Tissue Expander Reconstruction
Treating the chest area, just like the belly of a pregnant woman, expanding during her pregnancy, a tissue expander or ordinary breast implant is inserted under the chest muscle and preserved breast skin after the breast is removed. Temporarily placing an expander or implant will preserve the shape of the breast and breast skin during the upcoming radiation treatments and allow for the final benefit of a skin-sparing mastectomy technique.
A tissue expander is a balloon-type device that stretches the skin to create a “pocket” for the reconstructed breast under the skin. Once radiation is complete and tissues have recovered (4-6 months), the expander/implant that was used to maintain the shape of the breast is removed and replaced with a flap from the proper donor site as decided upon in consultation with your surgeon.
Latissimus Dorsi Flap Reconstruction
Your latissimus dorsi muscle is located in your back, just below your shoulder and behind your armpit. It’s the muscle that helps you do twisting movements, such as swinging a racquet or golf club. In a latissimus dorsi flap procedure, an oval flap of skin, fat, muscle, and blood vessels from your upper back is used to reconstruct the breast. This flap is moved under your skin around to your chest to rebuild your breast.
The blood vessels (artery and vein) of the flap are left attached to their original blood supply in your back. Because the flap contains a significant amount of muscle, a latissimus dorsi flap is considered a muscle-transfer type of flap. While the skin on your back usually has a slightly different color and texture than breast skin, latissimus dorsi flap breast reconstruction can look very natural.
TRAM Flap Reconstruction
In this method, the surgeon does not use an implant. This merhod is ideal for patients that have excess of fat and skin on their lower abdomen wall. Your surgeon removes tissue including muscle from your abdomen known as a tram flap. the trunk flap can be transferred as a free flap or pedicle flap. A pedicle tram flap uses your whole rectus muscle, one of the four major muscles in your abdomen. For muscle sparing tram flap your surgeon takes only a portion of your rectus abdominis muscle, which may help you retain abdominal strength after the surgery. each technique has different advantages and disadvantages. A pedicle tram flap is usually a less intricate procedure require less time in surgery.
Conversely, a muscle sparing free tram flap, uses a smaller portion of the rectus muscle so women tend to recover more quickly and have lower risk of losing abdominal muscle strength. In either case, a tram flap breast reconstruction uses natural tissue taken from the patient’s own body rather than artificial silicone breast implants. six months after the breast reconstruction, there is a second surgery to reconstruct your nipple and areola. This can be done with local anaesthetics and the tissue is taken from another part of your body, such as the inner thigh
