Breast Reconstruction

Breast Reconstruction encompasses a wide range of procedures. While we often think of breast reconstruction after breast cancer, it is also applicable other acquired and congenital breast deformities.

Breast Reconstruction Presentation

Breast Deformities

By definition, Breast Reconstruction requires there be a preexisting deformity. Breast deformities are classified either congenital or acquired. A Congenital Breast Deformity is a defect that is present from birth. Since the breast does not fully develop until puberty, some congenital breast deformities are not obvious until adolescence. An Aquired Breast Deformity has no genetic component, and is caused by surgery, trauma, infection or another exterior influence on the breast.

Congenital Breast Deformities

Congenital breast reconstruction can be life changing for women who are born without a breast. An example is Poland Syndrome. In Poland Syndrome, the breast, chest muscles and even the hand can be affected. If the hand is webbed (syndactyly), this is repaired at an early age to allow for proper hand function. The breast deformity repair is deferred until puberty, and is often staged to match the growth of the opposite normal breast.

Women who have misshapen breasts, like severe forms of tubular breast deformity, may also benefit from breast reconstruction. The characteristic shape of the tubular or tuberous breast does not become apparent until puberty. During breast development, the skin on the lower breast remains constricted and leads to a tubular breast, often with a puffy nipple called the “snoopy-nose” deformity. Tubular breasts can be present on one or both sides, and asymmetry is the norm.

Acquired Breast Deformities

The most common acquired breast deformity requiring breast reconstruction is the absence of the breast after a mastectomy for breast cancer. Burns, trauma and infection can also lead to breast deformities requiring surgical repair. Like the correction of congenital breast deformities, acquired breast deformity correction requires repair of the affected breast and attention to the opposite breast to maximize symmetry.

Breast Reconstruction Surgery

Breast Reconstruction Surgery may include reconstruction of all or some of the following three areas: the breast mound, the nipple and areolar complex and the opposite breast. Since acquired breast deformities usually occur after the breast has fully developed, matching procedures on the opposite breast to improve symmetry are more common.

Breast Reconstruction Surgery – The Breast Mound

Breast Reconstruction surgery often requires multiple surgeries to achieve the best results. For example, after a mastectomy, the breast mound needs to be reconstructed. Breast mound reconstruction can range from a simple, one-step procedure, to a series of complicated surgeries. If sufficient skin remains on the breast, reconstruction can be similar to a routine breast augmentation, and can often be completed at the same time as the mastectomy. For a breast cancer patient, this is termed immediate breast reconstruction, because the breast reconstruction is performed immediately after the mastectomy, during the same operation. This means waking up after your mastectomy with a breast mound.

However, the mastectomy often requires removal of skin, and sometimes it is necessary to replace some of the skin for an aesthetic breast reconstruction. If reconstruction is performed using a breast implant, recruitment of new breast skin is accomplished with staged tissue expansion. During the mastectomy, a tissue expander is placed under the breast skin. During a series of office visits, the tissue expander is gradually filled to allow the skin to stretch. Once enough skin is available, the expander is exchanged for a breast prosthesis (breast implant). When reconstruction is performed using a tissue flap, skin, fat and muscle can be transplanted as part of the flap, depending on what is needed. When performed during the same operation as the mastectomy, immediate breast reconstruction, a woman can maintain her breast mound.

Breast Reconstruction Surgery – The Nipple and Areola

Once the breast mound is made, if desired, a nipple and areola are reconstructed. Nipple Reconstruction and Areola Reconstruction are usually outpatient procedures, and can often be performed under local anesthesia.

Breast Reconstruction Surgery – Matching Procedures

During breast reconstruction, consideration is also given to treating the opposite breast. Sometimes a breast lift, breast reduction or breast augmentation may be indicated on the unaffected side, to improve symmetry.

Joseph Mele, MD performs breast reconstruction in Walnut Creek, California. Because of the individualization of the process, it is ideal to see a Board Certified Plastic Surgeon, like Dr. Mele, prior to the definitive cancer treatment. If this is not possible, delayed breast reconstruction is still an option. More information about breast reconstruction surgery is available on the American Society of Plastic Surgeons Breast Reconstruction page.

To learn more about Breast Reconstruction, please give us a call at (925) 943-6353, or contact our Plastic Surgery practice online today.

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