Virginia Breast Reconstruction
What is breast reconstruction?
Breast reconstruction is surgery to help restore a normal shape
and size to the breast. This may be needed because of loss of
the breast due to cancer or trauma, or because of differences
in size with development. The goal is to achieve as much balance
and normalcy as possible.
What techniques are used in breast reconstruction?
There are two main categories of reconstruction, one using the
patient’s own tissue and the other using implants to build
the breast volume.
How do I know what is best for me?
Dr. Wray will evaluate you and review your options with you,
which will depend on your medical history and physical exam. Dr.
Wray performs the tissue expander/implant type of reconstruction,
frequently using an acellular dermal graft to help with the reconstruction,
and also will sometimes use a muscle from the back to help with
the reconstruction. She no longer does the major breast reconstruction
using the abdominal tissue to form the breast mound.
When is the best time to have breast reconstruction?
The answer is simply “when you are ready”. Patients
who have just been diagnosed with breast cancer should have the
opportunity to talk with a plastic surgeon about reconstruction.
Some patients elect to start reconstruction at the time they are
having their mastectomies, whereas others elect to wait. This
decision involves a lot of different factors, such as how the
patient is able to handle more choices on top of those associated
with her cancer care, whether she wants to proceed with something
that may require multiple surgeries, the extent of her cancer,
or other health problems. There are situations when it is best
to postpone reconstruction until after the cancer has been treated.
Are there advantages to having reconstruction start at the time
of the mastectomy?
A patient actually combines the first step of reconstruction
with the mastectomy surgery, eliminating a separate surgery. The
scar tissue has not formed yet, so there is usually more supple
skin available, and the general surgeon can leave more skin which
will be used in the reconstruction.
What are the advantages in delaying the reconstructive surgery?
When the surgery is performed after the cancer treatment is completed,
we have the advantage of knowing what treatment was needed for
the cancer that was present. Specifically, we will know if the
patient needed radiation following the mastectomy, which will
affect the ability of the skin to stretch for reconstruction.
We may choose a different reconstruction based on the physical
exam once radiation is complete. Also, if any complications arise
from the reconstruction, they will not interfere with the cancer
treatment.
What is involved with a tissue expander type of reconstruction?
This type of surgery is usually done in two steps. At the first
surgery, a tissue expander is placed under the pectoralis muscle,
which is the large muscle that is under the breast. Frequently
an acellular dermal graft is also used to help cover the expander
below the muscle. An acellular dermal graft is a piece of skin
that has had all living cells removed, so there is just a framework
of the skin left. The patient is usually in the hospital overnight
after the surgery. A tissue expander is much like a water balloon,
so after the skin is healed, it can be blown up slowly allowing
the skin to stretch over it. Saline is added to the expander during
brief visits to the office, and the expander is usually filled
over a period of 1-2 months. Once it is stretched to the appropriate
shape, the 2nd surgery is planned about 3 months later. This is
an outpatient surgery to remove the expander and replace it with
an implant and to do any touch up that may be needed for balance
or appearance.
Can a nipple be reconstructed?
Yes, the nipple/areola complex (the nipple and the dark skin
around it) can be reconstructed. This is done in the office after
everything has healed after the implant is placed. First the bump
to make a nipple is recreated, then the color is tattooed once
the new nipple has healed.
Does anything need to be done to the breast without cancer?
In order to achieve better balance and appearance, sometimes
a procedure is done on the non-cancerous breast. Depending on
what is needed, a lift, a reduction, or even sometimes an augmentation
is done to give better shape and symmetry with the reconstruction
breast.
Is reconstruction covered by insurance?
Most insurance policies will cover reconstruction if it is done
because of loss of a breast due to cancer. Private insurance also
covers the procedure on the other breast needed to achieve symmetry.
You will need to check with your particular insurance to know
exactly what coverage you have.
For more information about Breast Reconstruction in Virginia...
The professionals at The Center for Plastic Surgery and MediSpa
are always available to answer any questions regarding our Breast
Reconstruction procedures. Please give us a call at 1-540-444-4343
to schedule a consultation. You can also schedule a consultation
online by clicking here: Schedule
a Consultation Online for a Breast Reconstruction
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