Understanding the Benefits of Breast Reconstruction
In general the benefits of breast reconstruction after mastectomy or lumpectomy are to recreate the breast mound so that a woman can feel and look normal and whole without a permanent deformity that can impact everything from her self esteem and sexuality to her ability to exercise and participate in sports as well as wear normal clothing without the need for a external prosthesis. Although many doctors will tell you that the goal is to make you look and feel normal when you are wearing clothing, Dr. Lerman feels that the goal is to make you look and feel beautiful even when you are not wearing clothing so that even a passing glance in the mirror allows you to be happy and satisfied with your appearance and mind set. Dr. Lerman feels strongly that many woman can look even better after completing breast reconstruction than they did before.
As with all plastic surgery procedures, there are multiple techniques available for reconstructing the breasts after mastectomy. In helping patients to decide which technique is best suited to their particular case, Dr. Oren Z. Lerman takes many factors into account, such as their age, weight, lifestyle, family and work. Each individual patient's circumstances can impact the decision as to what type of reconstruction best suits them but the important thing to remember is that almost all woman are candidates for breast reconstruction and in order to know what option is best for you, you must first be presented with all the options available. Their are many benefits of breast reconstruction but because many plastic surgeons don't perform all different types of breast reconstruction, many woman are only given a select few options for their reconstruction. Because Dr. Lerman specializes in the most advanced methods of breast reconstruction, especially DIEP flap and other natural tissue options, his patients get the opportunity to decide for themselves what option they prefer.
Whether you are preparing to undergo mastectomy or have already undergone mastectomy, schedule a confidential consultation with Dr. Lerman at his Manhattan, NYC plastic surgery practice. Dr. Lerman will detail the specific advantages associated with each method of breast reconstruction and advise you as to the method that will provide the best, longest-lasting and most aesthetically pleasing results in your particular case.
For further information about breast reconstruction benefits, or to schedule your initial consultation with Dr. Lerman, please contact our plastic surgery practice today.
Benefits of Autologous (Natural Tissue) Breast Reconstruction
One of the preferred method of reconstructing the breasts after mastectomy among modern plastic surgeons is to use the patient’s natural tissues whenever possible. This technique offers a variety of benefits that are unique among breast reconstruction methods, including a more natural and aesthetically pleasing result.
The most advanced technique used to perform autologous breast reconstruction is the DIEP flap. Named after the deep inferior epigastric artery that supplies the blood flow to the lower abdominal skin and fat and gets transplanted during the surgery. This operation is the most advanced and current method for transplanting tissue from the lower abdomen. The older method for doing this is called a TRAM flap or muscle sparing TRAM flap. The TRAM flap cuts the muscle of the abdominal wall, whereas the DIEP flap does not. This minimally invasive procedure leads to less postop pain and recovery as well as less risk of abdominal wall weakness or hernia. The fatty tissue from the lower abdomen is remarkably similar in feel to the natural breast. Dr. Lerman transplants a flap of tissue, including blood vessels, fat and sometimes skin to the chest using and meticulously reattaches the blood vessels and then contours the tissues to produce a natural-looking and feeling breast that lasts forever. This tissue moves like natural tissue and compresses like natural tissue so when you wear clothing or lay on your side or belly it feels like your own body.
There are a number of favorable reasons to use the DIEP flap technique, including:
- It has an extremely high success rate and lasts indefinitely: The DIEP flap surgery performed by Dr. Lerman has a 98-99% success rate. Once healed from the surgery the reconstruction lasts a lifetime and actually tends to look and feel better as time goes on.
- It looks, feels, moves and ages like natural tissue: No other reconstructive option will give you a more natural looking and feeling result than using your own tissue. Whether you are wearing clothing or not - nothing will look more natural. When you are moving, exercising or lying down in bed it will behave like your natural breast and move with you. As you get older the tissue will even get softer. It tends to look better as time goes by as opposed to breast implants that need to be changed down the road.
- It preserves the entire abdominal wall muscle: Unlike the TRAM flap or even the msTRAM (muscle sparing TRAM flap), the DIEP flap procedure leaves the rectus abdominus muscle intact. This allows the patient to maintain the strength of the abdominal wall and lowers the risk of post-surgical hernia.
- You get the added benefit of a flatter/slimmer abdominal area: For patients with excess abdominal fat, the DIEP flap procedure is the equivalent of undergoing two procedures in one. The removal of tissue from the abdominal region leaves the area smoother and trimmer, similar to the way an abdominoplasty (tummy tuck) would.
- It minimizes recovery time: Although the DIEP flap procedure is a major surgery, it results in a shorter, more comfortable recovery period than the TRAM flap procedure, largely due to the fact that the abdominal muscles are left intact.
For patients with insufficient fat in the belly region, Dr. Lerman can harvest tissues from other regions of the body, such as the posterior upper thigh (the PAP flap method) or the buttocks (the sGAP and iGAP methods). These methods offer similar advantages to the DIEP flap method, particularly when compared to the TRAM flap method.
Benefits of Breast Reconstruction with Implants
Breast implant reconstruction remains the most common type of breast reconstruction in the United States. This operation is especially beneficial for patients who are very slim and have limited availability of natural tissue; Those who do not want additional scars of their body; and those patients who cannot or do not want to undergo the longer surgery associated with autologous (natural tissue) reconstruction. The availability of the new form-stable, highly cohesive, anatomically shaped silicone-gel-filled breast implants has changed the expectations of breast implant reconstruction. Popularly known as “gummy bear” implants, these implants allow Dr. Lerman to achieve a result that is more natural looking than traditional breast implants and Dr. Lerman uses these new implants in the majority of cases. Additionally, with new mastectomy techniques such as nipple sparing mastectomy and the use of biologic mesh (Alloderm®), we can now perform implant breast reconstruction in fewer stages with more natural results.
Some of the beneifts of breast implant reconstruction:
- Shorter Surgery and Hospitalization: Unlike autologous breast reconstruction, reconstruction with implants is a shorter surgery with a shorter hospitalization.
- Form Stable implants maintain their shape over time: Because these implants are filled with a highly cohesive gel, they hold their original shape giving a more natural 'teardrop' shape to the breast.
- Rippling and folding are less likely with Form Stable implants: Again, because the implants are filled with a highly cohesive gel that maintains its original shape over time, rippling and folding are much less likely to occur.
- The risk of leakage is extremely low: The current generation of implants has an extremely low rupture rate when compared with prior generations of implants. The FDA continue to recommend MRIs every few years to ensure that there is no rupture or leakage.
Immediate Breast Reconstruction vs. Delayed Reconstruction
The results from breast reconstruction are best if it is performed at the same time as the mastectomy, however, there are certain situations in which a woman would wait to have a delayed breast reconstruction either in order to allow them to complete their treatment or because they were undecided at the time of the mastectomy. No matter the reason, almost all woman are candidates for breast reconstruction either at the time of mastectomy or afterward.
- Immediate breast reconstruction: By undergoing breast reconstruction at the same time as mastectomy, not only do you avoid the need to come back later to have breast reconstruction at a later date, but the result tends to look more natural. The breast skin is usually preserved at the time of the mastectomy and used to recreate the new breast. In a delayed reconstruction, this skin has flattened out and needs to be replaced or re-expanded using a variety of methods which tend not to look as good as the original.
- Delayed breast reconstruction: For those woman who did not have the availability of a reconstructive plastic surgeon at the time of their mastectomy. Or who were told to wait to complete all of their treatments before undergoing reconstruction. Or for those who simply have changed their mind about wanting reconstruction, most if not all of the reconstructive options are still available to them. Delayed breast reconstruction will replace the need for an external prosthesis (padded bra) and will allow patients to go back to feeling and looking normal and beautiful both in and out of clothing.
Learn More about the Benefits of Breast Reconstruction
To learn more about the benefits of breast reconstruction, or to schedule your initial consultation with Dr. Oren Z. Lerman, we encourage you to contact our plastic surgery practice today.
“The one thing that is most important when we're doing cosmetic surgery and aesthetic surgery of the face or the body is to make sure that the patient is happy afterwards...” Dr. Oren Lerman