Regardless of your age or station in life, losing a breast can be a difficult situation to confront. It is normal to feel anxious, uncertain and sometimes mournful about giving up a part of your body. Thankfully, today, there are many options for re-shaping and re-building your breasts to help regain a figure that is both proportional and symmetrical. Dr. Capuano is well versed with this type of surgery, and will take the time to guide you through the reconstructive process and to understand your specific goals and concerns.
Breast reconstruction can take place either immediately following mastectomy or at a later time. Reconstruction can also take place following partial mastectomy (oncoplastic reconstruction). It can be achieved through a number of plastic surgical techniques that attempt to restore your breasts to the shape, appearance and size they were prior to cancer surgery (lumpectomy or mastectomy), or to the shape and size that you desire. The two main types of surgery include implant-based approaches, using tissue expanders followed by permanent implants and flap reconstructions. The procedures that are most appropriate for you will depend on your individual circumstances.
Creation of a new breast following mastectomy, can help improve your self-confidence and self-image. Completion of breast reconstruction can be an emotionally rewarding process for a woman who has lost a breast to cancer.
The best candidates for immediate breast reconstruction are otherwise healthy adults, who are nonsmokers, who have a realistic expectations, and who’s cancer therapy will be completed at the time of mastectomy, with the exception of chemotherapy. If radiation therapy will be required, it is best to wait until the completion of your treatment before beginning the reconstructive process.
You can begin talking about your reconstruction with your plastic surgeon as soon as you are diagnosed with breast cancer. Your surgeon can help determine which procedure is right for you, after a careful examination of your anatomy, a thorough understanding of your cancer diagnosis and treatment requirements, and consideration of your individual goals.
Breast reconstruction using a tissue expander to stretch the remaining skin following a mastectomy, and subsequent placement of a permanent silicone implant is the most common type of surgery performed today. It requires the shortest operating time, and allows the quickest recovery. However, implant based reconstruction is a more lengthy process than flap reconstruction, because it entails biweekly office visits during a 4 to 6 month period to inflate the expanders, and a second surgery to remove the expanders and place permanent implants. The implants will re-create a breast mound, and a nipple reconstruction then can be performed, as well as nipple-areolar tattooing, to make the breast appear more natural.
Flap reconstruction uses donor muscle, fat and skin from a woman’s abdomen (TRAM flap) or back (Latissimus Dorsi flap) when insufficient tissue remains after a mastectomy or radiation for an implant based reconstruction. The techniques reposition your own muscle, fat and skin to re-create a breast mound, or coverage for an implant.
A TRAM flap uses donor tissue from the abdomen to reconstruct the breasts. The flap remains attached to it’s original blood supply, which is tunneled through the upper abdomen and lower chest to the mastectomy sight, where it can be used to re-create the breast mound.
The Latissimus dorsi flap uses donor tissue from the back to reconstruct the breasts, in conjunction with an implant based reconstruction. The flap remains attached to it’s original blood supply, which is tunneled through the axilla to the mastectomy sight, where it can be used to cover a breast implant to re-create the breast mound.
Is a group of surgical techniques, based on mastopexy and reduction mammoplasty principles, used to remodel the remaining breast tissue following a partial breast resection. The techniques are most useful for patients with large tumors and small breasts, tumors located near the inferior or medial portions of the breast, or in women who have very large breasts, who would benefit from a wide resection and a breast reduction procedure simultaneously.
The procedure takes between 3.5 to 5 hours depending on the patient’s anatomy, and is performed in the hospital under general anesthesia. An overnight stay will depend on individual medical condition and extent of surgery.
Most patients are able to return to work within about 2 weeks. You may begin light exercise at 2 weeks, while 6 weeks is required, before returning to strenuous activity or lifting. Bruising may be present for up to 3 weeks. Patients are instructed to protect themselves from direct sun exposure for 1 year, and to wear sunscreen. Silicone therapy is additionally used to improve appearance of scars. Small drains are left in place following surgery and are removed on postoperative day one. The final result of your facelift may not be apparent until 6 months post operatively.
Bruising, swelling, changes in hair position (may require laser treatment), temporary numbness or weakness, a sensation of facial tightness.
Risks include bleeding, infection, hematoma, seroma, changes in skin sensation, scarring, damage to underlying structures, injury to nerves that control facial muscles, asymmetry, loss of facial skin, unsatisfactory results requiring additional surgery.
Dr. Capuano consistently achieves excellent results with breast reconstruction. He is a Board Certified Plastic Surgeon, and is a member of the American Society of Plastic Surgeons, and he would be happy to discuss your options if you require reconstruction.
Contact the office of the Northern Center for Plastic Surgery @ (201)820-5280 to schedule an appointment. Dr. Capuano will be happy to discuss your reconstructive options with you.