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Any diagnosis of cancer is overwhelming - there
are tremendous implications for one's health, family,
and quality of life. But when women hear they
have breast cancer and that they will lose one or both
of their breasts, the emotional toll is extreme. In
addition to worries about health and family are added
concerns about how you will look and feel, and how
others will react to you. Because many women identify
their femininity with their breasts, the idea of losing
one or both breasts may make you feel like less of
a woman.
Breast reconstruction surgery can help you begin putting
the ramifications of breast cancer behind you and get
on with your life. Breast reconstruction surgery can
be very rewarding, whether it is done immediately at
the time of the mastectomy or months or even years
afterwards.
Breast Reconstruction Surgery. All
of the surgical procedures for breast reconstruction
have advantages and disadvantages. When discussing
your options with you, Dr Markus will consider variables
such as anatomy, weight, other medical conditions,
previous cancer therapy and desired results.
Skin expansion with a breast implant. This
most common breast reconstruction method involves inserting
a balloon expander beneath the skin and chest muscle
after the mastectomy. Over the course of several weeks,
Dr. Markus will gradually fill the balloon by injecting
a salt-water (saline) solution through a tiny valve
buried beneath the skin. The balloon causes the skin
to stretch, and when there is sufficient room the expander
will be replaced by a more permanent saline-filled
implant. Some expander balloons are designed to be
left in place as the permanent implant. During a future
procedure, Dr. Markus will reconstruct the nipple and
areola. In some rare cases, the skin-expansion process
can be skipped if there is enough skin available.
Flap reconstruction. There are two
basic methods of breast reconstruction surgery using
a “flap” of the patient's own skin, fat and muscle
to recreate the breast mound. The first method takes
tissue from the back or abdomen, and while still connected
to its original blood supply, this tissue is tunneled
beneath the skin to the front chest wall. Sometimes
the tissue has enough mass to create the breast mound
by itself; other women will require the additional
insertion of an implant.
The other more complex method involves removing tissue
from the abdomen, back, thighs or buttocks, moving
it to the chest, and microsurgically reconnecting the
blood vessels to existing vessels in the chest region.
Although more involved than other procedures, many
women prefer flap reconstruction because it uses a
woman's natural tissue in the rebuilding process and
it is completed during the initial operation. Although
recovery from a flap reconstruction procedure will
likely take longer and there are additional scars,
it doesn't require weekly office visits to add solution
for tissue expansion nor a second procedure to replace
the expander with a permanent implant.
Follow-up procedures. The initial
procedures create a breast mound; the next steps will
be reconstruction of the nipple and areola and, if
necessary, additional surgery to the opposite breast
to improve symmetry.
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