Plastic surgery for breast reconstruction involves the use of devices such breast
expanders and implants, or the use of the patient's own (autologous) tissues from the abdomen, back or buttocks.
Breast reconstruction can take place at the time of the mastectomy or later. The timing and type of breast
reconstructive procedure depends on stage of the breast cancer, desires and anatomy of the patient, and health
factors such as obesity, diabetes, high blood pressure, and smoking.
Risks associated with the breast reconstruction include bleeding, seroma formation,
infection, excessive scar tissue, and delayed wound healing. Breast reconstruction has no known effect on the
recurrence of breast cancer nor does it generally interfere with chemotherapy or
radiation. Breast surgery on the
opposite breast to reduce or augment its size may be required to restore symmetry.
The first stage of breast reconstruction is the creation of the breast mound. A
breast tissue expander inserted following the mastectomy begins staged breast reconstruction. Through a tiny valve
mechanism buried beneath the skin, a salt-water solution is injected to fill the expander over several weeks or
months. After the skin over the breast has stretched, the expander is removed and replaced by a permanent implant.
The nipple and the areola are reconstructed in a subsequent procedure.
Use of the patient's own tissue is an alternative approach to breast reconstruction
and involves creation of a breast mound using tissue taken from other parts of the body, such as the back, abdomen,
or buttocks. A TRAM flap involves moving tissue from the abdomen into the breast area. Most breast reconstruction
involves staged procedures.
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