Breast reconstruction offers hope for a woman losing her breast to cancer. Reconstruction can often be performed at the same time as the mastectomy, beginning the process of restoration and healing. Depending on health conditions, however, a mastectomy patient may have to wait before undergoing reconstructive surgery. Whether Breast Reconstruction is done immediately or on a delayed basis, this surgery holds much promise that the post-operative breast can match the natural breast again.
When reconstructive surgery is performed simultaneously with the mastectomy, it is a two-stage approach, inserting a tissue expander at the first operation, followed months later by replacement of the expander with a permanent breast implant, or the use of your own tissues to reconstruct the breast mound in one stage. In the first stage, a tissue expander is placed under the skin and muscles of the chest wall at the same time as the mastectomy procedure (immediate reconstruction). In other circumstances, the expander is placed many months or years after the mastectomy procedure (delayed reconstruction). After healing of the incisions, saline is added on a weekly basis to the expander. As the expander inflates, the skin envelope is gradually stretched and enlarged.
When the skin has been sufficiently stretched, the tissue expander is removed, and is replaced by a permanent breast implant in the second stage procedure.
Nipple reconstruction is the final step of breast reconstruction. This is an outpatient procedure that may be done with local anesthesia. The goal of the surgery is to create a nipple that has the appearance of the nipple of the opposite breast. To reconstruct the nipple, a local flap of skin is usually taken from the breast flap. To reconstruct the areola, skin may be taken from the inner part of the upper thigh or from behind the ear. These areas tend to have a darker pigment, which will provide a better contrast to the breast tissue. As a second procedure, the healed nipple can be tattooed to improve the color match of the opposite breast.
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