The Many Types of Breast Reconstruction

New and established options for implants and flap procedures

Today more than ever, women have a choice as to what they can do regarding breast reconstruction. The two main procedures – implants and tissue flap procedures – offer a variety of options.

Patients in need of breast reconstruction may be overwhelmed by the number of choices. Fortunately, plastic surgeons are prepared to guide patients toward a technique that meets their expectations.

Implants

Implants are filled with either a saline solution (most common) or silicone gel. Depending upon the situation, one-stage immediate breast reconstruction may be performed the same time as mastectomy.

Here, the implant may be put in the space where breast tissue was removed or behind the chest muscles. Or, more commonly, the implant may be done via two-stage or delayed reconstruction where the surgeon implants a tissue expander.

A salt water solution is injected to fill the expander over time, usually 4-6 months. Once the skin over the breast area is stretched, the expander may be removed and replaced with an implant or may even be left in place as the final implant. The FDA also recently approved “Gummy bear” implants, made with a highly cohesive silicone gel.

Tissue Flap Procedures

The two most common types of tissue flap procedures are the TRAM (transverse rectus abdominis muscle) flap, which takes tissue from the abdomen and the latissimus dorsi flap, which uses tissue from the upper back.

These operations require two surgical sites and leave scars where the tissue was taken and on the reconstructed breast. The newer DIEP (deep inferior epigastric artery perforator) flap procedure uses fat and skin from the belly and also the muscle to form the breast mound. This results is a “two-fer” that provides a tummy tuck in addition to breast reconstruction.

Photo by merrick310 on Flickr