Overview
Though this procedure was recently out of the
question after surgical procedures such as mastectomy, this type of
cosmetic surgery is becoming more common. Though most health plans cover
the cost for this operation in the US, some do not, considering it be
cosmetic; paying for this procedure oneself may be very costly. However,
as noted, most plans do cover this procedure as the cost may outweigh
the converse cost of counseling for the individual as they try to cope
with the emotional adjustment of losing a breast.
For individuals who have undergone a
mastectomy due to cancer, they are only eligible for this procedure if
the disease was eliminated due to the breast removal. It is possible for
this procedure to be carried out immediately following the mastectomy,
so the individual awakes with the newly formed breast already in place.
As with many other procedures, those with high blood pressure, obese
individuals or those who smoke are poor candidates for this operation.
Breast reconstruction is a large undertaking.
Most procedures take several operations. Sometimes these follow-up
surgeries are spread out over weeks or months. If an implant is used,
the individual runs the same risks and complications as those who use
them for breast augmentation.
Techniques
There are many methods for breast reconstruction.
The two most common are:
Skin expansion:
By far the most common method, the surgeon
inserts a small balloon expander beneath the skin and periodically, over
weeks or months, injects a saline solution to slowly expand the
overlaying skin. Once the expander has reached an acceptable size, it
may be removed and replaced with a more permanent implant.
Reconstruction of the areola and nipple are performed in a separate
operation after the skin has stretched to its final size.
Flap reconstruction:
The second most common procedure uses tissue
from other parts of the patient's body, such as the back, buttocks,
thigh or abdomen. This procedure may be performed by leaving the donor
tissue connected to the original site to retain its blood supply (the
veins are tunneled beneath the skin surface to the new site) or it may
be cut off and new blood supply may be connected. This procedure has the
downside of leaving scar tissue in both the donor and breast area, but,
since the donor is the recipient, tissue rejection is not an issue.
Also, the patient may end up with a better contoured abdomen if that was
the selected donor area.
External links
Breast Reconstruction Following Breast Removal
from the American Society of Plastic Surgeons
Breast Reconstruction resources
from American Society of Plastic Surgeons
