Dr. Alexander Sinclair

• Posted on July 7th, 2009

  Written by Plastic Surgery Beverly Hills

  Breast Reconstruction

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  Breast reconstruction is intended for breast cancer patients who had to undergo a mastectomy (removal of a breast or breasts) or a severely deforming lumpectomy (removal of just the cancerous area).
  Breast cancer can be devastating; even after recovering from it you might never feel the same, but breast reconstruction surgery might be able to help.

  While breast reconstruction after a mastectomy offers only a cosmetic solution, it might be something that truly helps boost your self-esteem and return your feminine confidence.
  There are different methods of reconstruction after breast cancer that should be discussed with your plastic surgeon, though different circumstances may require that a certain technique be used. In some breast reconstruction procedures, the skin is conditioned over weeks to months with a tissue expander filled with saline solution, and an implant is then inserted.

  An alternative breast reconstruction method called “flap reconstruction” pulls skin, fat, and muscle from other parts of the body to either create a pocket (or flap) for an implant, or create a breast mound on its own.

  During your consultation, your surgeon will work with you to determine the method that will meet your unique needs and expectations.

  Time Required for Breast Reconstruction:
  It can take anywhere from 2-6 hours to perform breast reconstruction surgery. Time requirements vary depending on the method of surgery chosen, and the extent of work needed.

  Is Breast Reconstruction an In Patient or Out Patient Procedure?
  Breast reconstruction may be outpatient or inpatient, depending on the extent of surgery and method used. Some situations may require that patients stay in the hospital for up to 5 days.

  What are the side effects of Breast Reconstruction?
  Breast reconstruction surgery side effects can include temporary swelling and scarring.  You can also expect a change in breast sensation - most feeling should eventually come back, but you won’t have the same nerve sensitivity you had before the surgery.

  How Long do Breast Reconstruction results last?
  Breast reconstruction results usually offer comfort to patients, as they improve overall appearance and contour. However, if you only have one breast reconstructed, it will likely have a different shape and firmness than the natural breast does.  Some women later have surgery on the natural breast to achieve better balance. The breast reconstruction surgery results are very long-lasting to permanent.

  What is the recovery time for Breast Reconstruction?
  Day 1-42 Overall physical recovery from breast reconstruction can take up to 6 weeks, though this can vary depending on the extent of surgery and method used.
  Day 10 Sutures are usually removed about 10 days after surgery.
  Day 21 By this point, it is likely that you can return to work.  However, many people still feel tired half way through the day and may opt to take more time off work.
  Day 21-42 It is usually recommended that anything strenuous – heavy lifting, sexual intercourse, contact sports – be abstained from for about 3-6 weeks after surgery.
  Note  After breast reconstruction, recovery of scarring can take up to 2 years to be complete.

  Will my insurance company cover Breast Reconstruction?
  Because of the reconstructive and emotional necessity of breast reconstruction surgery, insurance will most likely be involved.

  Is there much discomfort for Breast Reconstruction?
  After breast reconstruction, discomfort can be expected, as the breasts and donor area may be tender and sore for some time. Prescription pain medication will help control the discomfort.

  What else can I combine Breast Reconstruction with?
  Breast reconstruction surgery may be combined with nipple reconstruction, though many patients have them performed as two separate procedures. Also, many women have their natural breast lifted or augmented to be more symmetrical with their reconstructed breast.

  What else is Breast Reconstruction referred to as?
  Different breast reconstruction techniques include: Skin Expansion. Flap Reconstruction.
  
  What happens during breast reconstruction surgery?

  Step 1 - Anesthesia
  Medications are administered for your comfort during the surgical procedure. The choices include intravenous sedation and general anesthesia. Dr. Alexander Sinclair, your surgeon will recommend the best choice for you.

  Step 2 - Flap techniques reposition a woman’s own muscle, fat and skin to create or cover the breast mound.Sometimes a mastectomy or radiation therapy will leave insufficient tissue on the chest wall to cover and support a breast implant. The use of a breast implant for reconstruction almost always requires either a flap technique or tissue expansion.  A TRAM flap uses donor muscle, fat and skin from a woman’s abdomen to reconstruct the breast. The flap 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.  Alternatively, Dr. Alexander Sinclair, may choose the DIEP or SGAP flap techniques which do not use muscle but transport tissue to the chest from the abdomen or buttock.

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  A latissimus dorsi flap uses muscle, fat and skin from the back tunneled to the mastectomy site and remains attached to its donor site, leaving blood supply intact.

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  Occasionally, the flap can reconstruct a complete breast mound, but often provides the muscle and tissue necessary to cover and support a breast implant.

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  Step 3 – Tissue expansion stretches healthy skin to provide coverage for a breast implant. Reconstruction with tissue expansion allows an easier recovery than flap procedures, but it is a more lengthy reconstruction process. It requires many office visits over 4-6 months after placement of the expander to slowly fill the device through an internal valve to expand the skin. A second surgical procedure will be needed to replace the expander if it is not designed to serve as a permanent implant.

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  Step 4 – Surgical placement of a breast implant creates a breast mound.  A breast implant can be an addition or alternative to flap techniques.  Saline and silicone implants are available for reconstruction. Dr. Alexander Sinclair, will help you decide what is best for you. Reconstruction with an implant alone usually requires tissue expansion.

  Step 5 - Grafting and other specialized techniques create a nipple and areola.
  Breast reconstruction is completed through a variety of techniques that reconstruct the nipple and areola