Breast Reconstruction Surgery in San Antonio, TX

After a woman undergoes a mastectomy, she may feel dissatisfied with the appearance of her breasts. Breast reconstruction surgery can remedy this. Dr. Chan has several techniques he can perform for optimal results to give a woman back normal-looking breasts with enhanced shape and size. While the procedures differ, in all cases the surgeon will shape and position a breast mound from either a patient’s natural tissue or from an implant. The particular technique that will be chosen is based on the woman’s condition, which the plastic surgeon will thoroughly examine beforehand.

The surgical planning for a breast reconstruction typically begins at the same time as the planning for the mastectomy. Points to consider include how soon the patient will have the reconstruction and what type of reconstruction technique is best suited for the case. It will need to be decided whether implants or tissue grafts will be used, what type (if any) of nipple and areola reconstruction will be used, and what other techniques that are specific to the patient’s circumstance will need to be employed. The general goal is to help the patient regain a normal appearance of the breasts as part of the final phase of breast cancer treatment.

Surgical techniques vary and today, patients are getting more options that can match their personal preferences. It is important to find a highly specialized plastic surgeon to perform breast reconstruction and one who will work with the cancer surgeon to achieve a natural result.

Breast implants are a common method used with a reconstruction procedure. When implants are being considered, the reconstruction process is usually performed in a multi-stage treatment session. A tissue expander is placed in between the chest muscle and the skin during the mastectomy. This expander will be gradually filled with a saline solution to expand the skin and eventually replace it with an implant. Sometimes, the saline-filled expander is retained instead of an implant.

Flap procedures harvest skin and muscle tissue from donor sites and transfer it to the breast. The surgeon may choose between one of the following common techniques:

• TRAM flap involves grafting skin and muscle tissues on the lower part of the abdomen.
• DIEP and SIEA flap graft tissue from the lower part of the abdomen, but harvests only the skin and fat tissues instead of muscles.
• Latissimus Dorsi flap uses skin and muscle tissues from the upper back.
• GAP flap uses skin, fat and muscle tissues from the buttocks area.
• TUG flap harvests skin, fat and muscle tissues from the inner thighs near the buttocks area.

When a breast is surgically removed, the nipple and areola are not spared. To recreate this area, skin and muscle tissues are grafted and formed to look like a nipple, while the areola is achieved by tattooing. This is done when the breast reconstruction has fully healed.

Breast reconstruction uses general anesthesia, and the patient is often required to stay in a hospital if done simultaneously with the mastectomy. Patients who have flap surgeries sometimes stay up to 5 days for monitoring. There will be discomfort and pain within the first week, and the patient may feel disoriented with the newly formed chest. Temporary drain tubes and bandages are placed to assist in healing. It can be unnerving to go through a major body change; however, patients find it gratifying and relieving that they are able to once again look and feel normal as they start their new journey towards becoming a cancer survivor.

With breast reconstruction, a plastic surgeon will work alongside the cancer surgeon and be primarily involved and responsible as it pertains to restoring the appearance. It is a highly specialized surgery so it is critical to choose a plastic surgeon that has years of successful experiences in this type of surgery.

If a patient knows she will want to restore her breasts with a reconstruction procedure, it is recommended that this process begins at the same time as the mastectomy. During the breast removal portion, the tissue expanders can be put into place, which eliminates the need for a new surgery. This ultimately decreases the risk for complications.

Because the breast is completely removed and a new one is formed, there will be a loss of sensation. Over time, there is a possibility that this sensation can be slowly regained. This is different for every patient. While some patients regain their sensitivity, there is no guarantee that this will be the case for everyone.