Oncoplastic & Breast Cancer Reconstructive Surgery
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Oncoplastic & Breast Reconstructive Surgery
Many women living with breast cancer are choosing breast-conserving surgery (such as a lumpectomy or partial mastectomy/quadrantectomy) as part of their breast cancer treatment plan. In this type of breast cancer surgery, your surgeon removes the tumor and leaves most of the breast untouched.
Sometimes, women have a mastectomy, which involves the surgical removal of all or portions of the breast.
To help rebuild the shape of the breast after surgery, CTCA offers several options for breast cancer reconstructive surgery. Our surgeons also excel in oncoplastic surgery, which combines a series of techniques to remove tumors using both general and plastic surgery principles.
What Is Breast Reconstructive Surgery?
Breast reconstructive surgery is a procedure to rebuild the contour of the breast, along with the nipple and areola, if desired. There are two common types of reconstruction: saline breast implants and muscle flap reconstruction (using your own tissue).
- Saline breast implants involve placing a tissue expander beneath the skin and chest muscle to stretch the skin before inserting implants in the breast.
- Muscle flap reconstruction involves removing your own tissue (from your back, stomach or buttocks) to rebuild the contour of the breast. For instance, our surgeons can perform tram flaps (transverse rectus abdominus myocutaneous flap), where the skin and soft tissues from the belly are used to reconstruct the breast.
If you choose to have breast reconstructive surgery, your CTCA surgeon will help you decide the best type of reconstruction for your age and body type, and explain the risks and benefits of each. Your surgeon will perform the reconstruction either immediately following the surgery, or as a separate procedure.
Autologous Fat Grafting
In addition to the above tools our surgeons use to rebuild a breast, Dr. Stephen Ray at CTCA at Midwestern Regional Medical Center and Dr. Arch Miller at CTCA at Southwestern Regional Medical Center are now performing a breast reconstruction procedure called autologous fat grafting (also called autologous fat transplantation). Reconstructive surgeons have been using fat grafting for over 20 years, but only recently in the breast region.
This procedure involves taking the patient’s own fat tissue from part of the body where excess exists, and then transferring it to rebuild the breast after a mastectomy or lumpectomy. This technique can also help to re-contour the breast after breast implants.
Before the procedure, your surgeon removes fat from the abdomen, thighs, back, or buttocks using a gentle liposuction technique. Next, the fat is carefully processed to remove unwanted fluids and materials, and centrifuged down to concentrate it. Then, your surgeon transfers the fat by injecting it into the breast area through multiple, tiny tunnels.
This technique may involve between two to five procedures to completely rebuild a breast, depending on individual factors, such as breast volume. For some patients, we can start to rebuild the breast at the time of the mastectomy.
Potential Advantages of Fat Grafting
Some potential advantages of autologous fat grafting include:
We can build a breast using the patient’s own tissue.
We can avoid doing a big flap that leaves long scars in the abdomen.
It often results in a breast that is soft, pliable and feels and looks like a normal breast.
There are no visible incisions.
It allows for healthier looking skin and more elasticity.
There is a minimal recovery period.
Also, traditionally, many women who had a mastectomy and radiation therapy need to have a flap procedure to change the chest wall. However, fat grafting can convert the chest wall into thicker, more pliable tissue that can accept a tissue expander and implant.
Meeting Your Individual Needs
Before your breast cancer surgery, you'll consult with your reconstructive surgeon, even if the reconstruction will be performed later. You surgeon, along with the rest of your CTCA breast cancer team, will explain what you can expect, answer your questions, and help you feel comfortable with the upcoming procedure.
During breast reconstructive surgery, your surgeon will carefully reshape the remaining breast tissue. Our advanced breast reconstruction methods help to minimize scarring and maintain as much of the breast tissue as possible. Oftentimes, we are able to preserve the shape of the breast and salvage nipple tissue.
Your CTCA care team also understands that breast cancer surgery can have psychological consequences as well. Changes to your physical shape and form can raise concerns about your sexuality and womanhood. Your care team includes mind-body therapists, image enhancement specialists and spiritual counselors to help address these issues and enhance your overall well-being.
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