Breast Reconstruction Surgery

Types of Breast Reconstruction Surgeries Include:

Diep Flap Surgery

The DIEP flap procedure, or Deep Inferior Epigastric Perforator flap procedure, is a type of breast reconstruction surgery that uses tissues from the lower abdomen to reconstruct the breast. This procedure is often chosen by women who have undergone mastectomy to treat or prevent breast cancer.

The key advantage of the DIEP flap procedure is that it uses the patient’s own tissue, reducing the risk of rejection and providing a more natural look and feel compared to implants. However, it’s worth noting that this procedure is quite complex and requires a highly skilled surgical team. Recovery times may also be longer compared to other types of reconstruction.

The DIEP flap procedure involves taking skin, fat, and blood vessels from the lower abdomen area and transferring them to the chest to create a new breast. This tissue is usually taken from the area below the belly button, as it contains an abundance of blood vessels that can be used for reconstruction. The surgeon will carefully select and disconnect these tissues before reattaching them to the chest.

One of the main benefits of the DIEP flap procedure is that it preserves the abdominal muscles, unlike other types of flap procedures which may require sacrificing them. This can lead to a faster recovery and fewer long-term complications such as abdominal weakness or hernias. The reconstructed breast also has a more natural look and feel compared to those created with implants.

Recovery from DIEP flap surgery can take several weeks, and during this time, patients may experience discomfort, swelling, and bruising. It’s important to follow the post-operative care instructions provided by the surgical team and attend any follow-up appointments to monitor progress. Physical activity should also be limited during this time to allow for proper healing.

In addition to breast reconstruction after mastectomy, DIEP flap surgery can also be used to correct asymmetry in breasts or to improve the appearance of a previously reconstructed breast. It is important for patients considering this procedure to have realistic expectations and to understand that it may not result in a perfect match with their natural breast.

Overall, the DIEP flap procedure offers an alternative option for breast reconstruction that preserves muscle and provides a more natural result. It is important for patients to discuss their options with a qualified plastic surgeon to determine if this procedure is the best choice for them. Other factors such as medical history, body type, and personal preferences should also be taken into consideration when making a decision about breast reconstruction.

It’s also important to note that DIEP flap surgery can be a lengthy and complex procedure, and it may not be suitable for everyone. It is important to have a thorough consultation with your surgeon and discuss any potential risks or complications before undergoing this surgery.

In conclusion, breast reconstruction after mastectomy is an important aspect of the physical and emotional healing process for many women. The DIEP flap procedure offers a unique option that can provide natural-looking results and improved overall quality of life. As with any surgery, it is important to carefully consider all options and make an informed decision in consultation with a qualified medical professional.  So, if you or a loved one are considering breast reconstruction after mastectomy, be sure to do thorough research and consult with a trusted oncoplastic breast surgeon to determine the best course of action for your individual needs.

Latissimus Dorsi Flap Surgery

The Latissimus Dorsi Flap Surgery is another effective method for breast reconstruction post mastectomy. It involves the use of muscle, fat, and skin from the back, specifically the latissimus dorsi muscle, to construct a new breast.

The flap of tissue is tunnelled under the skin to the chest area, creating a pocket for an implant or to shape the breast itself. This method is often chosen when there is insufficient tissue in the abdomen for a DIEP flap procedure. While it may lead to some weakening in back strength, most patients do not notice significant functional loss.

However, a potential downside is the additional scar on the back. As with any surgical procedure, it’s crucial to understand the potential risks and benefits and discuss these thoroughly with a trusted surgeon before making an informed decision. 

Ultimately, the choice of breast reconstruction method depends on a variety of factors, including the individual’s medical history, body type, and personal preferences. The Latissimus Dorsi Flap Surgery is just one option among several others, such as implants or TRAM flap surgery.

Pedicled Flap Surgery

Pedicled Flap Surgery is another type of breast reconstruction that involves the use of tissue from a nearby area, such as the back or abdomen, to create a new breast. Unlike other methods, this procedure keeps the blood supply attached to the flap, so it remains connected to its original location. This reduces the risk of complications and improves healing time.

While pedicled flaps can provide a more natural look and feel compared to implants, they may not be suitable for all patients. For example, individuals who have undergone previous surgeries in the abdomen or back area may not have enough tissue to use for a pedicled flap.

Additionally, this method may not be feasible for women with larger breasts as there may not be enough tissue available to create a new breast of the desired size.

Free Flap Surgery

Free flap surgery, also known as microvascular surgery, is considered the most complex and technically demanding type of breast reconstruction. It involves taking tissue from one part of the body, such as the abdomen or buttocks, and transplanting it to the chest area using microsurgery techniques to reattach the blood vessels.

This allows for a larger amount of tissue to be transferred, making it suitable for women with larger breasts or those who have undergone previous surgeries in the breast area.

While free flap surgery may result in a more natural-looking and feeling breast, it also has a higher risk of complications due to the complexity of the procedure. Additionally, this method requires longer hospital stays and recovery time compared to other reconstruction methods.

Allogeneic (donor) tissue: In this type of reconstruction, healthy tissue is taken from a donor (usually a family member) and used to create a new breast. Allogeneic reconstruction is not as common as autologous flap (flap taken from the patient’s body) surgery.

Nipple Reconstruction

In addition to reconstructing the breast mound, nipple reconstruction can also be performed to create a more natural-looking breast. This procedure involves using skin from the reconstructed breast or another part of the body to create a new nipple. Tattooing may also be used to add colour and texture, giving the appearance of a real nipple.

While nipple reconstruction may not be necessary for all patients, it can often provide the finishing touch to a breast reconstruction, helping to improve self-image and confidence. However, not all women are suitable candidates for this procedure, especially those with underlying medical conditions that may increase the risk of complications.

Acellular Dermal Matrix

Acellular dermal matrix (ADM) is a type of graft material that can be used in breast reconstruction surgery. It is derived from donated human tissue and has been processed to remove cells and other components, leaving only a supportive scaffold for new tissue growth.

ADM can be used to support the reconstructed breast mound, providing additional strength and structure. It may also help improve the overall appearance and shape of the reconstructed breast. This material is gradually absorbed by the body over time, with new tissue replacing it for long-term support.

Implant Surgery

Implant surgery is another commonly used method in breast reconstruction. It involves the use of a saline or silicone implant to replace the breast tissue that has been removed. The process may be performed immediately after mastectomy or at a later date, referred to as delayed reconstruction. Implant surgery typically involves two stages.

First, a tissue expander is inserted under the skin and chest muscle where it is gradually filled with saline over several weeks or months to stretch the skin in preparation for the implant. Once the skin has stretched enough, a second surgery is performed to replace the expander with the implant.

While implant surgery can offer a shorter recovery time than other reconstruction methods, potential risks include implant rupture, capsular contracture (hardening of the scar tissue around the implant), and changes in breast sensation.

Revision Surgery

After a breast reconstruction procedure, some women may require revision surgery to make adjustments or improvements to their results. This can include correcting any asymmetry, addressing scar tissue, or improving the overall aesthetic appearance of the breast.

Revision surgery may also be necessary due to complications or changes in a woman’s body over time. It is important for patients to have realistic expectations about the results of their breast reconstruction and understand that additional surgeries may be needed in the future.

Expanders and Implants 

Expanders and implants form an integral part of breast reconstruction surgery, offering a route to regain physical symmetry and aid psychological recovery post-mastectomy. Tissue expanders function as temporary placeholders that prepare the breast area for the eventual implant by stretching the skin and muscle. This saline-filled device can be precisely controlled to expand at a comfortable rate for the patient, ensuring minimal discomfort.

The final implant, either silicone or saline, is put in place once sufficient expansion has been achieved. Silicone implants are often praised for their natural feel, while saline implants offer the advantage of adjustable size post-surgery.

Each option has its benefits and drawbacks; hence, the decision should be made in consultation with the medical team, considering the individual’s physique, health condition, and personal preferences. Patients should be aware that, while the results can be transformative, it’s a process that might require future adjustments and revisions.