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Following a surgical procedure or breast cancer treatment, many women seek a breast reconstruction to cover over the evidence of surgery or to restore one or both breasts to a natural and healthy appearance. Whether a patient has undergone a mastectomy, lumpectomy, or seeks to correct congenital deformities, she should feel empowered and informed on the reconstruction options available to her. Breast reconstruction can include a number of surgical procedures aimed at restoring one or both breasts to near normal shape, appearance, symmetry and size. Breast reconstruction is often performed in stages or with multiple surgeries. Reconstruction can be done with local tissue rearrangement, implant-based procedures, or tissue flap surgeries. If only one breast requires reconstruction, surgeries such as a lift, a reduction, or an implant can be done to the opposite breast to improve symmetry and give the breasts an even and natural appearance.
There are a number of factors that Dr. Kim will take into consideration when deciding what type of reconstruction is appropriate for each patient’s needs. Each patient’s reconstruction needs will differ based on factors such as the type of mastectomy or breast surgery required, the status of a patient’s cancer treatments, and the patient’s overall health, age and body type. Patients should have realistic expectations; although reconstruction will likely improve the appearance of the breast, the patient may still find an altered sensation or feel to the reconstructed breast.
Types of Procedure
Breast reconstruction may be performed in a hospital inpatient or outpatient setting. Surgery time can vary widely from one to six hours, depending on the procedures required. There are a number of procedures which may be involved in the reconstruction process. Dr. Kim will discuss these options with you and choose the procedures best suited to your requirements.
Local tissue rearrangement: This is a surgical procedure in which local breast tissue and fat are moved and reshaped to fill a defect or cavity, which may have formed after a large lumpectomy or a partial mastectomy. The breast will often be smaller in size but will have a more full and restored shape. An additional reduction may be performed on the opposite breast in order to maintain symmetry.
Implant based reconstruction: Immediately after a mastectomy, breast implants may be placed under the skin to restore volume and fullness. This implant is typically wrapped and supported with a type of collagen matrix (known as acellular dermal matrix-ACDM) to help with healing. More commonly, however, implant reconstruction is performed in several stages. At the time of mastectomy, tissue expanders are wrapped in the ACDM and placed into the breast pocket. Then over a period of weeks to months, these tissue expanders are slowly enlarged with saline to stretch the tissue. Eventually, a second surgery is done to exchange these tissue expanders for more long-term saline or silicone gel implants.
Flap based reconstruction: Some women choose not to use implants for reconstruction. Other times, the mastectomy or radiation therapy does not leave enough tissue on the chest wall to cover and support a breast implant. In these cases, breast reconstruction usually requires a flap-based reconstruction. In a flap-based reconstruction, Dr. Kim will use either lower abdominal muscle skin and fat (the TRAM flap) or a muscle of the back (the Latissimus muscle flap) to construct a breast shape.
Schedule a Consultation
for a Breast Reconstruction
To schedule a private consultation with Dr. CS Kim please call the office or request an appointment online. We welcome your visit.