Breast Reconstruction (& Diep flap) Treatment Options and Procedures
Offered at Our Houston Office By Dr. Downey
When cancer creates the need for the breast tissue to be surgically removed, a breast reconstruction may be performed to restore the breast. Breast reconstruction is an elective procedure that can be performed at any time following the cancer operation. Increasing technology has helped ensure that even those who have suffered the loss of both of their breasts now have a chance at a happy and normal future. There are 3 main categories of Breast Reconstruction: Implants, Tissue Based Reconstruction, and a Combination of Implants & Tissue.
Implant-Based Breast Reconstruction
When implants are used, often tissue expanders are placed at the time or following mastectomy to expand the skin envelope to the desired size and shape. Expansion can be easily performed in the office setting over a period of time determined by the patient’s schedule and comfort. A second procedure is then done to replace the temporary tissue expanders with the permanent implants. Implants may be contraindicated when radiation is required for cancer therapy.
Autologous Breast Reconstruction (DIEP, SIEA, TUG, SGAP)
Autologous reconstruction involves using the patient’s own tissue to replace the breast. Tissue can be transferred from a nearby area or microsurgical techniques can be imployed to transfer greater distances. The most common local transfer is the muscle and overlying skin of the latissimus dorsi. Many times this flap is used in combination with an implant (i.e. if radiation has precluded use of implant alone).
Free Tissue transfer and microsurgery can be used for transfer of excess abdominal tissue (diep inferior epigastric perforator flap –DIEP or superficial inferior epigastric perforator flap –SIEA), inner thigh (transverse upper gracilis flap – TUG) or buttock tissue (superior gluteal artery perforator flap – SGAP). Of these, the most common site is the lower abdomen, as patients tend to have more tissue in this area. For those that do not have enough abdominal tissue, buttock or inner thigh can be substituted for modest sized breast.
DIEP Flap Breast Reconstruction:
Who Qualifies for Breast Reconstruction Surgery?
Women who have had a Mastectomy, and some who are planning to or have undergone breast conservation therapy with lumpectomy may be candidates for reconstruction. Breast reconstruction can be performed immediately following the cancer operation or may be delayed for patient preference or advanced disease. It is never too late to decide on breast reconstruction and may still be an option for women in their 70’s. Autologous free flap reconstruction tends to be lengthy and patients must be optimized for longer times under anesthesia. Smoking may have detrimental effects on healing for these elective procedures.
Are There Any Risks to Having Breast Reconstruction?
Breast reconstruction is a major surgery, and all major surgeries have risks. Aside from the possibility of having a reaction to the anesthesia, there is also the chance of internal bleeding, poor wound healing, scarring, infection and even loss of the reconstruction. After having cancer, breast reconstruction can bring many women a new sense of hope about the future, and for this reason, the option of surgery may be worth the risks.
What is the Best Way to Choose a Surgeon?
It’s always best to speak with an experienced plastic surgeon trained extensively in breast reconstruction. Dr. Cara Downey will be able to guide you to a plan that is right for you taking into consideration your aesthetic desires, extent of disease and cancer treatments and body habits.
To get started with Breast Reconstruction, call our Houston office at (713) 496-2427, or Email Us.