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New Breast Construction Techniques

By: Kathryn Senior PhD - Updated: 18 Sep 2012 | comments*Discuss
 
Breast Reconstruction Mastectomy

Having breast cancer treatment today usually means that you can expect a very good outcome as treatments have improved dramatically over the last 20 years. Although newer drug treatments, including biological treatments and hormone therapies have been developed, surgery is still an important cornerstone of breast cancer treatment.

Usually, early stage breast cancer is treated by a lumpectomy, an operation that removes the tumour and a healthy margin of normal tissue all around it. Some women may choose to have a mastectomy, complete removal of the breast, or their cancer may have started to spread making this the best option. In both cases, the outward appearance of the breast can be altered dramatically; a lumpectomy will reduce the size of the treated breast and subsequent treatment with radiation therapy may make the skin look different.

Breast Reconstruction after Breast Cancer Treatment

In the UK, all women undergoing surgery for breast cancer will be offered some sort of reconstruction. There are many options to consider; sometimes the best option is to have the reconstruction at the same time as the surgery to remove the tumour. Other women either prefer to wait, or have a type of cancer or an initial operation that makes this difficult.

Whatever the circumstances, a good breast surgeon will discuss all of the options with you and each case will be treated individually. There are no set rules and emotional factors as well as medical factors need to be taken into consideration.

Breast Reconstruction after Lumpectomy

The removal of a significant amount of breast tissue may mean that your breasts will look asymmetrical after your surgery, so you can opt to have a breast implant put in place during your lumpectomy surgery. Breast implants are often used in cosmetic breast surgery and give a very realistic appearance. A surgeon can either use silicone based implants or saline filled implants. This second option is now considered safer, as if the saline leaks out if the implant breaks down it is completely harmless.

Autologous Tissue Breast Reconstruction

Although implants work well and are relatively simple to do, a more complex but very successful operation involves moving fat and other connective tissue from another area of the body and placing it inside the breast to restore it to its former size. The fat and other tissue can be removed from the abdomen or buttocks by liposuction, so that it doesn’t leave a scar. Some surgeons may consider removing the tissue from the abdomen and completing a tummy tuck operation at the same time. This can really restore the confidence of a woman who has just undergone breast cancer treatment, which can lead to a loss of self esteem.

Breast Reconstruction After Mastectomy

This type of breast reconstruction is generally more extensive and involves replacing the skin as well as the internal tissue, and may also involve reconstruction of the nipple if this cannot be saved during the mastectomy. A piece of muscle needs to be taken from a different part of the body too so that the skin of the new breast has its own healthy blood supply. Two main areas of the body are usually chosen – a muscle in the abdomen or a muscle in the top of the back. The first technique is known as a TRAM flap and the second is called a LAT flap.

Healing usually happens quickly, because this is your own tissue and this also prevents any possibility of tissue rejection. Very natural results can be obtained, and this type of reconstruction may be possible at the same time as a mastectomy.

Tissue Expanders – Why are they Needed?

Sometimes the breast reconstruction needs to be done in more than one stage because the skin needs to stretch to fit over the breast. This is very likely in a woman whose breasts are large – the breast being reconstructed needs to match the size of the other breast, and it is usually not possible to take enough skin from other body sites to accomplish this in one go.

A tissue expanded is like a saline implant but this is placed in the skin in the abdomen or the back, and gradually pumped up with extra saline over a period of weeks or even months. When a sufficiently large area of skin has been produced, the breast reconstruction can then go ahead.

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