Breast Reconstruction - Available Procedures - Plastic Surgery Associates of Tidewater

| Contact |

How can we help your needs?

Breast Reconstruction

One out of every nine women will be diagnosed with breast cancer during her lifetime. When this dreaded disease strikes the world seems to be instantly turned upside down. The removal of part or all of the affected breast may be necessary to treat the cancer.

When a lumpectomy or a mastectomy is required women no longer need to live in fear of being disfigured like these patients.

Neither does a woman have to fight the inconvenience, discomfort and embarrassment of wearing a "falsie" that must be held on to the chest using a robust brassiere.

The physicians at Plastic Surgery Associates of Tidewater specialize in breast reconstruction with natural tissue. By using the latest microsurgical Perforator Flap technique we are able to rebuild a breast that looks and feels normal in clothing, even swim wear and lingerie. The Perforator Flap uses a woman's own tissue without disturbing the abdominal muscles and avoids many complications associated with other methods of breast reconstruction.

More good news for women - Breast Reconstruction is covered by all insurance companies - it's the law. Thanks to Federal and State statutes a woman no longer has to worry whether or not her surgery to restore the breast will be covered by her insurance company.

Making the Decision:

Breast reconstruction is an important part of the managing breast cancer. When the diagnosis of malignancy is made a woman has numerous decisions to make. This is a difficult time - we understand. With the guidance of the general surgeon and oncologist plans are made for surgical removal of the cancer, and subsequent radiation or chemotherapy. Consultation at this time with your physician from Plastic Surgery Associates of Tidewater is essential to help you decide on immediate or delayed breast reconstruction.

There are obvious advantages to having the breast reconstruction performed at the same time as the mastectomy. After surgery the patient does not experience the loss of the breast - she recovers from her operation feeling whole. Immediate reconstruction also reduces the total number of surgeries and hospitalizations a patient will have. While we recommend this approach some women may prefer to have reconstruction after all therapy is completed. Some women have had a mastectomy years ago and only now feel comfortable availing themselves of the latest techniques in breast reconstruction. In effect, there is no wrong time to have breast reconstruction. The choice is up to each individual patient.

The Deep Inferior Epigastric Perforator (DIEP) Flap:

Plastic Surgery Associates of Tidewater is a leader in this community offering women the most advanced techniques in breast reconstruction. With the Deep Inferior Epigastric Perforator (DIEP) Flap a woman faced with losing one or both breasts to cancer can have realistic expectations for her reconstructed breast to look natural in almost all types of clothing - including swimsuits and lingerie.

New advances in plastic surgery provide the benefits of reconstructing the breast using similar tissue from the lower abdomen without sacrificing the underlying rectus muscle function, as it is done in the TRAM flap. The DIEP flap helps avoid abdominal hernias and muscle weakness that make sitting from a laying down position difficult. With this technique there is less pain after surgery and patients get back to a normal life quicker.

This illustration depicts the lower abdominal donor area and blood vessels that travel through the muscle to supply the skin and fat. The DIEP flap technique spares the muscle while using these vessels to keep the flap alive. In the middle we see the initial result with the tissue transferred to the chest wall and the blood supply re-established by microsurgery . The lower abdominal scar is typical of those seen in cosmetic tummy tucks. The final result usually requires other minor, outpatient procedures to create a new nipple and sometimes to lift, reduce, or enlarge the opposite breast for symmetry .

The Gluteal Artery Perforator (GAP) Flap

When the lower abdomen cannot be used as a donor area for breast
reconstruction we recommend turning to the buttock (gluteal) area. The gluteus muscle extends and rotates the thigh and is therefore an important muscles in running and jumping. Once again the concept of sparing the muscle is employed. The perforator technique allow us to take the skin and fat of the buttock to reconstruct the breast without injuring the muscle.

The illustration shows the outline of the flap to be taken from the buttock for
reconstruction of the left breast. The muscle is spared and the tissue transferred by microsurgical technique. The final result may again require outpatient surgery to reconstruct the nipple or to make adjustments for symmetry.

Examples