After a bilateral mastectomy has been performed, what breast reconstruction options will provide the most natural look?
Options for Reconstruction After Bilateral Mastectomy?
Doctor Answers (13)
Bilateral Mastectomy Reconstruction
The two major categories for breast reconstruction are 1) implant-based and 2) autologous (using your own tissue). With proper patient selection, we obtain outstanding results with both modalities. However, reconstruction is a process that requires some steps to achieve the best results.
Options will include Saline/Silicone Gel implants, Autologous reconstruction with DIEP or SIEA or TRAM flaps, etc. There are pro's and con's to each option. No single reconstruction is the best for everyone. If you have excess tissue in your lower belly (i.e. have you ever thought you might beneft from a tummy tuck?), then you may be a good candidate for a DIEP free flap (reconstructing your breast using your own tissue without the need of an implant).
We often visit with out of town patients to help them with their reconstructive journey. And we work with several outstanding breast surgeons to facilitate immediate reconstruction for out of town patients. Please visit our breast reconstruction website listed below to learn more about your options.
Web reference: http://www.breastreconstructionhouston.com
Most Natural Look after Bilateral Mastectomy
In my opinion, the most natural look and feel will come with use of your own tissue for reconstruction. In order to perform this procedure, you must have an adequate donor area to provide you with your desired cup size. The most common donor site is the abdomen, where we typically perform a muscle preserving DIEP Flap. Other donor sites include the buttocks (GAP Flap) and Inner Thighs (TUG Flap).
If you are not a candidate for tissue reconstruction, I would then recommend a silicone gel implant breast reconstruction with 2nd stage fat grafting to provide a smooth contour. However, if your cancer treatment involves radiation, this procedure would be contraindicated.
I wish you a safe and happy reconstruction process.
Web reference: http://www.drpaulgill.com
Natural Breast Reconstruction
The most natural reconstruction option, is one that is not known by most plastic surgeons. Yet. It is fat transfer to the breast with the external expander BRAVA. This process uses your own fat to rebuild entire breasts. We use no incisions and no foreign objects, and in most cases, it is an outpaitent procedure. We are pioneers in the use of large-volume autologous fat transfer.
For anyone who has gone through a cancer diagnosis, the difficult task of
undergoing major surgery, and sometimes the unpleasantness of radiotherapy or
chemotherapy, the thought of one or more major traumatic operations to reconstruct
her breast is exhausting. The fact that this fat grafting technique is now an option is a
giant breath of fresh air.When one adds the additional benefit of body sculpting through
the liposuction, hope for a normal, natural life begins to take hold.
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Breast reconstruction can involve implants, the body's own tissue (a flap) or a combination of these options
After a mastectomy for breast cancer or for risk-reducing surgery (BRCA gene positive women or those who wish to reduce their personal risk of breast cancer), there are a variety of options for breast reconstruction:
- Nipple-sparing mastectomy - provides the most natural results and allows reconstruction of the entire breast in a single operation
- Implant-based reconstruction - I specialize in a single-stage approach using adjustable permanent implants
- Flap-based reconstruction - using the body's own tissue to build a new breast, usually making use of extra skin and fat from the lower abdomen (DIEP or SIEA flap) or the inner thigh (TUG flap). Tissue is transplanted Microsurgically in my practice, sparing major muscles of the body like in the TRAM or the LD flap.
- Sometimes, a combination of a flap + an implant is done with the procedures staged 6 months apart. This will bring healthy new tissue to an area in need of a flap (for instance, after radiation or severe infection) and the implant will "augment" the flap, similar to a breast augmentation.
I encourage you to seek a Board-Certified Plastic Surgeon who specializes in breast reconstruction and who can offer you the full spectrum of options, including implants and Microsurgical procedures.
The goal in my practice is to achieve above all else a NATURAL reconstruction that best matches a woman's particular aesthetic goals. Please visit my website for more educational background information.
Karen M. Horton, M.D., M.Sc., F.A.C.S., F.R.C.S.C.
This requires your visiting a Board Certified Plastic Surgeon or surgeon who does a lot of these and can explore all your options. They will need to examine you and offer advice based on your previous therapy and what options are best for you now.
Web reference: http://elitemdspa.biz
Breast reconstruction options
There are many forms of breast reconstruction options including using autologous tissue usinf perforator flaps, other forms of free flaps, as well as pedicled flaps like a TRAM. Other forms of reconstruction include tissue expanders and then exchanged for implants.
the most natural look is with your own tissue, but that will depend on your doner site availability. it also means a longer operation. i generally suggest that you start with expander /implant reconstructions. they are easier on you and symetry is fairly easy to achieve. all reconstruction choices have their own set of complications. find an experienced surgeon in your community and he will help you with your choices
Bilateral breast reconstruction options
As a presumably non-radiated patient, you have all options open to you. Tissue reconstructions can be shaped and reshaped and feel warm and natural. These are the best reconstructions in the right candidate but involve more scars and much more technical skill from the surgeon. Bilateral implant reconstructions are easier and can usually look reasonably symmetrical too. Implants carry long-term baggage like scar tissue, deflation/rupture. Make sure you see surgeons who can offer ALL the options including microsurgery so the very best for you can be determined. Good luck!!
Immediate bilateral DIEP flap or other autologous breast reconstruction
Best results for bilateral breast reconstruction with implants
To begin, the best time to discuss reconstruction is before the mastectomies, since in many cases the reconstruction can be done at the same time. When both sides are done, it is easier to get a symmetrical and natural result with implants, but it can be more difficult to match an implant reconstruction to the opposite breast. Flap procedures are lengthier operations with a longer recovery time and of course this doubles for bilateral mastectomy. If you go the implant route, the use of an acellular matrix such as Alloderm can make a big difference in achieving a more natural appearing result.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.
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