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| Breast Reconstruction Procedure | Breast reconstruction may be done at the time of mastectomy (so called immediate reconstruction) or some time later (so called delayed reconstruction). Breast reconstruction is hardly ever finished in one operation, that’s why even if you pick immediate reconstruction, you'll likely come across with follow-up procedures later on.
Breast implants
A breast implant is a round or teardrop-shaped silicone shell, filled with salt water (saline) or silicone gel. A plastic surgeon locates the implant behind the muscle in your chest (pectoral muscle) in the same way as during breast augmentation surgery.
A small number of women are able to go through a one-stage process – having the implant located at the time of the mastectomy. The majority of women need a two-stage process, using a tissue expander before the permanent implant is inserted.
Tissue expanders
Tissue expansion is a procedure that lengthens out your remaining chest skin and soft tissues to create space for the breast implant. The procedure occurs gradually, naturally over several months.
Your surgeon puts a tissue expander, similar to a balloon, under your pectoral muscle at the time of your mastectomy. The tissue expander has a small valve that your doctor can access by inserting a needle through your skin. After the next few months your doctor or nurse injects saline into the valve, filling the balloon in stages. This gradual procedure permits the skin to stretch over time. You may feel modest anxiety or a sensation of pressure as the implant expands.
After the tissue expansion procedure is finished, your surgeon does a second surgery to take away the tissue expander and substitute it with a permanent implant. Some tissue expanders are created to be left in place enduringly, so the second operation may be less widespread and use only local anesthesia.
Tissue reconstruction
Autologous tissue reconstruction is the most difficult reconstructive option. Your surgeon transfers a section of skin, muscle, fat and blood vessels from one part of your body to your chest to make a new breast mound. Sometimes the skin and tissue need to be augmented with a breast implant to obtain the desired breast size.
Surgical methods that are be used:
- Pedicle flap surgery
The surgeon cuts some of the blood vessels nourishing the tissue to be moved but keeps other blood vessels unbroken. Tunneling the tissue under your skin to your chest area, the surgeon then forms the new breast mound or pocket for the implant.
- Free flap surgery
The surgeon disconnects the tissue totally from its blood supply and uses microsurgical techniques to reattach the tissue flap to new blood vessels close to your chest. Because of the complicated nature of reattaching blood vessels, free flap surgery usually takes longer to finish than does pedicle flap surgery.
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