The decision to have reconstructive breast surgery is a very personal one. The goal of the procedure is to help cancer survivors with mastectomies complete the healing process – especially the emotional healing process – by restoring a sense of wholeness, or a psychological and physical sense of feeling complete. Dr. Sadeghi recognizes that the experience of breast cancer and mastectomy is deeply transformative for women, and he offers several options of leading-edge microsurgical techniques to ensure each patient receives the utmost personalized care. Other options include the timing of the surgery, which can be performed at the same time of mastectomy or can be scheduled at a later date. When given the option, many women elect to have their reconstruction done simultaneously with the mastectomy. This eliminates the need for a second major operation, which would also require separate recovery times.
Your best option for breast reconstructive surgery is highly dependant upon your body and specific needs. During your complimentary consultation, Dr. Sadeghi will discuss the options that are best suited to you. For instance, one procedure includes the use of implants (see below). A more popular option is known as the perforator flap breast reconstruction (see below) in which the breasts are rebuilt using existing fatty tissue from another part of your body – usually the abdomen, thighs or buttock area.
If you choose to have breast reconstruction using implants, the process is completed in several stages. First, temporary implants referred to as tissue expanders are placed beneath your skin and chest muscle to preserve or to expand your breast skin for future permanent reconstruction. Over a period of weeks, the tissue expander is expanded by adding saline. This process can typically be done in an outpatient setting during an office visit. These injections stretch your skin and muscle to the size needed for the new breast mound (the latest advances in many of the newer skin sparing mastectomy techniques can eliminate the need for using the tissue expanders). Once the skin has stretched enough, you'll have a second procedure, where the tissue expander is switched to a permanent implant or a perforator flap (see below for more information on the perforator flap) from your own body. The implant is usually a silicone sac filled with saline solution or silicone gel. If an implant is chosen for your final reconstruction, you'll usually go home the same day the surgery is done. If a perforator flap is used, you will have a brief stay in the hospital for observation.
Perforator Flap Breast Reconstruction
Another reconstructive option to consider is having a new breast constructed using your own tissue instead of having artificial implants inserted. The tissue may come from your abdomen, buttock or thighs and consists of only fat and skin without the need to sacrifice important muscles. These leading-edge procedures are becoming the benchmark of breast reconstruction in the United States and have been performed in Europe for many years with excellent results. Over the years, the procedures have been refined to provide patients with a more natural result.
- Deep inferior epigastric perforator (DIEP) flap: This procedure allows the surgeon to only use the fat and skin from the abdominal wall in your lower abdomen for your breast reconstruction based on its deep blood supply. Abdominal muscle is left intact, to allow you to continue to use the abdominal muscles to maintain their core strength.
- Superficial inferior epigastric artery (SIEA) flap: This procedure allows the surgeon to only use the fat and skin from the abdominal wall in your lower abdomen for your breast reconstruction based on its superficial blood supply. Again abdominal muscle is left intact, to allow you to continue to use the abdominal muscles to maintain their core strength.
- Gluteal artery perforator (GAP) flap: Similar to the DIEP/SIEA flaps, this technique in reconstructive surgery does not sacrifice any donor muscles and allows the surgeon to reconstruct the breasts using the skin and fat from your buttock area.
- Transverse upper gracilis (TUG) flap: With this new procedure, the inner thigh fat and skin are used to perform breast reconstruction. The procedure is optimal for patients who have had previous surgery that precludes the use of the abdomen as a donor site.
While reconstructive patients certainly have options, not all patients are good candidates for each of the procedures listed. Contact us to schedule a complimentary visit with Dr. Sadeghi to discuss your options and find the procedure that is right for you.