What are the different types of breast reconstruction?
There are 2 main types of breast reconstruction that help rebuild the shape of your breast:
breast implants and tissue flaps (reconstruction that uses your own tissue).
Sometimes surgeons use both of these together for breast reconstruction. After implant or flap surgery, drains are inserted into your breast area or armpit to collect fluid build up (seromas). The drain can be removed when your body can absorb fluid on its own. You may have drains for up to three weeks. Your surgeon will tell you when the drains can be taken out.
Breast implant reconstruction
A breast implant is inserted under the skin or under the chest muscle during surgery. Implants are made of a silicone (a flexible, rubbery substance) outer shell and filled with either:
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Silicone gel - a type of silicone that is a thick fluid. Silicone implants may feel more like a breast compared to saline implants.
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Saline - a saltwater solution. Saline can be used to fill a breast implant.
For most people, the implant process takes more than 1 step:
1.
Your surgeon inserts a tissue expander under your skin or chest muscle, in the spot where the implant will go. A tissue expander is a balloon-like device that will stretch your skin and/or muscles to make room for your breast implant.
Some people may not need
a tissue expander.
2.
Over time, your surgeon will fill the tissue expander with saline (salt water) or air to stretch the skin and/or muscles gradually.
3.
Next, you will have surgery to replace the tissue expander with a breast implant.
Some people who have reconstruction at the same time as their mastectomy can have direct-to-implant reconstruction. This skips the tissue expander step, and puts in the implants right after the breast is removed. However, many people need the tissue expander because they do not have enough tissue to cover the implant.
Breast implant reconstruction
Tissue flap reconstruction
Tissue flaps use parts of your body, such as skin, muscle, and fat, to rebuild your breast shape. This tissue may come from your:
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Belly
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Back
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Thighs
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Buttocks
What are the most common tissue flap surgeries?
The most common tissue flap surgeries use tissue that comes from your belly or upper back.
Abdominal flaps
DIEP (deep inferior epigastric perforator) flap — This is when your surgeon moves fat and skin from your belly, but does not remove muscle from your belly. This surgery is less likely to weaken the muscles in your belly.
DIEP flap breast reconstruction surgery
TRAM flap breast reconstruction surgery
Latissimus dorsi flaps
This is when your surgeon moves muscle, fat, skin, and blood vessels from your upper back. It is usually combined with an implant or tissue expander because people usually have less fat and tissue on their back. This surgery may weaken the muscles in your back.
Lat flap breast reconstruction surgery
Other tissue flap surgeries use tissue from your thighs or buttocks, but not all surgeons do these.
The reconstruction options that are available to you can depend on your region, hospital, or doctor. Ask your doctor for more information about which types of surgeries they do, and which might be a good fit for you.