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July 21, 2022

Know Your Options For Breast Reconstruction

Did you know that not only does Dr. Ambay perform plastic surgery, but also breast reconstruction surgery? For those of you who aren’t familiar with this procedure, breast reconstruction consists of rebuilding a woman’s breasts after a mastectomy. Many plastic surgeons have different ways to perform this procedure. Some techniques have been around for ages while others have adapted to the new use of technological advances. In honor of Breast Cancer Awareness Month, we feel it is important that you know all your reconstruction options.

1. Implant based reconstruction

This involves using an expander. A tissue expander will be inserted either at the time of the mastectomy or at a later time (for those cases where reconstruction is decided at a later date). This expander will be filled to increase the size of the chest wall so an implant can later be placed.

2. Flap based reconstruction

This involves using tissue from other parts of your body to create a breast. There are a few different areas and ways you can take tissue from parts of your body. Some of these procedures include using your muscle as well. Below we will break down the different procedures used.

Flap Based Breast Reconstructions:

1. TRAM Flap

Also known as transverse rectus abdominis. This is a muscle located in the lower part of your stomach right above your pelvic bone. This flap reconstruction uses this muscle and surrounding skin, fat and tissue to reconstruct a breast. The blood vessels taken from the stomach are hand-stitched together to the blood vessels in the chest wall so the skin and flap can create a living, healthy breast. This procedure’s downfall is that it cuts through your muscle which can leave the stomach weak.

2. Latissimus Dorsi Flap

This is also a muscle. This muscle however, is located in your back right behind your armpit. Just like the other procedure, the muscle, surrounding skin, fat and tissue is taken from this area. The blood vessels taken from the back are hand-stitched together to the blood vessels in the chest wall. All of this is done under microsurgery and creates a breast from the woman’s back. Since this flap also takes muscle, it is usually not the first option suggested.

3. DIEP Flap

Also known as deep inferior epigastric perforator artery. This artery runs through the stomach. In this flap no muscle is taken from the body, instead just tissue, skin, fat and blood vessels are cut from the stomach. You can think of this as a standard tummy tuck procedure. After the cut is made it is all used to reconstruct the breast by hand-stitching the blood vessels to the chest wall. This is the most innovative procedure used for reconstruction today. Now you’re aware of all your options when deciding on breast reconstruction. However, there are a few other things to take note of:

  • It is possible to have a mastectomy and reconstruction performed at the same time.
  • In some cases, it is possible to have a nipple sparing mastectomy.
  • Nipple reconstruction can be performed if the nipples can’t be saved during a mastectomy.
  • It is often best to decide on your reconstruction option before getting your mastectomy if possible.

If you have any other questions or would like to schedule a consultation to go over the best treatment plan for you, please call our office at 813.406.4448.

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Dr. Raj Ambay, M.D.

Dr. Ambay is a triple board-certified plastic surgeon who specializes in cosmetic surgery of the face and body. He performs a wide range of aesthetic treatments at his Florida practice.

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