Choosing a Surgeon | Choosing an Implant | Choosing the Surgical Incision Site | Choosing the Type of Implant Placement | General Description of Breast Implant Surgery | After the Surgery | Choices in Reconstructive Procedures | Breast Reconstruction with Breast Implants | Immediate reconstruction is one-stage or two-stage reconstruction | Breast Reconstruction with Tissue Flaps | Questions to Ask Your Surgeon about Breast Augmentation | Questions to Ask Your Surgeon about Breast Reconstruction
Breast Implant Surgery
Breast Reconstruction with Tissue Flaps
The breast can be reconstructed by surgically moving a section of skin, fat, muscle, and blood vessels from one area of your body to another. The tissue may be taken from such areas as your lower abdominal area, upper back, or buttocks.
The most common types of tissue flaps are:
- the TRAM (transverse rectus abdominus musculocutaneous) flap that uses tissue from the lower abdominal area
- the Latissimus Dorsi flap that uses tissue from the upper back.
Flap surgery has the advantage of using your own tissue to construct a new breast. However, it is important for you to be aware that flap surgery, particularly TRAM flap surgery, is a major operation and more extensive than your mastectomy operation or breast implant surgery. It requires good general health and strong emotional motivation. If you are very overweight, smoke cigarettes, have had previous surgery at the flap site, or have any circulatory problems, you may not be a good candidate for a tissue flap procedure. Also, if you are very thin, you may not have enough tissue at the flap site to construct a breast mound.
Tissue flaps, in general, can be moved to the reconstruction site by one of two methods. The first method is when the flap is left attached to the muscle and blood vessels and tunneled under the skin to the reconstruction site. The second method is when the flap is completely removed and then transferred to the reconstruction site and reattached by microsurgery. More specifically, the TRAM flap can be done by either of these two methods while the Latissimus Dorsi flap procedure involves only the first method. In addition, for TRAM flap surgery, your surgeon may also need to build you a new belly button after the lower abdominal area is reshaped.
Flap surgery requires a hospital stay of several days and generally a longer recovery time than breast implant reconstruction. While you can resume normal daily activity after several weeks, some women report that it takes up to one year to resume a normal lifestyle.
Flap surgery also creates scars at the site where the flap was taken and possibly additional scars on the reconstructed breast. You may also have some temporary or permanent decreased muscle strength at the flap site.
As a special note regarding the TRAM flap procedure, if you are considering pregnancy after your reconstruction, you should discuss with your surgeon how this procedure may affect your abdominal muscle strength. In addition, although abdominal tissue feels like breast tissue to the touch, the nerves are cut during the surgery, so there may be little feeling or sensitivity in your breast. Also, you should know that a surgeon can take tissue from your abdomen only once. If you later need a mastectomy of your second breast and want to have a tissue flap procedure, then the tissue will have to come from another site, such as your back.
Choosing a Surgeon | Choosing an Implant | Choosing the Surgical Incision Site | Choosing the Type of Implant Placement | General Description of Breast Implant Surgery | After the Surgery | Choices in Reconstructive Procedures | Breast Reconstruction with Breast Implants | Immediate reconstruction is one-stage or two-stage reconstruction | Breast Reconstruction with Tissue Flaps | Questions to Ask Your Surgeon about Breast Augmentation | Questions to Ask Your Surgeon about Breast Reconstruction
FDA Breast Implant Consumer Handbook - 2004
U. S. Food and Drug Administration
http://www.fda.gov/cdrh/breastimplants/handbook2004/glossary.html
