Breast Procedures
Breast Reconstruction in Freehold, New Jersey | Red Bank
Information on breast reconstruction in Freehold, NJ - Red Bank with plastic surgeon Chang Soo Kim. Read about the surgery itself, tissue expanders, surgical techniques and more.
Breast reconstruction offers much hope for a woman losing her breast to cancer. Reconstruction can often be performed immediately after the mastectomy, so the woman does not have to live with one breast. Depending on health conditions, however, a mastectomy patient may have to wait before undergoing reconstructive surgery. In either case, reconstructive surgery holds much promise that the post-operative breast can match the natural breast again.
A tissue expander is inserted following the mastectomy to prepare for reconstruction.
The expander is gradually filled with saline through an integrated or separate tube to stretch the skin enough to accept an implant beneath the chest muscle.
After surgery, the breast mound is restored. Scars are permanent, but will fade with time. The nipple and areola are reconstructed at a later date.
The Surgery
When reconstructive surgery is performed immediately following mastectomy, a breast mound is created in place of the breast that has been removed. This is done in the hospital under general anesthesia. Dr. Kim will work with your oncologist to ensure the best possible conditions for reconstruction.
With flap surgery, tissue is taken from the back and tunneled to the front of the chest wall to support the reconstructed breast.
Breast reconstruction usually involves more than one operation, and follow up procedures may be performed on an outpatient basis. Follow-up procedures may only require local anesthesia. Sometimes surgery is performed on the natural breast to match the reconstructed breast.
Once the breast mound is removed, Dr. Kim may follow up with a skin expander and breast implant or flap reconstruction.
Skin Expander with Breast Implant
This is the simplest of breast reconstructions. In this procedure, a tissue expander is placed under the skin. Once sutures are removed, saline is added weekly to the expander. This stretches the skin as it expands.
The transported tissue forms a flap for a breast implant, or it may provide enough bulk to form the breast mound without an implant.
When the skin has been sufficiently stretched, the tissue expander is removed and replaced by a permanent breast implant in a two-stage procedure. Nipple reconstruction, if desired, is a separate procedure.
Advantages: Simplest surgery and shortest recovery from surgery. This is the favored procedure for persons who have heath problems or contraindications to extensive surgery.
Disadvantages: Multiple trips to the office over several weeks or months to undergo expansion. Capsule formation or poor cosmesis due to thin skin.
Latissimus Dorsi Myocutaneous Flap
This surgery involves moving the latissimus dorsi muscle and overlying skin from the back to the chest to create a new breast mound. The incision is usually made along the bra line so the scar will be concealed.
Tissue may be taken from the abdomen and tunneled to the breast or surgically transplanted to a new breast mound.
A breast implant can be placed under the flap if necessary to balance a difference in size. Nipple reconstruction is done later.
Advantages: This is a very reliable procedure, which provides a good environment for an implant. The chances of capsule formation around the implant are reduced.
Disadvantages: Scar across the back. There may be decreased strength in the back due to muscle loss. Capsule formation may occur and result in the need for additional surgery.
Rectus Abdominus Myocutaneous Flap (TRAM)
This is the most complicated and the longest reconstructive procedure, involving about 4 hours of surgery. One of the rectus abdominus muscles is tunneled along with the overlying skin up to the chest. The breast mound is created to match the opposite site.
After surgery, the breast mound, nipple, and areola are restored.
Breast implants are not usually required. The tissue is generally adequate to match the size of the opposing breast. If the opposite breast is large or pendulous it can be decreased in size by a breast reduction. A synthetic mesh is placed over the area where the muscle is moved. This strengthens the abdominal wall and minimizes the chance of herniation. Nipple reconstruction is done as a second procedure. Some contouring of the new breast mound may be necessary at the same time.
Advantages: This provides the most natural looking breast reconstruction with the added benefit of a “tummy tuck”. No implant is needed so capsule formation is not a risk. The scar is easily hidden with clothing.
Disadvantages: There is a risk of herniation of the bowel resulting from moving the rectus abdominus muscle. Abdominal strength may be diminished. This is the longest procedure.
Nipple Reconstruction
Scars at the breast, nipple, and abdomen will fade substantially with time, but may never disappear entirely.
The reconstruction of a nipple adds a very pleasing final touch to the breast. This is a simple outpatient procedure that may be done with local anesthesia. An average time for this is about 1 hour. The goal of the surgery is to create a nipple that has the appearance of the nipple of the opposite breast. Skin is taken from the surrounding skin. These areas tend to have a darker pigment, which will provide a better contrast to the breast tissue. As a second procedure the healed nipple can be tattooed to improve the color match of the opposite breast.
Reconstruction of the breast following mastectomy is a very rewarding procedure to both the patient and the surgeon. Many women describe a feeling of once again being whole. There are many materials available regarding breast reconstruction. There are support groups available where one can meet women who have gone through these procedures. Ask us for references, books and support groups in your area. Take advantage of these invaluable resources.
Information on breast reconstruction in Freehold, NJ - Red Bank with plastic surgeon Chang Soo Kim. Read about the surgery itself, tissue expanders, surgical techniques and more.
