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Plastic Surgery Following Mastectomy

Breast Reconstruction Stamford, Connecticut – Reconstruction Surgery

Breast cancer affects one in eight women and is a major health concern in the United States.  Surgical treatment to remove the tumor involves either a lumpectomy, in which only a portion of the breast is removed, or a mastectomy, in which the entire breast is removed.  In the case of a mastectomy, a Plastic Surgeon can get involved to reconstuct the breast(s).  Studies show that having breast reconstruction following a mastectomy generally improves the quality of one's life.

There are two main ways to reconstruct a breast.  The first involves using an implant, usually preceded by a temporary device called a tissue expander.  The second method of reconstruction is autologous in which one's own tissue is used to create a new breast.  The most common example of autologous reconstruction is the transverse rectus abdominis (TRAM) flap.  In a TRAM flap, the lower abdominal skin, fat, and muscle are used to mold a new breast.  An added bonus to this procedure is that it is similar to a tummy tuck in that it can get rid of some excess tissue of the lower abdomen.  There are other types of tissue reconstructions such as the latissimus dorsi (LD) flap from the back. 

Implant reconstruction usually takes 2-3 surgeries.  The first occurs at the time of mastectomy when a tissue expander is placed under the pectoralis major muscle.  A second stage occurs about 3 months later where a permanent implant is placed in the pocket after the expander is removed.  The final stage is nipple reconstruction.  Autologous (tissue) reconstruction also utilizes a second stage for nipple reconstruction.

The choice of reconstruction following mastectomy can be complicated.  Many factors go into the decision-making process, such as the need for radiation or chemotherapy, previous procedures, and medical conditions like smoking, diabetes, obesity, and emphysema.  I urge any patient who is in need of a mastectomy to seek consultation with a Plastic Surgeon so that the important issues affecting the choice of reconstruction type can be reviewed.  Like any other surgery, the choice of procedure is individualized to each patient's specific situation.