BREAST RECONSTRUCTION is a surgical procedure performed often by plastic surgeons to reconstruct a breast which has been lost due to cancer or prophylactic ( preventative ) mastectomy to avoid cancer risk. 

     There are a number of options available to the mastectomy patient including utilizing implants, latissimus dorsi back flap or transverse rectus abdominis myocutaneous flap ( TRAM Flap) 

     Reconstruction with implants is the most common method and is normally done by first placing a tissue expander immediately following a mastectomy.  It allows expansion of the skin in the area where the breast was removed, to the size and shape necessary to reconstruct a normal appearing breast.  When the skin has been expanded sufficiently to accommodate the desired size implant, the tissue expander is removed and a permanent implant is placed into the pocket created by the tissue expander.  Expansion of the skin may take several weeks or months, depending on the patient's tolerance for the process.  Incisions to place the implants are made to keep scars as inconspicuous as possible.  The method of inserting and positioning the breast implants will depend on your preferences, your anatomy and Dr. Brantner’s recommendation.

     Breast implants that contain silicone gel have been restricted by the United States Food and Drug Administration (FDA) since February 1992 to women who are participating in approved study programs.  The FDA continues to review the safety of silicone implants, and use of silicone implants is subject to device tracking according to federal law.  However, this restriction has recently been relaxed, and women receiving silicone implants are no longer required to participate in a follow-up study, although it is encouraged.  Silicone and saline breast implants are widely available for both breast augmentation and reconstruction.  There is no current government study or restriction on the use of saline.

     Patients undergoing breast reconstruction utilizing a breast implant must consider the possibility of future revisionary surgery.  Breast implants cannot be expected to last forever.    

     A LATISSIMUS FLAP is a surgical procedure to remove skin and a large portion of the latissimus muscle from the back to reconstruct the breast.   Plastic surgeons use a variety of techniques for Latissimus Flap reconstruction, and the care following surgery.  It is possible to have a latissimus flap reconstruction and also have an implant placed for size, shape and/or symmetry.  When an implant is placed with a latissimus procedure, it can usually be placed at the same time, without utilizing a tissue expander.

     The TRAM FLAP ( transverse rectus abdominis myocutaneous flap )  is a surgical procedure done to remove excess skin, fatty tissue and muscle from the middle and lower abdomen to reconstruct the breast.   Plastic surgeons use a variety of techniques for Tram Flap reconstruction, and the care following surgery.   While many patients think they would like this procedure because it also allows the option of a "tummy tuck" at the same time, it also carries the most risk of possible complications following surgery.  Risk is common to every surgical procedure, however, and if you and Dr. Brantner feel you are a good candidate for this procedure, it could be the best option for you. 

     If you have more questions about breast reconstruction options, we suggest you click on the link below, which will take you to the website of the American Society of Plastic Surgeons.  They will have the greatest amount and the most up-to-date information available to help educate you about breast reconstruction options.  If you have questions specifically about breast implants, another website you might find helpful is www.breastimplantanswers.com (If clicking on this web address does not take you to the site, you can copy and paste this address into your web browser)  Allergan is a manufacturer of breast implants, and they maintain this site provides answers to many frequently asked questions. 

Associated URL: http://plasticsurgery.org