Breast Reconstruction
The goal of breast reconstruction surgery is to rebuild the contour of the breast so that it matches the normal cancer-free breast in symmetry and shape. Nipple areolar reconstruction and tattooing aims to restore symmetry between the nipples and areolas. Breast reconstruction has come a long way in the last twenty years. Most patients will get an excellent result with more than one technique. As a Board-certified Plastic Surgeon, Dr. Tyrone will help you choose the right technique for you. In addition to the technique chosen to perform your breast reconstruction, the timing of your breast reconstruction also merits some discussion. While most patients are candidates for immediate reconstruction (i.e. reconstruction at the same operation as your mastectomy), some patients will be better served by a delayed reconstruction. Though some women may not be interested in breast reconstruction, they should certainly be aware of their options. Finances should not be an issue when dealing with breast reconstruction. In 1998, the Women's Health and Cancer Rights Act was passed. This act mandates insurance companies to cover patients' procedure of choice in all cases of cancer patients who have had mastectomies, as well as surgery on the opposite breast to achieve symmetry.
Dr. Tyrone understands that the decision to undergo breast reconstruction is an important one. Dr. Tyrone knows the importance of educating you before, during and after the procedure as he firmly believes the most informed patients are also the most comfortable, confident and satisfied patients. Several before-and-after breast reconstruction patient photographs are available on this website. Additional photographs are available for viewing in our Gainesville, Florida office.
Breast Reconstruction Frequently Asked Questions
Please click below to learn more about the following:
Am I a good candidate for breast reconstruction?
If you have been diagnosed with breast cancer and are having or had a mastectomy, you owe yourself a consultation with a plastic surgeon to discuss breast reconstruction. Most patients are candidates for breast reconstruction. Breast reconstruction is generally performed after mastectomy for breast cancer, but may also be performed to correct a congenital absence or acquired loss of the entire or a portion of the breast. . The procedure may be either “immediate” or “delayed”, and may involve the use of an implant or transfer of your own tissues to reconstruct the breast. Often times, a combination of your own tissue with an implant is used. “Immediate reconstruction” is usually performed during the same operation as the mastectomy, while “delayed reconstruction” is performed at some later date after the tissues have healed. Reconstruction with an implant may involve placement of a tissue expander to create a pocket for either a saline or silicone gel filled implant. As with any implant, additional surgical procedures may be necessary in the future to correct changes or replace the implant. In contrast, autologous reconstruction involves the transfer of your natural tissues onto the chest to reconstruct the breast mound. The most commonly utilized techniques are the TRAM (transverse rectus abdominus myocutaneous) and LD (latissimus dorsi) flaps. These flaps typically require a longer initial surgical procedure and a short in-patient hospitalization, but can give excellent long term results. Breast reconstruction is not a simple procedure. There are often many options to consider as you and your doctor explore what's best for you. Dr. Tyrone can best educate you on which procedure may be best for you.
What are the basic types of breast reconstruction performed by Dr. Tyrone?
The goal of breast reconstruction is to create a breast mound that matches the remaining normal breast in size and shape. Dr. Tyrone utilizes numerous techniques to achieve this goal. Any breast reconstruction involves the use of an implant or a “flap”. Some techniques of breast reconstruction utilize an implant and a “flap”. “Flaps” used in breast reconstruction are composed of muscle, fat and skin which are transferred from the abdomen or back to the breast. Once the “flap” is transferred to the breast, it is shaped to reconstruct the breast mound. The most common flaps used by Dr. Tyrone are the transverse rectus abdominus myocutaneous flap (TRAM flap) and the latissimus dorsi myocutnaeous flap. The benefit of flap reconstruction of the breast is that a breast mound can often be created without the use of an implant and frequently the entire reconstruction only requires one operation under general anesthesia). Breast reconstruction using expanders and implants is often the easiest in terms of recovery for the patients. An expandable implant is placed at the time of your mastectomy in cases of immediate breast reconstruction; this expandable implant is replaced with a saline or silicone-filled breast implant after it has been expanded to a volume that matches the unaffected breast. In cases of bilateral reconstruction, the expanders are expanded symmetrically. Using expanders and implant alone for breast reconstruction requires at least 2 surgical procedures. Furthermore, in thinner patients, the implants are frequently palpable and implant rippling may be noticeable. Problems with rippling and palpability have been reduced by using Alloderm® for inferior implant coverage. Alloderm is placed at the time of the mastectomy and helps to better define the fold underneath and lateral to the breast and provides additional padding where muscle coverage of the implant is more difficult (“Alloderm Sling”).
What will my breast reconstruction consultation with Dr. Tyrone entail?
During your initial breast reconstruction consultation, Dr. Tyrone will inquire about your medical and surgical history including current medications and allergies. It is important to be thorough when discussing your medical history as safety is Dr. Tyrone’s top priority. Your full disclosure of all pertinent medical information prior to surgery will reduce the incidence of unwanted complications after surgery. Dr. Tyrone will also contact your surgical oncologist or breast surgeon prior to your consultation so he will be aware of what your cancer surgery will entail (removal of a portion or your entire breast) and whether or not it seems likely that you will need postoperative radiation therapy. Both of these issues affect your breast reconstruction. Your objectives and goals will be discussed. Dr. Tyrone will then discuss the different types of reconstruction available. Photographs of patients reconstructed with a variety of techniques will be shown to you.
You will then be asked to put a gown on. Photographs will be taken. Dr. Tyrone will then review your photographs with you. Differences between the 2 breasts (i.e. asymmetry) will be noted and proposed incisions demonstrated. Computer imaging is an invaluable part of the consultation. Dr. Tyrone encourages you to ask any questions during you consultation. Following your consultation, you will meet with Dr. Tyrone’s patient coordinator, to discuss scheduling your surgery and answer any questions you may have forgotten to ask Dr. Tyrone. Frequently, Dr. Tyrone recommends surgery on the normal breast that is not affected by cancer. He will do this if the normal breast is particularly large or droopy as it is difficult for a reconstructed breast to attain the same degree of size and droop that is frequently present.
Breast reconstruction surgery is not an exact science. Although the majority of women experience no complications, Dr. Tyrone will discuss potential risks and complications of breast reconstruction surgery at the time of your consultation. Prior to undergoing breast reconstruction surgery with Dr. Tyrone, it is important for you to fully understand the risks and potential complications associated with your procedure. Techniques of breast reconstruction are constantly evolving. There are many factors to be considered in determining the optimal technique and timing of your breast reconstruction.
What do I need to do to prepare for my breast reconstruction surgery?
Once you have scheduled your breast reconstruction surgery with Dr. Tyrone in Gainesvlle, Florida, you will be given preoperative instructions that discuss everything from wound care to follow-up visits after your surgery. Prior to your breast reconstruction, you may need basic blood work and medical clearance form your primary medical doctor. You will receive prescriptions form Dr. Tyrone’s patient coordinator prior to surgery. It is important to have the medication prescriptions filled in the days prior to your surgery so they are waiting for you when you return home from surgery.
You will receive a list of medications (i.e. aspirin and nonsteroidal anti-inflammatory drugs) to avoid for 14 days prior to your breast reconstruction surgery with Dr. Tyrone. Additionally, although there is no scientific proof that certain medications reduce bruising, swelling and pain after breast augmentation surgery, you will be asked to obtain Arnica Montana, Bromelain and Vitamin A pills to take prior to and after your procedure. Finally, the night before surgery, shower and wash as you would normally and do not eat or drink after midnight.
Where will my breast reconstruction surgery take place?
Dr. Tyrone performs breast reconstruction surgery in Gainesvlle, Florida at North Florida Regional Medical Center. If the reconstruction is immediate (@ the time of your cancer surgery), patients remain in the hospital until they are stable to go home. The length of the hospital stay varies with the breast reconstruction technique used.
Secondary procedures can be performed in the same hospital as the original surgery or at one of several outpatient operating facilities in Gainesville, Florida. These smaller procedures include implant exchanges as well as nipple-areolar reconstruction and tattooing. The Ambulatory Surgery Facility (ASF) located in Gainesvlle, Florida is certified at the highest level by American Association for Accreditation of Ambulatory Surgery Facilities. Our entire staff is dedicated to your comfort and satisfaction.
What results can I expect from my breast reconstruction surgery?
Provided you are a good candidate for breast reconstruction surgery, any technique of breast reconstruction should provide you with reasonable symmetry between the breasts. The results are typically long lasting though a secondary procedure may be needed to fine tune your result wither immediately or further down the road.
Maintaining a relationship with Dr. Tyrone after your breast reconstruction surgery is important to help you address changes and other concerns which may arise. Regular examination by Dr. Tyrone and routine mammograms at prescribed intervals will help assure that any complications, if they occur, can be detected early and treated.
Please contact our cosmetic plastic surgery practice in Gainesville, Florida to schedule a breast reconstruction surgery consultation with Dr. John Tyrone.
|
