Breast Reconstruction Monterey
Important Note: Women who have revision/touch up surgery have the best results in breast reconstruction.
1. Implants and Tissue Expanders
Following mastectomy, your surgeon will insert a balloon expander beneath your skin and chest muscle. Through a tiny valve mechanism buried beneath the skin, he or she will periodically inject a salt-water solution to gradually fill the expander over several weeks or months. After the skin over the breast area has stretched enough, the expander may be removed in a second operation and a more permanent implant will be inserted. Some expanders are designed to be left in place as the final implant. The nipple and the dark skin surrounding it, called the areola, are reconstructed in a subsequent procedure.
Some patients do not require preliminary tissue expansion before receiving an implant. For these women, the surgeon will proceed with inserting an implant as the first step.
2. Latissimus Dorsi Flaps
This takes its name from the back muscle that lies below the shoulder and behind the armpit.An oval section of skin, fat, and latissimus dorsi muscle is detached and slid around through a tunnel under the skin to the breast area. Blood vessels remain attached whenever possible. The tissue is shaped into a natural-looking breast and sewn into place. If blood vessels have been cut, they are reattached by microscopic surgery to blood vessels in the chest area. The procedure takes about two to three hours.
In general, latissimus dorsi is only a good option for a woman with small- to medium-sized breasts, because there is so little body fat in this part of the back. An implant (inserted during the same operation) is almost always necessary to create a breast of moderate size.
3. TRAM/Abdominal Flaps
TRAM stands for the transverse rectus abdominis muscle, which is located in the lower abdomen, between the waist and the pubic bone.
TRAM is the most popular of all reconstruction options, especially for a woman with excess belly fat or an abdomen that has been stretched out by pregnancy. You end up with a “tummy tuck” as a fringe benefit of surgery. Also, abdominal tissue feels most like a natural breast to anyone touching you. For you, the new breast will have little, if any, sensation.
An oval section of skin, fat, and muscle is taken from the lower half of the abdomen and slid up through a tunnel under the skin to the breast area. Blood vessels remain attached whenever it’s possible. The tissue is shaped into a natural-looking breast and sewn into place. If blood vessels have been cut, the surgeon reattaches them to blood vessels in the chest area using a microscope to sew the tiny, delicate attachments. The procedure takes about three hours. The new breast can also be made larger during this surgery, with an implant underneath your own tissue.
4. Nipple Reconstruction
Nipple reconstruction techniques have evolved significantly. From the simple tattoo to the more technologically advanced tissue engineering, today’s techniques are able to provide long-lasting, satisfactory reconstruction with minimal morbidity.
Disclaimer: there is no guarantee of specific results and the results can vary.
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