When considering Breast Reconstruction after cancer, I will guide you through the possibilities for creating the most natural, beautiful breasts. There are a couple of different types of surgery that you may want to familiarize yourself with beforehand. These are the kinds of Breast Reconstruction surgeries available through my office. Some options utilize the body’s own tissue taken from areas with a little extra, such as the abdomen or thighs, and the others use silicone or saline implants.

DIEP Flap Breast Reconstruction

DIEP stands for Deep Inferior Epigastric Perforator. This technique uses excess skin and fat from the lower abdominal area. The incision is similar to the one used for a Tummy Tuck and can be easily hidden by clothing or bathing suit. Another benefit to this surgery is that it flattens the abdomen for an overall beautiful body contour. It spares the abdominal muscle and there is significantly less pain in the shorter recovery process. Since the muscles are in tact, the abdominal wall strength is not affected.

Tram Flap Breast Reconstruction

This is another technique that uses the abdominal tissue to rebuild the breasts, however the difference from the DIEP is that it does use abdominal muscle in addition to the skin and fat. The incision will still be discreet and hidden by the clothing or bathing suit, but recovery will take longer due to harvesting muscle. I am skilled in offering options within this surgery, which are to take the tissue connected to a blood supply, which is called pedicled, or not attached to the original blood supply and requires connection to a new one, which is called free flap. Both of these methods require immense skill and unique challenges. For example the pedicled technique is to avoid muscle rotation, which can create an abdominal bulge, and the free flap technique is even more intricate of a surgery as it requires successful reconnection of arteries using microsurgery.

Gracilis Flap Breast Reconstruction

This surgical technique uses excess skin and fat from the inner thigh to reconstruct a natural appearing breast. This can be done without taking any muscle, which it would then be called the Transverse Upper Thigh Flap surgery. Sometimes the inner thigh flap requires a small amount of muscle in order to assure an adequate blood supply to the flap. The muscle that’s used to do this is the gracilis muscle, which is what the surgery is named after. Unlike missing a part of the abdomen muscle, the gracilis muscle is often not missed unless you do a lot of exercises or sports mostly depending on quick changes of going side to side. A side benefit of taking tissue from the inner thigh is that it often can reduce inner thigh friction.

Latissmus Flap Breast Reconstruction

This surgery reconstructs the breasts using a flap of skin and muscle from the back of the same side as the operated breast. This living tissue is used to recreate the breast mound. It is mostly used for women who don’t have enough abdominal tissue or have had previous abdominal incisions. There are usually no complications and the blood supply is highly dependable. The use of the latissmus flap can be combined with implants.

Breast Reconstruction with Implants

Because of the familiarity with implants for Breast Augmentation, this is an option chosen by thousands of women each year who undergo a mastectomy. It is also commonly used for women who are thin and don’t have extra tissue to use. A major benefit is that this can be done sequentially under the same anesthesia as the mastectomy surgery, called immediate reconstruction. This process still usually requires 2 or more surgeries, as we will have to navigate unique issues with the skin stretching (possible loss of elasticity due to radiation treatments) and addressing scar tissue.

You can rest assured that I am using the most cutting edge and advanced techniques along with my immense experience to help guide you to the right surgical options for your Breast Reconstruction. Please schedule a consultation to discuss what might be the best option for you, www.davinciplastic.com.

Sincerely,

Steven Davison M.D.

Board Certified Plastic/Reconstructive Surgeon

STAGE TWO BREAST RECONSTRUCTION

From previous blogs you know that Stage I involves placement of the Tissue Expander…often placed under the same anesthesia as your mastectomy surgery… and called Immediate Breast Reconstruction.  Delayed Reconstruction means you choose to wait a few weeks or months before starting the restoration process.

Here are the steps leading up to Stage II Reconstruction:

During the mastectomy skin and breast tissue are removed, leaving the chest tissue flat and tight.  The “expander” is inserted under the chest muscle and skin to serve as a “space saver.” The expander is slowly filled with saline solution (over many weeks) to stretch the remaining skin and muscle to allow for the future breast implant.

Expander surgery is done under the same anesthesia as the mastectomy surgery.  (Immediate Reconstruction)  Healing takes 4-6 months

NOW Stage II begins: The new Breast Implant is placed when Dr. Davison determines the space is sufficient and then the expander is removed.  This is done through the original incision.

Stages III & IV …Begin about 3 months later and Involves A new nipple and areola…with additional breast beautification.

I become your primary care physician during this entire process…generally about a year.

Stage II Breast Reconstruction involves rebuilding a new breast mound by using what is called a Flap Procedure.  There are several options for flap procedures that I will cover in my next blog.

Every year the numbers increase of women who choose breast reconstruction.  Vast experience enables me to gently guide you through the process to eliminate frustration and confusion, until you eventually see the tremendous benefits of your choices.  During the consultation you will come to understand your options and be able to choose a course of action that restores both form and self confidence.

All we do…we do sensitively, expertly and with outstanding results to improve your health and wellbeing. The results of all surgeries should be both…functional and beautiful.

Dr. Steven Davison

At DAVinci…we combine the supreme elements of art & surgical science.