A diagnosis of breast cancer can be difficult to accept. Fortunately, there are a wide range of breast reconstruction surgery options to improve self-image, self-confidence, and quality of life after a mastectomy. While implant reconstruction is currently the most popular type of reconstruction, it is not always an option and may not be desirable for all women.
Many women choose to use their own tissue for breast reconstruction. Many patients also like the added benefit of the “tummy tuck” effect on their abdomen in addition to the more natural reconstruction. Historically, the lower abdomen has been transferred along with abdominal muscles as a TRAM flap. This is still an acceptable option today and is performed by many plastic surgeons that do not perform microsurgery. I believe a better option is the DIEP flap which utilizes the same often undesirable lower abdominal skin and fat, but spares the muscle. During DIEP flap breast reconstruction specifically, the DIEP (deep inferior epigastric perforator) blood vessels connected to skin and fat are carefully freed from the patients’ core rectus muscle which stays where it belongs rather than just including it for expediency sake as in the TRAM flap. When you opt for the DIEP flap procedure, only skin and fat are removed. No abdominal muscles are sacrificed.
Because no muscle is removed with the DIEP procedure, patients often experience less post-operative pain and a faster recovery compared to a conventional TRAM flap. Also, the TRAM flap technique disturbs the crease under the breast often with a visible lump where the sacrificed muscle is tunneled up from below. The biggest drawback, in my opinion, to the TRAM reconstruction is the unacceptably high hernia rates in bilateral reconstruction where both rectus core muscles are sacrificed.
It’s important to know that if you do not want to decide on the type of reconstruction while still reeling from the diagnosis, our recommendation would be for a tissue expander to be placed to act as a spacer until thoughts and information can be gathered so that you can make your best choice when you are ready. This has little or no effect on your hospitalization or recovery. Also it is important to know that these options remain available indefinitely should you initially forego reconstruction. As with any plastic surgery procedure, breast reconstruction should be done for you, not to meet another person’s expectations or ideals. —Dr. B
At BangorPlastic and Hand Surgery, we know the decision to have plastic surgery is extremely personal and every patient’s goals are unique. Our board certified plastic surgeon and qualified staff strive to provide you excellent patient care, comfort, and state of the art services in a warm, friendly environment that includes a private, AAAASF accredited, cosmetic only operating room.
To pursue the benefits of cosmetic or reconstructive surgery and explore new options regarding appearance and rejuvenation, visit our website www.bangorplastic.com or call 207-947-5657 or toll free 1-888-501-1855 to schedule a consultation. Look better, feel better, live better.