There has been amazing advancements in medical techniques and devices that allow surgeons to remove cancer or other diseases from a breast and create a new one that matches a natural breast in form and appearance.
Breast reconstruction surgery in Portland lets patients wake up with a breast already in place after a breast removal (mastectomy) so she does not have the unpleasant experience of seeing herself without a breast.
There is a period of emotional adjustment in dealing with the reconstruction of a breast. It is a sensitive part of your body, both physically and self-consciously. A loss of a breast takes getting used to. It is normal for a woman to feel nervous about the idea of having a new breast. Dr. Bartholomew strives to deliver the best breast reconstruction surgery Portland has to offer.
A post-mastectomy reconstruction can improve, though not perfectly, your appearance as you move forward in your life.
Many women opt to have a breast removed and reconstructed at the same time. The best candidate for a breast reconstruction is a woman with cancer.
There is no easy decision when it comes to dealing with cancer. Some women prefer not to have surgery unless absolutely necessary. Others are advised by their surgeons to wait depending on their health condition, including obesity, smoking and high blood pressure.
The key is to get all the information that you can and become informed about your reconstruction options. The majority of women who lose a breast to cancer end up getting it rebuilt through reconstructive surgery.
A tissue expander is inserted following the mastectomy to prepare for reconstruction.
The expander is gradually filled with saline through an integrated or separate tube to stretch the skin enough to accept an implant beneath the chest muscle.
Like any procedure, there are certain risks with a breast reconstruction surgery. It can include bleeding, excessive scar tissue or fluid collection. An infection can develop within a couple of weeks if an implant is used in the surgery. Sometimes, the implant may be removed until the infection clears up.
Capsular contracture happens when the scar tightens around the implant, which causes the breast to feel hard to the patient. It can require the removal or scoring of the scar tissue or replacement of the implant.
This procedure does not interfere with chemotherapy (if cancer recurs). Dr. Bartholomew may recommend follow up mammograms on the breast, reconstructed and/or normal.
After surgery, the breast mound is restored. Scars are permanent, but will fade with time. The nipple and areola are reconstructed at a later date.
With flap surgery, tissue is taken from the back and tunneled to the front of the chest wall to support the reconstructed breast.
During your initial consultation, you will have the opportunity to discuss your situation, your cancer, and formulate a plan for reconstruction. Dr. Bartholomew will listen to your concerns and develop a strategy with you in how best to deal with your crisis. He will explain the type of procedure you will need based on his years of experience as a surgeon.
Dr. Bartholomew will examine the various reconstructive options available to you based on your age, health and body. This is the time to have a frank discussion about your fears and what you hope to achieve with a breast reconstruction in Portland.
You will be given instructions on how to prepare for the surgery, including what not to eat and drink and what to do with medications.
The risks and limitations of each possible option will be considered as well as what your insurance company may cover. Most policies pay for most or all of the cost of post-mastectomy reconstruction.
The transported tissue forms a flap for a breast implant, or it may provide enough bulk to form the breast mound without an implant.
Tissue may be taken from the abdomen and tunneled to the breast or surgically transplanted to form a new breast mound.
There are a number of possible options available for our Portland breast reconstruction patients. Dr. Bartholomew will go over which type of flap might be best for you and your body.
The first option is “skin expansion,” a common technique that uses skin expansion and the insertion of an implant. After your mastectomy, Dr. Bartholomew will insert a balloon expander underneath your skin and inject a salt-water solution to fill it, periodically, over several weeks or months. Once the skin stretches enough, the expander is removed in another operation when a more permanent implant gets inserted. Some women receive the implant the first time not needing tissue expansion before receiving the implant.
A second option is a “flap reconstruction” which generates a skin flap using tissue taken from other parts of your body. One technique sees the tissue, still attached to its original site to keep its blood supply, channeled beneath the skin of your chest to create a place for the implant. Sometimes, a breast mound is conceived so there is no need for an implant.
Another technique of the flap reconstruction is to take tissue from other parts of your body (like abdomen or buttocks) and transplanting it to your chest by reconnecting the blood vessels to new vessels in the targeted area.
An abdominal flap uses muscle in that area and skin from a tummy tuck incision to create a new breast mound. Implantable mesh from the donor site is utilized to reinforce the abdominal wall and prevent hernias.
A third option is the Latissimus Dorsi musculocutaneous flap. It takes back muscle and tunnels it to the front of your chest for a breast mound. This procedure is often combined with an implant and does not require the use of mesh or an abdominal incision. This surgery is more complex than skin expansion. Your recovery is longer than with an implant. There will be scars at the tissue donor site and the reconstructed breast. However, being constructed entirely with your own tissue has a big advantage and the results are more natural, including an improved abdominal contour. There are also no worries about a silicone implant.
The majority of breast reconstruction requires follow up procedures that may involve replacing a tissue expander with an implant or the reconstruction of a nipple and areola. An additional surgery can help to enlarge, reduce or lift the natural breast to match the reconstructed breast.
After surgery, the breast mound, nipple, and areola are restored.
Scars at the breast, nipple, and abdomen will fade substantially with time, but may never disappear entirely.
Your hospital stay could be as much as five days depending on the extent of your surgery.
Expect up to six weeks to fully recover from a combined mastectomy and breast reconstruction depending on the extent of your surgery. You should stay away from strenuous exercise, overhead lifting, and sexual activity for three to six weeks.
For the first two weeks after surgery, you will feel tired and in some discomfort. Dr. Bartholomew can prescribe medication to deal with the pain.
Your stitches are taken out after a week. It may take a year or two for your scars to fade away but they never completely disappear.
With a breast reconstruction surgery in Portland, your breasts will feel firmer and give you a more youthful appearance. You may be under the impression that your breast does not have the same contour as before surgery or that it matches your other breast. But that will only be apparent to you. In the end, the surgery will dramatically improve your appearance and the quality of your life.