Breast Reconstruction

Dr. Sabry strives to create a new breast and nipple that resemble the patient’s natural breast in shape, size and position. Newly reconstructed breast maintains body proportion, allows clothes to fit better, and most important of all, boosts self-confidence for women who have lost breast(s) to mastectomy or who lack breasts due to a congenital or developmental abnormality.

The procedure is more commonly performed immediately following mastectomy, so that the patient wakes with a new breast mound. Alternatively, reconstruction may be delayed due to concurrent medical problems or advanced nature of disease.

Breast reconstruction can be performed in many different ways, expander/implant reconstruction, reconstruction using your own tissue (TRAM flap), or a combination of the two (latissimus flap with implant). The choices are dependent upon physical attributes, concurrent medical problems, requirement for chemo adjuvant and patient preference. All options will be thoroughly discussed with you by Dr. Sabry in helping deciding the best one for you.

Procedures

Expander/ Implant reconstruction:

The most common technique combines skin expansion with implant insertion. First, the surgeon inserts a balloon expander beneath the skin and chest muscle where the reconstructed breast will be located. A saline (salt water) solution is then injected into the expander through a tiny valve beneath the skin over a few weeks or months, eventually filling it and stretching the skin. The expander may then be left in place or replaced with a permanent implant. Some patients do not require tissue expansion and begin with the implant.

Autologous Breast Reconstruction:

Breast(s) can be reconstructed using your own tissue.

Latissimus Flap reconstruction:

Using skin and muscle from your back and rotated to create a new breast. Often, patients require an implant to add volume and projection with this type of reconstruction. Advantages – one stage surgery. Disadvantage – donor site scar in the back (and longer recovery than expander/ implant.

TRAM (Transverse rectus abdominis myocutaneous) Flap:

Skin and muscles are mobilized from your lower abdomen to the chest to create a new breast. The added benefit of this particular reconstruction is that no implant is used and patients get a toning effect ie. Abdominoplasty. Advantages over implant insertion are a more natural look and feel for the breast and abdomen; disadvantages are scars and longer recovery.

Free Flap reconstruction:

Tissue for the flap (skin, fat and muscle from the back, abdomen or buttocks and may be surgically removed and reattached to the vessels in chest area. Dr. Sabry does not perform free flap reconstructions.

Both implant insertion and tissue flap surgery is followed by nipple and areola reconstruction. A lift or reduction of the opposite breast is often necessary for better match. This can be performed at the time of nipple areola reconstruction.