Free Flap Breast Microvascular Reconstruction “DIEP/muscle sparing TRAM”

Breast reconstruction is a physically and emotionally rewarding procedure for a woman who has lost a breast to caner or another condition.

Following a mastectomy, the goal of breast reconstruction is to replace the chest wall deficit with a soft, natural looking breast silhouette. This can in turn, dramatically improve a woman’s visual appearance, self-image, and outlook on life.

Breast reconstruction can either be performed at the same time or a later time following a mastectomy. Immediate reconstruction is performed immediately after the mastectomy. The main advantage of this type of procedure is that the woman does not have to submit to a flat chest wall because the first stage of the reconstruction has already been initiated. A delayed reconstruction is done at a later time to allow for adequate healing or other procedures that may need to be completed before the reconstruction. Such procedures might include chemotherapy or radiation.

It is important to be educated on the different techniques of breast reconstruction surgery. Such would include using the patient’s own tissue via various types of tissue flaps, and/or by the use of an expander/implant.

A tissue flap is a section of skin, fat, and muscle, which is relocated from a donor area of the body such as: the abdomen with a TRAM/DIEP flap or the back with a Latissimus muscle flap. These flaps can be augmented with implants if necessary. Alternative flaps are offered on an occasional basis when donor sites for the more common flaps are not suitable.

The breast expander implant technique utilizes a fluid-filled device that is surgically implanted under the remainder of the chest wall tissue. The expander is periodically enlarged until the desired breast volume and location is achieved and a new breast silhouette is created. The expander is then replaced with a rubber-shelled implant filled with either saline or gel.

Breast reconstruction is a critical, decision-making process that encompasses the patient, her overall medical condition, her breast shape and size, her lifestyle, as well as her goals and objective from the reconstruction.

The ideal candidate for breast reconstruction would be:

  • Healthy, emotionally stable woman
  • Able to cope well with your diagnosis and treatment
  • Someone who has a positive outlook and realistic goals for restoring your breast and body image

It is essential to recognize that breast reconstruction is an elaborate, multi-staged surgical treatment with an artistic touch, and requires a long-term commitment.

Dr. Chahin will discuss with you these procedures, and what is mutually felt to be the best method of treatment to aid in achieving optimal results for you.