer patients who have lost their sense of empowerment due to this terrible disease. My goal is to help them get it back.”
There are 2 approaches to breast reconstruction surgery; immediate or delayed. Once the mastectomy has been performed the 3 methods of reconstructing the breast that Dr. Ditesheim utilizes are the Latissimusdorsi Flap Reconstruction, the TRAM Flap technique, and Tissue Expansion.
- Immediate Reconstruction
- Delayed Reconstruction
- Latissimusdorsi Flap Reconstruction
- TRAM Flap
- Tissue Expansion
Immediate Breast Reconstruction
Immediate breast reconstruction surgery can be performed at the same time as the mastectomy. However, this is dependent largely upon the stage and location of the cancer and should be weighed against any additional post-surgical treatments. Benefits of immediate breast reconstruction include undamaged chest tissues from radiation and scarring and the fact that it serves as one less surgery to have to endure. Dr. Ditseheim will advise you in your consultation if this would be advantageous in your specific treatment plan.
Delayed Breast Reconstruction
Delayed Breast Reconstruction is performed when it is not advisable to have immediate reconstruction surgery following mastectomy. In most cases, this option is selected when the patient is scheduled to have radiation treatments after the mastectomy. Radiation therapy can create complications after surgery and delayed reconstruction surgery is a method used to offset this and avoid any ramifications. During the first procedure, a tissue expander is implanted beneath the chest muscle. Through a tiny valve under the skin saline is injected every few visits to expand the balloon and the surrounding skin. Once the skin has stretched to allow for a breast implant, the expander is replaced by an implant during a second procedure. Dr. Ditesheim will develop and discuss a customized treatment plan for you in your initial consultation to determine which course of action makes the most sense for you.
LatissimusDorsi Flap Reconstruction
Flap reconstruction is an alternative to the use of an implant for breast reconstruction. A latissimusdorsi flap reconstruction takes tissue from the upper back to reconstruct the breast. The flap consists of skin, fat, muscles, and blood vessels. The flap is tunneled under the skin to the chest. The flap creates a pocket for the implant and, sometimes, may be used to create the breast mound itself. This procedure is more intricate in nature than the tissue expansion, as it serves to buffer the chest wall with healthy tissue which is a great benefit to patients that have undergone radiation treatments.
TRAM Flap Reconstruction
TRAM flap reconstruction surgery (transverse rectus abdominis muscle) has rapidly grown in recent years as one of the more popular procedures in breast reconstruction surgery. Sections of skin, muscle and fat are all taken in oval pieces from the abdomen and are transferred to the breast area through a tunnel created underneath the skin. The tissue is then molded into a natural-looking breast and sewn into place. A reason for the TRAM flap’s rise to popularity could probably be attributed to the fact that a tummy tuck is part of this procedure, giving women enhanced volume in the breast region while omitting excess skin and fat from the abdomen region.
Tissue Expansion
Tissue expansion is commonly performed in breast reconstruction, and is a viable option for women seeking surgery. Commonly, this method is used when there is not enough skin on the chest wall to house permanent implants. Tissue expansion allows the body to generate extra skin, allowing reconstruction to take place. Dr. Ditesheim is able to achieve this by inserting a silicone expander underneath the skin of the pectoral muscle. This expander is gradually filled with saline over several visits to the office, creating growth and skin elasticity over time, until the expander is ready to be replaced with the permanent implant. While the results of tissue expansion in breast reconstruction are reasonable, the recovery process is an extremely rigid one. Dr. Ditesheim will be able to address which method of breast reconstruction best suits you in your consultation.
Breast Reconstruction Pre-Operative Overview
While the decision to have breast reconstruction surgery is a very emotional and personal one, it is important to gather information about your options for breast reconstruction as soon as you are diagnosed with cancer. Dr. Ditesheim will work with your general surgeon to develop a strategy for reconstruction that will allow for the smoothest healing and transition possible. It is important that you discuss your expectations and goals with Dr. Ditesheim in the original consultation so that, after evaluating your health, he may pinpoint the most appropriate treatment plan for you. Dr. Ditesheim and his experienced staff will provide you with pre-surgical information that includes guidelines about drinking, smoking and avoiding certain vitamins and medications. The location of the procedure will be determined between you and Dr. Ditesheim once you have discussed your options.
Breast Reconstruction Post-Operative Overview
After your surgery you will more than likely feel tired and sore for about a week or two. Dr. Ditesheim will prescribe medications for pain management to aid in any discomfort. You may spend a few nights in the hospital for observation and rest purposes in order to generate the most successful outcome.
Breast Reconstruction Recovery
It may take 2-6 weeks to recover from a breast reconstruction procedure, depending on the procedure(s) administered. You will be advised to refrain from strenuous lifting, active sports and sexual activity for three to six weeks. Most scars will fade over time, but it is important to recognize that they will not disappear completely.
Breast Reconstruction Cost
Most insurance companies cover the cost of a post mastectomy or lumpectomy breast reconstruction. Please check with your insurance policy to find out about any restrictions on your coverage. We have an experienced staff that will help you with any questions you may have regarding your particular insurance coverage. Contact us directly at (704) 754-8351.
