About Breast Reconstruction
There is so much more to a person than their outward appearance. Still, for women who have undergone a mastectomy, they may feel like they have lost a huge part of themselves, as well as their femininity. To help Tucson, AZ female patients regain what they have lost, board-certified plastic surgeon Dr. Arun Rao performs breast reconstruction. Surgical breast reconstruction aims to restore a woman's breasts to a natural shape and size after mastectomy, lumpectomy, or trauma. Developments in reconstruction techniques make it possible for you to feel complete once more and attain beautiful, full breasts even after they have been removed or negatively affected by an unforeseen event. This surgery can consist of a few procedures in various stages that can either be performed at the same time as your mastectomy or at a later stage. If you're considering this impactful procedure, contact Rao Plastic & Hand Surgery to schedule a consultation. Dr. Rao will perform a thorough evaluation of your breasts and work with you to formulate a customized surgical plan that meets your goals.
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If you are self-conscious or have trouble living with the loss of one or both breasts, then breast reconstruction surgery could be a wonderful solution. Breast reconstruction is a very personalized procedure. Every patient will have a thorough consultation with Dr. Rao to create their treatment plan based on their needs, concerns, and available options. If you're planning to have breast reconstruction surgery, it's vital that you have realistic expectations. Dr. Rao strives to create a natural appearance, but there are differences between the feel, look, and sensation of your newly reconstructed breast(s) in comparison to your original breast(s). You should get approval from your oncology doctor to have surgery, and let Dr. Rao know about any factors that could impact your healing.
There are a variety of techniques available today for breast reconstruction. There are also many factors that Dr. Rao considers when determining the technique that will produce your best results. Some of these factors include cancer diagnosis, reconstruction timing, and history of radiation. There are two options for breast reconstruction: an implant-based reconstruction or an autologous, or flap-based reconstruction.
An implant-based reconstruction typically involves the placement of tissue expanders in either the same setting as the mastectomy or during a later surgery. After allowing your incisions to heal, the tissue expanders will be filled on a weekly basis with saline. Filling of the tissue expanders with saline helps to stretch the skin, creating space for the placement of permanent implants. Once the expanders are filled to the patient's desired volume, we will allow the skin to stretch for up to six more weeks to allow it to adjust to the volume. Then the patient will undergo a second breast surgery in which the expanders are removed and the permanent breast implants are placed. Additional procedures, such as fat grafting and nipple reconstruction, are accomplished in separate surgeries.
Flap procedures accomplish this breast reconstruction by using your own skin, fat, and muscle to create, cover, and build the mound. The most common flap techniques are:
- TRAM Flap: This method uses skin, fat, and muscle from your stomach to create the breast. The tissue used to create the new breast can be detached from the abdomen or it may remain attached to the donor location, keeping the original blood supply.
- DIEP Flap: Like a TRAM flap, a DIEP flap removes fat, skin, and blood vessels from the lower stomach, but it doesn't take the muscle. The DIEP (deep inferior epigastric perforator) flap removes fat and skin from the belly to form the breast mound, then uses microsurgery to attach the blood vessels to the chest.
- Latissimus Dorsi Flap: This method uses muscle, skin, and fat from your back. During this procedure, tissue is moved from the back to the mastectomy site through a surgically created tunnel and remains attached to the donor location, which leaves the original blood supply intact.
- PAP Flap: Another flap alternative is the PAP (profunda artery perforator). This technique takes skin, fat, and muscle tissue from your inner thigh to create your breast(s).
- LTP Flap: While the TRAM flap tends to be one of the more common methods used during reconstruction, sometimes there is not enough muscle, skin, and fat that can be taken from the abdominal area. In these situations, the LTP flap may be used, which takes tissue from the lateral thigh area.
- Composite Flap: Also known as a composite stacked flap, this method combines flaps from different areas on your body to reconstruct the breast.
What to Expect
Breast reconstruction surgery is performed in various stages. During certain phases (such as creating a flap, inserting an expander, or placing implants), general anesthesia is often used. Some patients will require an overnight stay, but this will depend on the current phase of treatment. Once the final step has been completed in the breast reconstruction process, you will wear a compression bra for the chest and you will be given medication by Dr. Rao to manage pain and discomfort. Your recovery time will vary based on the surgical procedure that was decided upon by you and Dr. Rao. Typically, healing from a breast reconstruction procedure could take from seven days to three weeks. Over time, you will feel more confident. Ongoing monitoring with mammograms and breast exams are important and recommended for long-term health. We will continue to monitor your progress during follow-up appointments at our Tucson, AZ office.
Frequently Asked Questions
How much does breast reconstruction surgery cost?
Breast reconstruction is a complex surgery. To ensure you get high-quality and safe care, as well as results you can be proud of, you should concentrate on choosing a plastic surgeon with years of experience, like Dr. Rao, rather than the lowest possible quote. At your consultation, Dr. Rao will listen to your needs and goals before crafting your customized reconstruction plan. Breast reconstruction is covered by insurance plans and a member of our team will help guide you through the process.
Does insurance cover my surgery?
The WHCRA (Women's Health and Cancer Rights Act) of 1998 requires insurance plans that cover mastectomies to also cover breast reconstruction surgery. If you have insurance, a member of our team will help you understand your policy and coverage. We will also help you submit the needed paperwork to your insurance provider.
I am going to have a mastectomy for breast cancer. What are the options for my reconstruction?
The type of reconstruction you receive will depend on several factors, such as:
- Your need for radiation
- Your natural body shape
- The presence of previous scars
Possible methods for surgery include implant-based reconstruction and reconstruction using tissue from your abdomen, back, or buttock. Dr. Rao will discuss all of your options with you and help you make an informed decision that provides you with a natural-appearing chest.
What about nipple reconstruction?
Reconstruction of the nipple can be performed with a local flap or with 3D tattooing while the creation of the nipple-areola complex is usually performed with cosmetic tattooing. If you are interested in having your nipple-areola complex tattooed onto your reconstructed breast(s), you should tell Dr. Rao during your consultation. He will go over your options so you can decide if you want 3D tattooing of the nipple and areola to be a part of your treatment plan.
Should I have reconstruction with my mastectomy or wait?
Whether or not you choose to have breast reconstruction alongside your mastectomy will depend on several things. Some patients choose to have their reconstruction performed at the same time as their mastectomy while others may prefer to wait. Dr. Rao recommends you schedule a consultation after your cancer diagnosis so you can begin to learn about your options. This will make it easier for you to determine when you may want reconstruction surgery. If you decide to have reconstruction at the same time as your mastectomy, Dr. Rao will work with your oncologist and breast surgeon to plan your surgery.
Reclaim Your Self-Confidence
While the breast reconstruction process can be lengthy, it is considered one of the most worthwhile reconstructive surgeries for our Tucson, AZ female patients at Rao Plastic & Hand Surgery. This life-changing procedure can help decrease the emotional and physical impact of a mastectomy while also allowing you to boost your self-confidence and figure. If you have been diagnosed with breast cancer, have had trauma to the chest, or were born with a defect that affects the shape of your breasts, we invite you to call our plastic surgery office and schedule your consultation with board-certified plastic surgeon Dr. Arun Rao.