If you are among the 1 in 8 American women who receive a diagnosis of invasive breast cancer, you owe it to yourself to make smart, informed choices when it comes to your care. If conservative therapy is not an option, and a mastectomy proves necessary, ask your doctor about ALL of your reconstruction options before you schedule your surgery.
Immediate Reconstruction After Mastectomy
An immediate reconstruction is often possible in situations where no radiation therapy is required (most often in patients with stage I or II breast cancer). A single procedure allows for a speedier recovery, and gives your reconstructive surgeon more options. Better yet, the patient goes home “whole,” with a breast mound in place.
If radiation is going to be required, however it is best to wait to perform a reconstruction. And in cases where it is unclear whether or not radiation is necessary, it may be beneficial to insert saline-filled tissue expanders at the time of the mastectomy in order to preserve the infra-mammary fold. Having done so, we are able to retain the patient’s “true” form, pending eventual reconstruction.
Implant-Based Reconstruction
Still the most commonly-performed reconstructive procedure, silicone-based implants are a reliable option for women seeking post-surgical breast reconstruction. The goal, as always, is to restore one’s sense of dignity and “wholeness,” and with advances in implant technology, a skilled surgeon can approximate the size, shape, and appearance of the sacrificed breast tissue in the right patient.
Autologous (“Own” Tissue) Reconstruction
When we talk about the state-of-the-art in reconstructive breast care, most often the discussion turns to autologus reconstructions—sophisticated surgeries that borrow tissue from elsewhere on the patient’s body in order to replace breast tissue sacrificed during a mastectomy. There are distinct advantages and notable risks associated with these procedures, and it is important that you and your doctor examine all available options, given your unique situation.
TRAM Flap Reconstruction
Despite recent advances in the field, TRAM flap reconstruction is still popular option among many women seeking reconstructive surgery. This procedure replaces breast tissue with skin, fat, and muscle borrowed from the patient’s abdomen, creating a “living” breast of own tissue. With that said, the disruption of muscles at the donor site is a notable disadvantage, requiring longer recovery times, with post-operative pain and chronic weakness in the abdomen.
DIEP Flap Reconstruction
Dr. Cannon is proud to have performed the first successful DIEP (Deep Inferior Epigastric Perforator) flap breast reconstructions in Savannah. This sophisticated microsurgery has been called the “new, gold standard” in reconstructive breast care, as it improves upon the former standard by leaving the muscles of the abdominal wall intact.
“DIEP flap essentially combines all of the advantages of TRAM flap without most of its disadvantages.”
Borrowing only skin and fat, in the right patient Dr. Cannon is able to craft a “living” breast with a more natural look and feel. There is a 1 to 5% risk of complete flap failure, but the surgery generally results in less postoperative pain and speedier recovery times than its predecessor. Read more about DIEP flap reconstruction here.
