Breast Reconstruction Surgery: Restoring Confidence and Form

Breast reconstruction is a transformative procedure designed to restore the shape, symmetry, and appearance of the breasts following mastectomy or injury. Women who undergo a mastectomy due to breast cancer or other conditions may choose breast reconstruction to regain a natural-looking silhouette and boost their self-confidence. This procedure can be performed immediately after mastectomy or as a delayed procedure, depending on individual circumstances.

There are several surgical techniques available for breast reconstruction, each tailored to meet the unique needs of the patient. Among the most common methods are tissue expander to implant reconstruction, latissimus dorsi flap reconstruction, and deep inferior epigastric perforator (DIEP) flap reconstruction.

Tissue Expander to Implant Reconstruction

Tissue expander to implant reconstruction is one of the most widely used methods for breast reconstruction. It involves a two-stage approach to gradually recreate the breast contour using an implant.

Procedure Overview

  1. Placement of Tissue Expander: During the first stage, a temporary tissue expander is placed under the skin at the time of mastectomy or in a delayed setting. This expander serves as a placeholder, gradually stretching the skin and muscle to accommodate a permanent implant.

  2. Expansion Process: Over several weeks to months, saline is injected into the expander during office visits. This controlled expansion process allows the skin to stretch gradually, creating space for the final implant.

  3. Exchange for Permanent Implant: Once the desired expansion is achieved, a second surgery is performed to replace the tissue expander with a permanent silicone or saline implant, restoring breast volume and contour. Fat grafting may be performed at the same time to provide a more natural contour to the breast mound.

Advantages

  • Less invasive than flap-based reconstruction

  • Shorter recovery time

  • Predictable results with implant sizing

Considerations

  • May not be suitable for patients with significant radiation damage

  • Risk of implant complications, including capsular contracture

  • Requires multiple procedures to achieve final results

Latissimus Dorsi Flap Reconstruction

Latissimus dorsi flap reconstruction is a technique that uses a flap of tissue from the upper back to create a new breast mound. It is often combined with an implant for added volume and projection.

Procedure Overview

  1. Tissue Harvesting: A portion of the latissimus dorsi muscle, along with skin and fat, is carefully transferred from the back to the chest.

  2. Tissue Repositioning: The flap remains attached to its original blood supply and is tunneled through the underarm to the chest to create the breast mound.

  3. Implant Placement (If Needed): In many cases, an implant is placed beneath the flap to achieve the desired breast size and shape.

Advantages

  • Reliable and well-vascularized tissue transfer

  • Suitable for patients with prior radiation treatment

  • Provides a natural look and feel

Considerations

  • Leaves a scar on the back

  • Longer recovery time compared to implant-only reconstruction

  • May cause mild weakness in the back or shoulder

  • Often requires an implant to achieve suitable breast size.

DIEP Flap Reconstruction

Deep Inferior Epigastric Perforator (DIEP) flap reconstruction is an advanced microsurgical technique that uses a patient’s own abdominal tissue to reconstruct the breast, offering a natural feel without the need for implants.

Procedure Overview

  1. Tissue Harvesting: Fat, skin, and blood vessels from the lower abdomen are removed while preserving the abdominal muscles.

  2. Microsurgical Transfer: The harvested tissue is transplanted to the chest, where blood vessels are reconnected using microsurgery to ensure proper circulation.

  3. Breast Molding: The surgeon sculpts the tissue to create a natural breast shape.

Advantages

  • Uses the patient’s own tissue for a more natural look and feel

  • Avoids complications associated with implants

  • Provides an added benefit of a flatter abdominal contour

Considerations

  • Longer and more complex surgery

  • Requires sufficient abdominal tissue for harvesting

  • Recovery time is longer than implant-based reconstruction

Choosing the Right Breast Reconstruction Method

The best breast reconstruction technique depends on several factors, including:

  • Patient preference and aesthetic goals

  • Previous treatments such as radiation therapy

  • Body type and available donor tissue

  • Overall health and medical conditions

During a consultation, the Dr. Kearney will discuss all available options, helping each patient choose the method that aligns best with their lifestyle and desired outcome.

Recovery and Postoperative Care

Recovery times vary depending on the type of reconstruction performed. General guidelines include:

  • Tissue Expander to Implant: 4-6 weeks

  • Latissimus Dorsi Flap: 6-8 weeks

  • DIEP Flap: 8-12 weeks

Postoperative care includes pain management, drain care, and gradual return to daily activities. Patients should avoid strenuous exercise and heavy lifting for several weeks and follow up regularly with Dr. Kearney to ensure proper healing.

Conclusion

Breast reconstruction is a deeply personal choice that can restore confidence and provide a sense of wholeness after mastectomy. With various surgical options available, Dr. Kearney works with patients to select the approach that best fits their needs. Whether choosing an implant-based method or a natural tissue flap reconstruction, modern techniques offer safe, effective, and aesthetically pleasing results.

For more information or to schedule a consultation, contact Dr. Kearney’s office today to discuss your breast reconstruction journey.