If you choose to have a breast reconstruction following breast cancer surgery, you and your breast surgeon will discuss some of the different types of reconstructive breast surgeries we offer at Wake Forest Baptist Health. First, you must decide on when the breast reconstructive surgery will occur. Options for breast reconstruction include:
- Simultaneous. This is a good option for women who do not need radiation to treat their breast cancer. Immediately after the removal of the tumor, your plastic surgeon will reconstruct your breast. Many women find this a reassuring option.
- Staged. If you do need to have radiation treatment, your breast surgeon and plastic surgeon will probably recommend this option. During a staged breast reconstruction, your doctor will insert a tissue expander under any skin that was spared. This tissue expander prevents the skin from shrinking, and gives your plastic surgeon more natural tissue to use during breast reconstruction.
- Delayed breast reconstruction. For some women, the idea of more surgery to improve their cosmetic appearance is overwhelming during breast cancer treatment. It may also be recommended for women who will need both chemotherapy and radiation. Delayed reconstruction is an option you should discuss with your breast surgeon, as well as your plastic surgeon.
Types of Reconstructive Breast Surgeries
Reconstructive breast surgeries are complex surgeries that require the expertise of breast surgeons and plastic surgeons that specialize in breast cancer surgeries. At Wake Forest Baptist, our plastic surgeons have performed hundreds of these procedures. They include:
- Tissue expanders. Inflatable breast implants. After your reconstructive breast surgery, your surgeon will insert the expander to preserve your natural skin. By controlling the size of the implant, your surgeons can be sure the skin is stretched and healthy enough to perform a breast reconstructive surgery.
- Implants. Breast implants are a good option for many women. The implants are typically filled with saline, with a harder silicon external shell, and are inserted once breast cancer treatment is completed. In the case of simultaneous reconstruction, they can be inserted immediately following reconstructive breast surgery. Read an article from our health library about breast reconstruction with implants.
- AlloDerm Slings. Your breast surgeon may recommend the use of the AlloDerm sling, if you choose to have simultaneous breast reconstruction. Immediately following the mastectomy, your plastic surgeon can use your own skin, as well as a collagen sheet, called AlloDerm. The addition of the AlloDerm supports the implant, and relieves your natural skin of the additional weight while healing takes place.
FLAP Surgeries: Breast Reconstruction Surgery Performed Using Your Own Skin
There is a category of reconstructive breast surgeries known as autologous tissue reconstructions. These are breast reconstructions performed using your own skin. Also known as FLAP surgeries, because they use flaps of natural skin and the patient’s own fat to reconstruct the most natural look and feel of the breast.
The skin flaps preserve the natural blood supply, fat, nerves and skin. Because your own natural skin is used, you should be able to have natural sensations in your breast, once the reconstructive breast surgery has healed.
Our breast and plastic surgeons perform the following flap surgeries:
- DIEP Flaps. During this reconstructive breast surgery, your plastic surgeon will take fat and skin from your belly and use it to fill your breast(s). This results in a more natural feel.
- SGAP Flaps. During an SGAP flap, your plastic surgeon will take fat and skin from your buttocks, and use that fat and skin to reshape and fill your breast(s).
- TRAM. The TRAM flap uses the patients’ own skin, fat, nerves and muscles, but never disconnects the skin from the abdomen. Instead, the flap is tunneled through the abdomen and used to reconstruct the breast. In some cases, your surgeon will use the flap to create a natural skin cover for the implant.