Breast Reconstruction

Breast reconstruction is a surgical process to reconstruct lost breast with artificial implants and flaps that appear natural in shape, size, and symmetry. Breast cancer is the most common type of cancer diagnosed in women in the recent era. As part of the cancer treatment, the affected breast or breast tissue is removed to eliminate the spread of cancerous tissues to other parts of the body. Gene mutation, obesity, radiation, use of alcohol and hormone therapy is some of the reasons that cause breast cancer in women.

Breast reconstruction

Breast reconstruction is a series of surgical procedures performed to rebuild the breast. The procedure is also performed to rectify breast abnormalities or deformed breast. The breast is reconstructed using an implant or by tissues obtained from other parts of the body mainly abdominal area and buttocks. A nipple and areola are created in the newly reconstructed breast. There are few types of breast reconstruction method and is selected by the aesthetic surgeon depending on the body type, age and undergoing cancer treatments. The procedure can be performed immediately after removing the breast as part of cancer treatment or as a separate procedure.

Breast reconstruction using implants

Breast reconstruction using implants is performed by placing an implant behind the pectoral muscle of the chest. The implants are filled with silicone gel or saline solution. Breast implants are used for immediate reconstruction of the breast. Before inserting the breast implant, the patient has to undergo a tissue expansion procedure. Tissue expansion is a preparation process during which a balloon-like tissue expander device is placed under the pectoral muscle. The tissue expander is then injected with saline solutions over the months to allow expansion and stretching of the skin to accommodate the breast implant in position. When the expansion is adequate to hold in the implants, the device is replaced with the permanent breast implant.

Breast reconstruction using body tissue

Breast reconstruction using body tissue is a surgical procedure during which tissue from another part of the body is obtained and placed in a position of the breast. The relocation is performed using a pedicle flap or free flap surgery.

Pedicle flap method: in this process the aesthetic surgeon separate the body tissue along with some of the blood vessels. The tissue is then channeled across from the original site to the chest area.
Free flap surgery: This method involves removing the tissue along with the blood vessels and reattaching the flap in the chest area using microsurgery to reattach blood vessels in the site.

The flap reconstruction is termed after the location and muscles involved in the reconstruction process.

  • Abdomen TRAM flaps surgery: uses the tissues obtained from the abdomen
  • Free TRAM flap or a muscle-sparing free TRAM: used muscle, skin, and fat from the lower abdomen
  • Abdomen DIEP flap and Superficial inferior epigastric artery (SIEA): transfers only skin and fat from the abdomen
  • Latissimus dorsi flap: uses skin, fat and muscle tissue from the upper back
  • Gluteal flap: transfer tissue from the buttocks
Authored By Dr. K Prem Anand - Facio Maxillary & Aesthetic Surgeon, Bangalore