Breast
Reconstruction
Patient who have breast cancer and elect for mastectomy or preventive mastectomy can have a reconstruction or rebuilding of the breasts. Patients are referred to plastic surgeons to discuss reconstruction. Reconstruction after mastectomy can be done at the time of surgery or be delayed. There are two main types of reconstruction, one is with implants and second is with own natural tissue, called a tissue flap.
Some patients can have reconstruction after mastectomy with direct implant in the same operation. This option increases convenience if patients are candidates. Most patient usually undergo implant reconstruction with a staged process with tissue expander first. The tissue expander is a temporary implant with adjustable volumes. Placement of the expander helps stretch the skin in patients who are not a candidate for direct implants.
The natural type of reconstruction with a tissue flap provides the highest quality of reconstruction. It is usually done in 2 stages: first one is a natural transfer of own tissue and second is a nipple areola reconstruction with possible revision. The flap tissue can be used from multiple body areas with excessive fat. The most common flaps are called DIEP, deep inferior epigastric artery perforator, or PAP, profunda artery perforator. DIEP flap uses lower abdomen and postoperatively patients look as if they had a tummy tuck. PAP flap uses fat and skin from the upper thigh, postoperatively patients look as if they had a thigh lift.
