DEAR MAYO CLINIC: My sister was simply identified with breast most cancers and could have a double mastectomy. What forms of reconstruction may she have, and when can the reconstruction be executed? Are there any new reconstruction choices that she ought to pay attention to? I’ve heard about 3D tattooing. Is that an choice?
ANSWER: Breast reconstruction is a process that restores the form of your breast after mastectomy, which is an operation that removes your breast to deal with or stop breast most cancers.
Breast reconstruction may be carried out with both an implant — silicone units crammed with silicone gel or saline — or a affected person’s personal tissue. Most individuals who bear mastectomy have a tendency to decide on implant-based breast reconstruction, with a smaller portion opting for flap, or autologous, reconstruction. Breast reconstruction with flap surgery includes taking a piece of tissue — pores and skin, fats and sometimes muscle — from one space of your body, most frequently your stomach, and relocating it to create a brand new breast mound.
Each technique has its advantages and drawbacks. For instance, implant-based breast reconstruction includes a shorter operation and restoration, whereas flap surgical procedure is an extended, extra complicated operation with an extended restoration time. Also, implants are short-term and would require removing or substitute on common each 10 years. With flap surgical procedure, sometimes, no additional operations are crucial.
Breast reconstruction begins on the time of mastectomy. A group of breast oncologic and plastic surgeons working collectively to plan the suitable plan for your wants is essential.
Depending on the situation of the tumor and the affected person’s breast dimension, they might be a candidate for a nipple-sparing mastectomy, which permits for a extra pure reconstruction look. A nipple-sparing mastectomy includes the removing of the breast tissue, however spares the pores and skin, nipple and areola, additionally known as the nipple-areolar complicated.
If the tumor is abutting the nipple-areolar complicated, the affected person will want surgical removing of the nipple. Nipple reconstruction may be executed with a 3D nipple-areola tattoo with or with out the creation of a raised space of pores and skin to reconstruct a raised nipple. 3D nipple tattooing is very inspired for all sufferers who’ve required surgical excision of the nipple-areolar complicated. Data reveals sufferers are extra glad with reconstruction and can transfer ahead from their most cancers journey when reconstruction of the nipple is carried out.
In the previous, breast reconstruction wouldn’t present the identical sensations as earlier than mastectomy. However, breast resensation is the brand new frontier inside breast reconstruction. This is a brand new strategy of breast nerve restore throughout breast reconstruction that may doubtlessly restore feeling after a mastectomy. This may be executed in one in all two methods.
First, suppose the affected person is a candidate for nipple-sparing mastectomy and is roughly a C cup or much less on the time of mastectomy. In that case, we will establish the nerves on the lateral chest and bridge the hole beneath the nipple-areolar complicated with a nerve graft. The nerve will then regenerate by way of the graft, offering sensation to the nipple-areolar complicated. While this may take as much as two years, it ought to restore gentle contact to the breast and nipple-areolar complicated, however it is not going to totally return premastectomy breast sensation.
The second method is pursued if the affected person is present process flap surgical procedure. We can establish a nerve on the tissue from the stomach and join that by way of nerve graft to a nerve within the chest. This may be an choice for sufferers who’ve already had a mastectomy — and presumably implant-based breast reconstruction — and need extra sensation.
Breast reconstruction is a superb choice for many sufferers. It can provide you a breast contour, present symmetry to your breasts underneath clothes and provide help to keep away from the necessity for an exterior prosthesis inside your bra. Many sufferers discover that their vanity and body picture enhance after reconstruction, and it helps to erase bodily reminders of their most cancers journey. However, earlier than breast reconstruction surgical procedure, seek the advice of a plastic surgeon who’s board-certified and skilled in breast reconstruction following mastectomy. — Dr. Christin Harless, Plastic Surgery, Mayo Clinic, Rochester, Minnesota
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