Breast Reconstruction (Reconstructive Surgery)

Breast reconstruction (reconstructive surgery) is performed to restore one or both breasts that have been removed due primarily to breast cancer. Breast reconstruction (reconstructive surgery) is performed using a variety of techniques including using tissue from your abdomen or back, as well as using tissue expanders and breast implants. It is not unusual to perform some form of surgery on the opposite breast to improve final breast symmetry. This may include a breast lift procedure, breast reduction or sometimes breast augmentation. During your consultation with Dr. Lynam, the various types of breast reconstruction (reconstructive surgery) procedures will be discussed. Not everyone is a candidate for every type of breast reconstruction surgery. Dr. Lynam will use his years of experience to help guide you through the reconstructive surgery process.

INSURANCE APPROVAL FOR BREAST RECONSTRUCTION (RECONSTRUCTIVE SURGERY)

Insurance companies must pay for breast reconstruction (reconstructive surgery). Unfortunately, certain aspects of breast reconstruction (reconstructive surgery) are often considered experimental by your insurance company and may not be covered. Plastic surgeons are working diligently to change this situation so women may have the most current state of the art reconstructive surgeries.

CANDIDATE FOR BREAST RECONSTRUCTION (RECONSTRUCTIVE SURGERY) PROCEDURE

Some women will be candidates for beginning breast reconstruction (reconstruction surgery) at the time of their mastectomy surgery. This is called “immediate breast reconstruction”. Other women may require delayed reconstruction due to the patient requiring radiation therapy and/or chemotherapy. Other women will present years after their initial mastectomy for breast reconstruction (reconstructive surgery) to improve their appearance and self-image. In the United States 30% of women undergoing breast cancer surgery will elect not to have any breast reconstruction done, but will wear a bra fitted with a prosthesis.

The average time required to complete breast reconstruction (reconstructive surgery) is often just over one year and requires approximately three to four outpatient surgeries. Dr. Lynam uses Mentor breast expanders and implants and often requires a tissue product called Neoform or Alloderm.

THE BREAST RECONSTRUCTION (RECONSTRUCTIVE SURGERY) PROCEDURE

Dr. Lynam offers a number of options. One is a tissue expander, which is placed at the time of your mastectomy. Reconstruction using flaps of skin, fat and muscle from either the abdomen or back are transferred to the chest wall and shaped to form a breast. This is called autologous breast reconstruction. TRAM flap or Latissimus Dorsi Flap operations involve a much longer recovery and much higher rate of complications. Not everyone is a candidate for a certain type of reconstruction. The breast reconstruction (reconstructive surgery) is usually done at the time of your mastectomy. Dr. Lynam will be in the operating room with your surgeon so your reconstruction can be performed immediately following your mastectomy. Both procedures combined take approximately 2 to 3 hours and are done under general anesthesia. If breast reconstruction (reconstructive surgery) is performed at the time of your mastectomy, you will most likely spend one night in the hospital prior to going home.

There is usually one drainage tube placed that is used to remove any small amount of fluid collection for the first few days following surgery.

AFTER BREAST RECONSTRUCTION (RECONSTRUCTIVE SURGERY)

Drain tubes are removed in the office 5-7 days following breast reconstruction surgery. Occasionally after your drain tubes have been removed, fluid collections will form and require drainage several times a week in the office. Breast expanders are inflated in the office every 1-2 weeks to fill the expander and stretch and grow new skin to replace the area of skin removed from surgery. After several months the tissue expander is replaced for a final softer implant. Saline or silicone implants will be used depending on the patient’s choice. Most patients can return to reasonably normal activities 6-8 weeks following surgery.

NIPPLE RECONSTRUCTION

Reconstruction of the nipple is performed using skin from the breast mound that has been created. Dr. Lynam uses one of several techniques depending upon your skin and size of the nipple that we wish to create. The nipple reconstruction procedure is done as an outpatient basis taking 30 minutes per nipple to perform and is done under sedation. A small plastic guard is worn for approximately 4 weeks to protect the newly created nipple and is held in place with small pieces of tape. Patients can remove it for showering everyday.

AREOLA RECONSTRUCTION

Dr. Lynam prefers to reconstruct the pigmented areola skin using a tattoo machine in his office. Customized colors of tattoo pigment are mixed. Several 15 minute appointments allow us to achieve the desired color. Initially the color will be a bit darker and will fade overtime. For certain patients the traditional use of a skin graft from the inner thigh is used to create the areola pigmented skin.

At the time of your consultation, Dr. Lynam will discuss what options and choices are right for you. The procedure and routine post operative healing process will be explained in detail and all of your questions will be answered. Your medical history will be reviewed to insure you are in as good health as possible.

Dr. Lynam and his staff will take every step necessary to assist you during this stressful time.

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