Breast reconstruction is a type of surgery that re-creates or restores the shape and texture (including size, color, and symmetry) of the breast after a mastectomy, due to breast cancer treatment, or congenital deformity. A diagnosis of cancer and the loss of one or both of your breasts can be a traumatic event in a woman’s life, as well as having a congenital deformity. For most women, the loss can cause psychological, and physical consequences that undermine their confidence and feminine view of themselves. It can also affect how they feel and fit in the clothing they wear.
It’s important to consult with a board certified, highly skilled surgeon like Dr. Tantawi, to get your questions answered, and see what options are available for your unique situation. Dr. Tantawi understands the emotional and physical concerns you may have, when choosing the right surgeon and procedure. He has performed breast reconstruction on many women, and cares about giving you the results you desire and deserve, to restore your femininity. Book a consultation with him well in advance of your surgery, so he can plan your procedure for the best outcome possible.
If you are having a mastectomy or lumpectomy, your breast surgeon and oncology team will also be involved with the procedure. They may consult with Dr.Tantawi about your surgery and cancer treatment, so he will have an idea of the best type of surgery to be performed in your situation. You will need to bring, or have all your medical records sent, list of medications, and any over the counter supplements you are taking. He will look over your records and consult with your breast surgeon ahead of time.
Breast reconstruction is personal for all women. You may elect to have breast reconstruction at the same time as your mastectomy or lumpectomy. Having reconstruction surgery at the same time, can eliminate the need to have surgery twice, and has the added benefit of you coming out of surgery with your breast(s) already done. This will let you get back to your normal life sooner. Some women choose to wait and delay breast reconstruction to a later time. Dr. Tantawi can give you the information you need to make the best decision for you.
Breast Reconstruction Procedure
Breast reconstruction is used to restore your breast(s) after surgery, disease, trauma or a congenital defect. Your options for breast reconstruction include implant-based and tissue flap procedures. All surgery is performed under general anesthesia or IV-drip sedation so you will feel no pain.
Implant-based breast reconstruction uses a saline or silicone implant to rebuild a breast mound after mastectomy surgery (breast removal). Tissue flap procedures use your own tissues, muscles and fat from other areas of your body to rebuild a breast mound. It’s also called microvascular free tissue transfer. In this type of procedure, an implant can be inserted too.
In implant reconstruction, Dr. Tantawi will insert a silicone implant under your chest muscle, or the skin envelope. This is called submuscular placement. Breast implants can be placed above or below the muscle depending on your anatomy and body weight, among other factors.
The incisions for implant-based breast reconstruction are often shorter than those used for tissue flap procedures, because they’re usually done through keyhole incisions. Implant reconstruction works best with small breasted women, as there is not as much skin needed, or if a lumpectomy is performed as all of the breast is not usually removed.
Depending upon the implant procedure performed, Dr. Tantawi may need to perform surgery twice. The first surgery is performed when your mastectomy or lumpectomy is done and a tissue expander is inserted. The expander is gradually expanded during office visits. When it reaches the correct size, another surgery is performed to insert the implant.
Tissue Flap Procedures
Tissue flap procedures use tissues from another part of your body to rebuild a breast mound after mastectomy surgery (breast removal). A free flap transfer involves removing a section of tissue from one area of your body, and reattaching it to reconstruct a breast. Breast implants can also be used in tissue flap procedures.
To reconstruct the breast mound, Dr. Tantawi will move one of the following types of tissue flaps:
Free flap transfer
This type of reconstruction uses muscles, fat, skin and blood vessels from another part of your body to build a breast mound. The area used for this includes your back or abdomen, also called an abdominal flap.
Latissimus dorsi muscle (LD) flap
This reconstruction is done by transferring the latissimus dorsi muscle from your back, to rebuild your breast, along with its blood supply and skin covering. It’s often preferred for large implant reconstructions .
Transverse upper gracilis myocutaneous (TUG) flap
Dr. Tantawi may use this procedure if there isn’t enough tissue on your abdomen to create a flap. The TUG flap uses a section of muscle and skin from the inner thigh.
Fat grafting, also called fat transfer, is a procedure that uses your own body fat to improve the appearance of breasts that have been surgically removed.. During the surgery, Dr. Tantawi will remove fat cells from another part of your body, such as your thighs, hips, or buttocks. Then he will inject them into your breasts. An implant may be used as well. Fat grafting may be used to reconstruct your breast(s), and can be more natural looking.
Breast Reconstruction Recovery
Breast reconstruction can be a complicated procedure. Recovery time, office visits and the instructions you are given by Dr. Tantawi can vary depending upon the surgery that has to be performed. In some cases, you may need a second surgery, with a waiting period to heal in between. Due to the highly individualized treatment, it’s best to ask Dr. Tantawi at your consultation what you can expect, as far as recovery procedures.
In general you will feel better in 3 days and be able to return to normal activity in 6 weeks. Dr. Tantawi will prescribe medication for pain and infection prevention. You will also be given instructions on caring for yourself during your recovery period, and follow up appointments will be scheduled in advance.
Breast Reconstruction FAQs
Yes, it is considered major surgery. Patients usually stay in the hospital for 2 to 3 days after surgery. Also, more than one surgery may be required to completely reconstruct the breast(s). Implant surgery has a shorter recovery time than flap surgery.
Most breast reconstruction surgery is covered by insurance. You will need to contact your insurance plan administrator to see if you are covered.