Types of Breast Reconstruction
There are generally two types of breast reconstruction that Dr. Ali Mosharrafa and Dr. Tamir Mosharrafa perform. You will discuss the right option for you during a consultation.
Implant-Based Breast Reconstruction
The first phase of this technique typically involves placing a tissue expander into the breast. Tissue expanders are temporary, adjustable volume implants that are used to create a new breast mound. Saline solution is gradually inserted into the expander over time to achieve the desired result. Dr. Ali Mosharrafa and Dr. Tamir Mosharrafa generally perform these expansions in 1-2-week intervals, and multiple expansions are usually required to achieve the desired outcome. The use of tissue expanders allows you to have greater input regarding the final breast size.
At the end of the expansion phase, Dr. Ali Mosharrafa and Dr. Tamir Mosharrafa will replace the tissue expander with a breast implant. In most instances, this will occur approximately 3 months after your mastectomy and initial placement of the expander. However, if chemotherapy is necessary, Dr. Ali Mosharrafa
and Dr. Tamir Mosharrafa will generally wait to replace the expander with an implant until at least one month after the completion of your chemotherapy treatments. If radiation therapy is required, you may need to wait up to 6 months before beginning the implant phase of your procedure.
In some instances, Dr. Ali Mosharrafa and Dr. Tamir Mosharrafa may recommend performing breast augmentation or a breast lift on the other breast during the implant phase of reconstruction. This often helps improve breast symmetry, creating a more complete outcome.
If the nipple was removed during your mastectomy, Dr. Ali Mosharrafa and Dr. Tamir Mosharrafa will perform nipple reconstruction about two months after your implant is inserted. In most cases, tissue from the chest wall will be used to create the new nipple and areola. Once you have healed following the nipple reconstruction procedure, you can have medical tattooing performed to conceal the scars and achieve a more natural-looking appearance.
Flap-Based Breast Reconstruction
Flap-based breast reconstruction is a more extensive procedure and will result in the creation of a scar in the donor site as well as in the breast region. However, the final result typically looks and feels more natural than implant-based reconstruction procedures.
During a flap-based reconstruction procedure, Dr. Ali Mosharrafa and Dr. Tamir Mosharrafa will remove tissue from the donor site and use it to rebuild your breast mound. As a result, the procedure is more permanent than an implant-based reconstruction and will require less maintenance down the road.
There are several different techniques that can be used for flap-based breast reconstruction:
- Muscle-sparing microvascular free TRAM flap: This spares more muscle than the traditional TRAM flap technique.
- Traditional TRAM flap: This technique requires the tunneling of fat, skin, and muscle from the abdominal wall in order to rebuild the breast.
All these techniques achieve beautiful results, and the right option for you will depend on your unique individual needs. During your consultation, Dr. Ali Mosharrafa and Dr. Tamir Mosharrafa will discuss these options with you in detail before making individualized recommendations for your treatment plan.
Combination Procedure
In some instances, flap-based reconstruction can be performed in conjunction with implant-based reconstruction to provide more durable, long-lasting results than can be achieved with an implant alone. Dr. Ali Mosharrafa and Dr. Tamir Mosharrafa will use fat, skin, and muscle from the back to cover the breast implant. This tissue provides additional support for the breast implant while also providing a more natural-looking and -feeling appearance.
Whenever possible, Dr. Ali Mosharrafa and Dr. Tamir Mosharrafa will place the incision on the back in a location that will conceal the scar beneath the bra line. The positioning of this scar is usually discrete enough to be concealed when you wear lower-cut clothing.
This procedure is more involved than an implant-based reconstruction and will add some time to your hospital stay and recovery period. In most cases, you should be able to resume normal activities within 4-6 weeks.
Am I a Breast Reconstruction Candidate?
Breast reconstruction may be an option for any woman who has undergone surgical treatment for breast cancer, including:
Ideal breast reconstruction candidates:
- Mastectomy
- Double mastectomy
- Lumpectomy and radiation
It is also an option for women who have had prophylactic mastectomies due to their family history or positive genetic testing. It is best to work closely with both your reconstructive surgeon and oncologist to determine your best options.