Ever since I worked with Atlanta Plastic Surgery co-founder Dr. Carl Hartrampf to develop the TRAM flap technique for breast reconstruction back in the 1980’s, cosmetic and reconstructive breast surgery has been an extremely important part of my practice. I have always believed that helping women who have been affected by breast cancer through breast reconstruction surgery is one of the most significant things a plastic surgeon can do and I personally consider it an honor to help these women take back a sense of control over their lives. Although breast cancer is believed to affect as many as one in eight women and the number of breast reconstruction procedures continues to increase every year, many still have questions about what this entails. Essentially, there are three distinct ways to approach breast reconstruction surgery after a mastectomy.
Breast Reconstruction with Tissue Expander and Implant
Oftentimes, the easiest way to reconstruct the breast after a mastectomy is with an artificial breast implant, identical to the kind used during a cosmetic breast augmentation procedure. Because there are so many types of breast implants choose from, many patients see this as an opportunity to get breasts that are exactly the size and shape they have always wanted. However, it is possible that after a mastectomy the patient may lack sufficient skin to accommodate the desired breast implants. In these cases, a specialized form of temporary breast implant called a tissue expander can be used to gradually stretch the skin around the breast so that the new implants can then be safely inserted.
Breast Reconstruction with Autologous Tissue Flaps
For women who desire a more natural approach to breast reconstruction, autologous tissue flaps use skin, fat, and muscle that are moved from another location in the patient’s own body to reconstruct the breast mound. Different forms of the procedure can utilize tissue from different areas of the body, depending on the specific anatomy of the patient, but the most common type, called the TRAM flap procedure, focuses on the abdominal area. Because tissue flap breast reconstruction procedures use living, growing tissue, the results can continue to change as the body ages, often creating a more natural looking final result. However, it is important to note that not all women are suitable candidates for this procedure, so a detailed consultation will be needed in order to determine whether it is an appropriate approach for you.
Sometimes, when breast cancer is caught in the earliest stages, a full mastectomy may not be necessary for treatment and much of the breast tissue may be spared. However, even a limited lumpectomy can potentially change the appearance of the breasts. Oncoplastic surgery is a relatively new approach to breast reconstruction where the surgeon performing the mastectomy works closely with the plastic surgeon, carefully planning the placement of incisions and rearranging of the breast tissue to preserve or even enhance the overall appearance of the breast. In some cases, breast implants or even fat transfer techniques can be used to further enhance the appearance of the breasts and give the patient the look she may have always wanted.
Every woman’s body is unique, so there is no such thing as a “one-size-fits-all” breast reconstruction procedure. In my more than thirty years as a board-certified plastic surgeon, I have performed thousands of cosmetic and reconstructive breast procedures and can work with you to determine which approach will ultimately be best for you. If you have questions about your options or want to schedule a consultation, please feel free to contact me, Dr. Philip Beegle. And don’t forget to stay connected by following me on Facebook.