What to Expect on the Day of Breast Reconstruction
Depending on what is discussed with Dr. Heidari during your consultation, you will first be administered medication to give you a more comfortable experience in the form of general anesthesia.
Dr. Heidari can use various techniques in order to reach the best results for you. If there is insufficient tissue in your chest as a result of a mastectomy or radiation therapy, breast reconstruction usually requires either a flap technique or tissue expansion.
A TRAM flap will use donor muscle, fat, and skin taken from your lower abdomen as reconstruction material. The flap is then either left attached to the original blood supply and tunneled up through the chest wall or completely detached and formed into a breast mold.
Dr. Heidari may choose to use the DIEP flap or SIEA flap techniques, which do not use the abdominal muscle, but only the skin and fat. If your lower abdomen lacks sufficient tissue, your buttocks or thighs can work as a substitute.
An alternative flap technique is the latssimus dorsi flap which uses muscle, fat, and skin from your back that is tunneled to the mastectomy site, but remains attached to the donor site and leaves the blood supply intact.
Some women do not require breast radiation, in which case an implant-based reconstruction is an option. If tissue expansion is used, it allows an easier recovery than flap reconstruction, but it is a lengthier process, requiring several office visits over 1 – 2 months after Dr. Heidari places the expander – a device that is gradually filled with saline through an internal valve. If the expander is not designed to serve as a permanent implant, a second surgical procedure will be needed to replace it. Dr. Heidari uses the most recent advances in expanders and specialty implants to reconstruct the female breast in these cases.
If you are not a candidate for a nipple-sparing mastectomy, there are other methods for breast reconstruction used for the nipple and areola. These techniques usually involve folding skin to create the shape of a nipple, followed by 3D nipple-areolar tattooing to create a realistic appearance with the illusion of projection.
Breast Reconstruction can often be enhanced with staged revision procedures to improve symmetry, use liposuction with fat grafting, and improve the appearance of the donor site.