The four most common types of breast reconstruction are: immediate reconstruction with a silicone implant utilizing Alloderm, tissue expansion, latissimus dorsi flap and TRAM flap (transverse rectus abdominis muscle). Immediate Reconstruction with a Silicone Implant The newest and most gratifying of the procedures is breast reconstruction with a silicone implant, often utilizing Alloderm. This procedure has so many advantages because the mastectomy is performed utilizing a skin-sparing technique which preserves the majority of the skin envelope and results in a minimal scar on the breast. Oftentimes, the nipple and areola can be preserved. No expansion is needed and, therefore, this is a one stage procedure. Most patients feel good within one week and are back to normal activities in two weeks. Alloderm is a natural skin dermal substitute that is used as a sling to completely cover and protect the implant.
The Tissue Expansion This technique involves placing a temporary implant (expander) under the chest muscle and enlarging it weekly with saline injections. Once the expander is stretched enough, it is replaced with a permanent silicone implant. The nipple and the darker skin surrounding it, called the areola, are reconstructed in a subsequent procedure.
The Latissimus Dorsi Flap uses back muscle to cover a permanent silicone implant. The tissue is tunneled to the front of the chest wall to support the reconstructed breast. The nipple areola complex is reconstructed at this time.
The TRAM Flap, consisting of the lower abdominal skin, fat and muscle with its blood supply, is tunneled beneath the skin to the chest. A breast mound is created without the need for an implant.
It is imperative that the general/oncologic surgeon performing the mastectomy works closely with the plastic and reconstructive surgeon. The best results are achieved following a "skin sparing" mastectomy with immediate reconstruction. Not all general/oncological surgeons perform a "skin sparing" mastectomy. For most mastectomy patients, breast reconstruction can dramatically improve one’s appearance and quality of life after surgery. If you think that you may be a candidate for Breast Reconstruction, contact Dr. Virden and his staff to schedule a consultation by calling 775-348-9798 or schedule a consultation online.