Breast Reconstruction Surgery
Completing Your Breast Reconstruction Journey in Milwaukee
Breast reconstruction surgery is a procedure that usually takes place at the end of or concurrent with a longer journey of recovery from cancer. In the case of breast reconstruction after mastectomy due to breast cancer, the stages of cancer treatment and recovery can often be mixed together for better results.
For example, breast reconstruction procedures may be performed concurrently with the initial mastectomy and other procedures will often be scheduled later during gaps in cancer treatment.
The goal of this scheduling is simple: we want to complete your treatment in a timely fashion and get your feeling like yourself as quickly as possible. Study after study has shown that, when oncological surgeons and reconstructive surgeons work together, the final results are improved for everyone. The experiences of our Milwaukee breast reconstruction patients echo and confirm that research.
What is Breast Reconstruction Surgery?
As a cultural identifier of femininity, the breast can be a central piece of your identity. You might not feel like yourself if your breasts aren’t the size and shape you’re used to or the size and shape you desire. Additionally the breast serves a functional purpose in relation to undergarment wear and how female clothes are made to fit your body. The most common procedures used to treat breast cancer are are mastectomy and lumpectomy.
In cases of mastectomy, nearly all the breast tissue is removed in order to mitigate the risks associated with the cancerous tissue returning. In the case of lumpectomy a smaller area of the breast is removed, excising both the tumor and some normal tissue around it. Lumpectomy procedures are typically followed by a course of radiation therapy. Your cancer surgeon will help you choose the cancer procedure which is best for you.
Breast Reconstruction Surgery can more accurately be understood as a series of procedures designed to restore or recreate the breasts after a mastectomy or lumpectomy. This is different from cosmetic breast augmentation as the breast tissue has been removed in part or in full. Depending on your unique situation and choice reconstruction can be accomplished through the use of implants, your own tissue or a combination of both. Because all women are different, there are various techniques plastic surgeons employ to get the desired results.
Tissue Expander Surgery
When the breast tissue is removed, as in the case of mastectomy, the “pocket” where a traditional breast implant would be placed is no longer available. This means that before any implants can be inserted, a new pocket must be created. Tissue expander surgery is designed to implant a temporary device that will help create this new pocket and restore the breast mound. There are several different variations of this device, but they all have the same basic function: they slowly expand, and in doing so, create a skin/muscle envelope that a breast implant can later rest in.
This procedure can be performed at various times throughout the cancer recovery and treatment process. Many women elect to have the tissue expander inserted at the same time they have their mastectomy in order to cut down on operations and recovery time. However, that is not the only time the tissue expander can be inserted.
Indeed, many women choose to delay breast reconstruction until after the breast cancer treatment, and elect then to have the tissue expander surgery once they are again healthy enough for surgery. Ultimately, the timing of this procedure is largely up to the patient however there may be circumstances that relates to cancer treatment that may strongly influence this decision.
Once the tissue expander has accomplished its goal, it’s time to schedule the second stage reconstruction procedure. The most common second stage breast reconstruction procedure after tissue expanders have been placed involves the use of breast implants. These devices come in a variety of shapes and sizes and Dr. Bosbous will help you make the decision on what implant will help you achieve your desired results.
In conjunction with implants Dr. Bosbous often time employs a technique known a fat grafting. During this portion of the procedures fat is removed via liposuction, processed and then injected in the tissues surrounding the implants to help give a more natural appearing result.
Breast Reconstruction FLAP Procedures
Some women will choose to undergo a “Flap” procedure to reconstruct the breast. This procedure can be done in both and immediate (at the time of mastectomy) or delayed fashion. However a second stage procedure is required to finalize the result following the initial reconstructive procedure. There are several areas where this tissue can be taken from.
The most common areas are the back and the abdomen. A lattissimus flap uses a muscle from the back along with the overlying skin and fat to transfer to the chest a create the breast mound. In some cases this can done without the use of a small breast implant or in order to achieve the desired breast size an implant may also be needed. The most common Flap procedure related to the abdomen is something called a TRAM Flap procedure. During a TRAM flap procedure, donor skin, fat, and muscle is taken from the abdomen and transferred to the chest to create a breast mound.
Partial breast reconstruction is a procedure that typically occurs in an outpatient setting and is performed at the same time as the lumpectomy procedure. In many cases lumpectomy procedures can leave patients with aesthetic results that are less than optimal.
Working with the cancer surgeons in some cases Dr. Bosbous can proceed with a breast reduction or mastopexy (breast lift) procedure immediately follwiong the lumpectomy. This allows for the optimal breast shape and size to be achieved before radiation therapy decreasing chances of complications that may occur related to healing after radiation has been given to the breast.
In some cases partial breast reconstruction will occur following radiation. Typically this requires a 10-12 month period for the breast to heal from the treatment before proceeding. Several procedures may be required to reconstruct a breast following lumpectomy and radiation including fat grafting, breast reduction, breast lift or flap procedures. Dr. Bosbous will assist you in coming up with an individualized plan to meet your goals.
Most breast reconstruction procedures are performed in a hospital setting, and require at least a twenty-four hour recovery period before the patient can return home. There will be soreness in both the breast and the donor site (the abdomen, in the case of TRAM Flap procedures, for example). Patients are encouraged to walk the following day. Drainage tubes are left in place for up to 7-10 days in order to remove excess fluid from the reconstruction site. Total recovery can take a number of weeks to accomplish.
The last phase of the breast reconstruction journey is something called nipple reconstruction. Once healing of the reconstruction has progressed to a sufficient level, Dr. Bosbous is able to create a nipple from the skin of the breast reconstruction. Adding color to the nipple reconstruction is performed in clinic several months afterward using a medical grade tattoo procedure.
The results are usually quite lifelike and satisfying to the patient. It brings to a close a long journey of recovery for our Milwaukee area breast reconstruction patients.
Recovery and Results
It can be difficult to put into words the profound impact that breast reconstruction surgery has on many of the Milwaukee breast reconstruction patients that Dr. Bosbous treats. Of course, the decision to undergo breast reconstruction surgery is a deeply personal one, and there is no right course of action.
What we’ve heard from our patients is that breast reconstruction can help breast cancer patients achieve a sense of wholeness and closure, so many women feel it’s an important step on their overall journey of recovery. If you’re looking for a plastic surgeon who is experienced in this procedure and in working with a team of healthcare professionals to ensure the best results possible, schedule a consultation with Dr. Bosbous today.
It’s time to begin your reconstructive journey! Contact us today.