What is it?
Breast reconstruction surgery is often recommended for patients who have had both breasts removed or have undergone a mastectomy. While the procedure may be used to rectify deformities in the breasts the cause of the removal may be related to cancerous or pre-cancerous conditions. The procedure can be done during a mastectomy. However, some women have delayed it for months and even years. It is important for patients to consult with their doctors before they decide which method works best for them.
There are over two types of breast reconstruction procedures –
As the name implies this type of breast reconstruction involves removing a section of fat, skin and muscle from a particular area on the body. The skin flap is used to create the breast. Unlike breast implantation, flap reconstruction has a longer recovery time. It also has the potential to leave scars on the donor site and the breast.
The constructed breasts feel and look normal as well since they are made from natural skin tissue. A surgeon might recommend this procedure if a patient’s skin won’t expand enough to cover an implant entirely. Flap reconstruction comes in the following types –
The skin that is used to construct the breast in this procedure is drawn from a section of the back muscle that is located from the top of the hip to the arm below the shoulder. This area is also known as the latisssimus dorsi hence the name. The surgeon may use a small implant during the procedure since the skin is quiet thin.
TRAM or Transverse Abdominus Musculocutaneous flap can either be performed as a free or pedicle flap. The new breast is formed by a section of the skin, muscle and fat that is removed from the abdominal area. This might seem similar to a regular tummy tuck procedure. However, this procedure comes with risks. Patients who are planning pregnancies are recommended to consult with their doctors before they choose TRAM. This is largely due to the fact that abdominal muscles become weakened during the procedure.
Other Types of Flaps
The latissimus abdominal tissue might not always be satisfactory in some cases. In cases such as these, the surgeon may decide to draw a flap from the middle, upper, or lower part of the buttocks. However, like the procedure mentioned before, this also comes with its fair share of risks. In addition to restricting a patient’s activities it can weaken the gluteal muscles. Since these muscles are not long enough from the chest to the armpit the surgery also involves the removal of a vein from the leg. The surgeon might take a piece out of the patient’s “love handles” if all other techniques fail. However the procedure may leave the hips uneven as well. The skin on this area is not always considered to be suitable for shaping breasts either.
Any type of breast reconstruction procedure takes almost one to two hours. However, flap reconstructions tend to take longer. The average procedure in this case may take about two to 4 hours. Microsurgery to connect blood vessels is often required in free flap procedures so this type of procedure may take longer. TRAM flap construction is extensive and can take as long as 6 hours to complete.
This is the most common type of breast reconstruction that is recommended by experts. Common breast implants are rubber shells that are either filled with a saline solution or silicone gel. During the procedure the doctor inserts a bag or a silicon balloon surgically under a patient’s chest muscles. This is followed by a sterile saline solution that is filled in the bag with the help of a valve and expands it. The bag in question is replaced by a permanent implant once the surgeon determines that the skin has expanded as much as it should. This is done during the second surgery.
A surgeon may recommend another surgery if the nipple and areola need to be reconstructed as well. The new breast is given time to settle first. This can take about three weeks and is done to ensure that the nipple is properly placed. The nipple itself is usually constructed from a small piece of skin that is drawn from the breast mound. The areola constitutes another skin graft. Both will be colored to match through medical tattooing.
Breast reconstruction is covered by health care companies if the procedures are carried out after mastectomy. This is thanks to the federal Women’s Health and Cancer Rights Act of 1998 that requires all health insurers to do so. Procedures that are paid with healthcare usually cost around a few hundred to several thousand dollars. The price may range from $10,000 to $12,000 or more. If the flap procedure is opted for without health insurance it can cost from $25,000 to $50,000 per breast or $100,000 to $50,000 for both sides.
Patients might need to replace implants every ten to fifteen years. The cost of insurance usually suffices for this. The cost may also include expenses for travel and two to three additional surgeries. Surgeon costs are also to be taken into consideration. Patients are advised to choose qualified plastic surgeons who are certified and are experienced in carrying out several breast reconstruction procedures. In addition, they are also recommended to take precautions after surgeries in order to counter possible risks such as swelling, infections, bleeding, scarring and pain. Such instances may require surgeons to carry out more procedures. A patient may also react to the anesthesia used during the procedures.
A woman who has both breasts removed goes through a lot of emotional stress. Their absence can be a daily reminder to a patient who lost them due to cancer. Breast reconstruction allows women to acquire a physical appearance that they had before the mastectomy. As a result, it can help restore their self confidence, sense of wholeness and their femininity that they felt was lacking.
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