The
American Cancer Society estimates that over 100,000
women have a mastectomy each year as a result of breast
cancer. Physicians and lay people alike noted that
the deformities and scards resulting from this procedure
can have a devastating emotional impact on the patient.
The
most common surgical procedure to reduce the physical
deformity following mastectomy is referred to as a
breast reconstruction. This procedure is performed
by placing an implant underneath the muscle of the
chest wall, its size determined by the woman's other
breast. In some cases, the surgeon may elect to perform
a mastopexy or reduction mammoplasty on the woman's
opposite breast to create symmetry.
The
breast reconstruction is a staged procedure; that
is, the surgeon first inserts a tissue expander which,
as its name implies, is designed to stretch the existing
tissue so that it may accommodate the presence of
an implant inserted during a second procedure. Occasionally,
a tissue expander is not required and the permanent
implant may be inserted during the first operation.
Lastly, in a subsequent procedure, the surgeon createds
a nippe from existing tissue.
Although
the plastic surgeon cannot create a new breast which
matches the unaffected breast, the surgeon can improve
significantly the appearance of the mastectomy site,
making it unnecessary for breast cancer patients to
wear special undergarments or clothing to make the
deformity less obvious. There are various other techniques
used in breast reconstruction, such as a latissimus
dorsi flap whereby muscle is removed from the back
and attached beneath the skin of the affected area
to correct the deformity. This procedure is used most
often in cases where a radical mastectomy has been
performed, that is, where muscle and breast tissue
have been removed.
Another
method of breast reconstruction is the transverse
abdominal flap whereby the skin and fat from the abdomen
which is normally descarded in a "tummytuck"
procedure is left attached to the muscle of the abdominal
wall and is brought up to the chest defect to form
the new breast. This porcedure has the advantage of
not requiring an implant in most patients.
