RECONSTRUCTIVE SURGICAL PROCEDURE: Breast Reconstruction

Breast cancer affects nearly 1 in 8 women in the United States (National Cancer Institute). Once diagnosed, women with breast cancer go through a process of deciding the best treatment options with their physicians. Surgery oftentimes involves removal of one or both breasts and this can have a devastating impact on any woman physically as well as emotionally.

Reconstruction of a breast that has been removed for cancer is one of the most satisfying and rewarding procedures performed by Dr. Almonte. New surgical procedures and devices have been developed to create a breast that comes close to the form and shape of a natural breast. The patients that come to see him are usually referred by their primary physicians or breast surgeons. The first visit is a lengthy one during which Dr. Almonte takes a complete medical and surgical history as well as documentation of a patient’s medications and allergies. After the examination, he discusses all the details of breast reconstruction.

Dr. Almonte spends a lot of time to discussing the entire process with his patients so they leave with a full understanding of the timing of surgery, risks, benefits, and possible complications. He takes into account additional treatments a patient may need such as chemotherapy and radiation treatment.

Breast reconstruction is a complex and lengthy process. It may take several months to complete. But once completed, the benefit that a patient gains is the feeling of being whole again, the feeling of looking “normal” in clothes and in daily life.

The first decision to be made with the patient is whether she would like the reconstruction to be IMMEDIATE, at the same time as mastectomy, or DELAYED, several weeks after mastectomy.

The next decision to be made is what type of reconstruction to perform. These options include the use of AUTOLOGOUS TISSUE, which is the patient’s own tissue such as the abdominal skin and fat OR an IMPLANT RECONSTRUCTION in which the breast shape is made with an artificial implant. This implant can be SALINE-filled or SILICONE-filled.

Autologous tissue reconstruction uses the abdominal skin and fat, also known as a TRAM Flap, or the back skin and fat, also known as a Latissimus Dorsi Flap.

Implant reconstruction can take place in one stage or two stages. The most common one used by Dr. Almonte is the two-stage technique. In this procedure, Dr. Almonte places a Tissue Expander (STAGE 1) under the muscle in the chest and closes the skin over it. Over the following weeks or months, he will inject saline into the expander in the office in order to gain more skin and more volume.

Once the desired size is obtained, a few weeks are allowed to pass in order for the skin to accommodate the filled expander. A second operation (STAGE 2) is then performed to replace the expander with the final implant. This final implant may be saline filled or silicone filled.

After the breast mound is created by either autologous tissue or an implant, a final option for the patient is the creation of a nipple. The NIPPLE RECONSTRUCTION is an additional operation in which a small “nub” of skin is created onto the breast followed by tattooing of an areola. Some women choose to forgoe this last step. The final result is a breast the comes close to the shape and form of a natural one.

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EL DORADO HILLS PLASTIC SURGERY CENTER
Dr. Arnold Almonte, D.O.

(916) 941-1556

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