Breast Reconstruction: Implant and Tissue Flap Options

Breast reconstruction is not something many people think about until it is forced upon them. Recently a friend of mine was diagnosed with two forms of Breast Cancer. One form was relatively harmless and would have more than likely remained in one place and would never have caused any problems. However, the other form if not removed, would not only have spread to the non-effected breast but would have also spread through her body, ravaging her healthy tissue and organs. She is thirty-five. Breast reconstruction never crossed her mind until her diagnosis.

Breast reconstruction is an option available after Breast Cancer surgery. The sole purpose for breast reconstruction is to make the body symmetrical after a mastectomy or lumpectomy. For those choosing a double mastectomy, breast reconstruction gives the feminine look back to their body. Or as my friend put it, it keeps her from looking like a twelve year-old boy. There are many options available for breast reconstruction, including implants and tissue flap transplanting.

Silicone Implants

Silicone Implants are the most controversial topic patients will hear about during their breast reconstruction. After being banned by the FDA to the general public in 1992, they were once again approved for use by the FDA in 2006. The approval of the FDA was based on clinical studies of the implant manufactures. The silicone implant is often the choice for mastectomy patients because it is said to feel and look more like a natural breast. This video clip shows the durability of the new silicone implants that are used in breast reconstruction surgeries.

Saline Implants

Saline Implants are the most widely used implants in breast reconstruction surgery. The saline implants have a silicone rubber shell with an attached valve for inflation during surgery. Inflation during surgery gives the surgeon the ability to adjust the symmetry as needed. Saline implants are considered a safer implant because the body will absorb the sterile solution into the body.

TRAM Flap

Breast reconstruction using the muscle, fat, blood vessels, and skin from the lower abdomen is called the TRAM Flap. The TRAM Flap option may not be available to women who have had other abdominal surgeries due to the abdomen already being weakened by the previous surgeries. There are 2 types of TRAM Flap procedures. The pedicle flap is tunneled under the skin leaving the blood vessels connected to the original area. The free flap is completely removed from the abdominal area. When it is reattached to the breast area, micro surgery is necessary to connect the blood vessels. The Tram Flap is a more evasive surgery and will have a longer recovery period than implants.

Dorsi Flap

Blood vessels, fat, skin, and muscle is taken from the lower back area when using the Dorsi Flap procedure in breast reconstruction surgery. The Dorsi Flap is tunneled under the skin, leaving the blood vessels attached to their original blood supply. Breast reconstruction using the Dorsi Flap may cause weakness in the back, arm, or shoulder after the procedure.

DIEP Flap

The DIEP Flap is a newer procedure that is similar to the TRAM Flap. The abdomen muscle remains intact for the DIEP Flap. Only the skin, blood vessels, and fat are removed from the abdomen to create the new breast. This surgery takes longer than the TRAM Flap but may be an option to women who have had previous abdominal surgeries.

Gluteal Free Flap

The Gluteal Free Flap takes Skin, tissue, blood vessels, and skin from the buttocks. This breast reconstruction flap surgery is done by cutting the tissue and blood vessels away from the body and reattaching it to the breast area using microsurgery. The Gluteal Free Flap is often an option for women that are unable to have the TRAM Flap procedure due to previous surgeries.

There are many things to take into consideration before deciding which procedure is right for you. Be sure to ask your surgeon what options he thinks are best for your situation. Ask him to explain why certain procedures may be better than others and don't be afraid to ask about a procedure he did not mention if you think it right be right for you.