What Option of Breast Reconstruction to Choose?

Breast implants are the most frequent type of breast reconstruction, and they consist of a silicone shell filled with either saline (sterile seawater) or silicone (gel). Implant surgery entails several processes.

First, during mastectomy, a temporary tissue expander is placed underneath or on top of the pectoralis muscle in the chest. Your surgeon will explain which breast reconstruction strategy is appropriate for you. After a few weeks, as things begin to mend, they progressively fill the expander in the clinic with saline, allowing the skin and muscle if the tissue expander is beneath the muscle to spread out. On average, the expansion process lasts six to eight weeks.

After another six to eight weeks, they remove the expander and place the final implant. Before the second surgery, you will have to choose between a silicone or saline-filled implant.

Is There a Good Candidate for Breast Implant Reconstruction?
Women with small to moderate breasts make excellent candidates for implants. Fuller-breasted ladies can have implant reconstruction, but if they have had a unilateral mastectomy (one breast removed), we may need to reduce the natural breast to establish symmetry. Similarly, for women with lesser breast sizes, we may need to do breast augmentation of the natural breast to establish symmetry.

What Is a Soft Tissue Flap Breast Reconstruction Surgery?
Flap reconstruction reconstructs the breast using a woman's own tissue, which may include skin, fat, and, on occasion, muscle. That tissue and skin can be taken from a range of sources, and the location and method we use will be determined by aspects such as the quantity and quality of tissue available, as well as the patient's preferences.

Breast Reconstruction - TRAM Flap (Abdominal Muscle)
The initial procedure, pedicled TRAM flap reconstruction, uses tissue from below the belly button. The skin, fat, and at least one abdominal muscle tunnel beneath the skin and up into the breast area, but they stay connected to their blood arteries in the abdomen.

This allows the transferred tissue to continue to receive blood flow from its original location, making it the simplest of the flap surgeries. The disadvantage is that it necessitates muscle loss, which may impair abdominal function.

DIEP and Muscle-Sparing TRAM Flap Breast Reconstruction.
The strategy is to sacrifice the least amount of abdominal muscle possible in order to maintain abdominal function, and in most cases, no muscle at all. This can be achieved with either the muscle-sparing TRAM flap or the DIEP flap. These surgeries entail tissue translocation as well as the reconnection of the tissue's blood supply, necessitating the use of microvascular surgery techniques.

Microvascular surgery is conducted on very small blood vessels utilizing an operating room microscope and a variety of tiny, specialized equipment. A muscle-sparing TRAM flap removes relatively little muscle, whereas a DIEP flap spares no muscle at all.

Thigh and Buttock Flap Breast Reconstruction
The thighs and buttocks, in addition to the abdomen, are frequently densely packed with tissue. The TUG and DUG flaps use skin, fat, and a little bit of thigh muscle to reconstruct the breast. The gluteus flap reconstructs the breasts by using skin and fat from the buttocks.

What Are the Advantages of Using Your Own Tissue for Breast Reconstruction?
Using your own tissue creates the most natural-feeling breast. So, if you desire a larger, softer breast, a flap is an excellent option. Furthermore, it usually provides the best match with a contralateral natural breast if you are having a unilateral mastectomy. With flaps, newly restored breasts mature similarly to natural breasts.

Women should check with their doctor before making this very personal decision. Every case is different. You must have enough tissue accessible to donate, whether from your abdomen, thighs, or buttocks. For ladies who are very thin, implants can be a better option.