The Right Training and Expertise
Beginning with his surgical fellowship in Cosmetic and Reconstructive Surgery of the Breast at Georgetown University, Dr. Slack has accumulated a great deal of training and expertise in helping women who need breast reconstruction. He has found that these surgical procedures are very gratifying to both patient and surgeon.
Considerations Regarding Breast Reconstruction
For many women breast reconstruction is an option at the time of their mastectomy; however, there may be reasons to delay reconstruction until a later time. Whatever the timing, breast reconstruction can restore the symmetry and contour of the body and improve a woman’s quality of life. If you are considering having a breast reconstruction performed, it’s a good idea to talk to Dr. Slack. As a double board-certified plastic surgeon, Dr. Slack is able to answer all of your questions and concerns, and he treats everyone as the unique individuals that they are.
Each Breast Reconstruction Patient Is Unique
Each person’s breasts have their own unique size and shape. This, along with the patient’s desire, will be used to develop a reconstructive plan unique to each patient. Dr. Slack will describe in detail the choices available to you during in the initial consultation – including reconstructive options that he does not currently offer.
His goal is for each of his patients to understand what options are available as well as the pros and cons associated with each. He wants his patients to feel comfortable and confident before going forward with any surgical procedure. Spending time educating his patients is essential to accomplishing this goal. He understands that breast reconstruction, in particular, involves matters that are often central to a woman’s feelings about her body and her femininity but never loses sight of the main goal which is to treat and cure the patient’s cancer.
When and How a Breast Can Be Reconstructed
For some women, the initial phase of breast reconstruction takes place during the same procedure in which the existing breast is removed; however, reconstruction can also be performed as a separate procedure months or years later. Many breast reconstructions involve more than one procedure (or steps) that are performed over time; in fact, more often than not, a breast is not reconstructed in a single operation.
Several techniques are available for breast reconstruction, and the procedure chosen for a particular patient depends in part on the amount of breast tissue and skin that remain after a breast’s removal. One version of breast reconstruction that is frequently used requires skin expansion with a tissue expander followed by the insertion of a breast implant. In some cases, a patient will not need the skin expansion step.
Types of Breast Reconstruction Procedure
There are various techniques used to perform a breast reconstruction. One common method, as mentioned above, involves inserting a tissue expander beneath both the skin and the chest muscle to expand the skin so that it can accommodate an appropriate sized implant. The tissue expander is temporary. Over a period of several weeks it is gradually filled in the office with saline solution. When the skin has expanded enough, the tissue expander is taken out and a permanent breast implant is inserted. The reconstruction of the breast’s nipple and the area around the nipple (the areola) may be done at the same time or at a later time.
The second general category of breast reconstruction involves using the tissue from another part of your body to create a breast. This is called autologous breast reconstruction. The most common parts of the body used for transferring tissue are the abdomen (TRAM and DIEP flaps) or the back (Latissimus flap). These are generally more involved procedures that involve surgery on other areas of the body besides the breast that will need to heal. Breast implants are typically not needed with TRAM or DIEP breast reconstructions but are used with Latissimus reconstructions.
The breast implant can be filled with saline or silicone gel. A wide variety of breast implants are available, differing in cup size, contour, firmness, dimensions, and texture. Dr. Slack with discuss each of these options to help determine which one is best for you.
The reconstructed breast will look and feel as close as possible to both the breast that was removed and the remaining breast. Many patients are surprised and pleased at how “realistic” the reconstructed breast is, but unfortunately it is not exactly the same as a real breast. Most of the scarring left by a breast reconstruction will fade significantly over the months following the surgery but will never completely go away. Understanding unique issues associated with the breast reconstruction method you choose and the unique issues related to your breasts and breast cancer treatment is key. It will help you develop realistic expectations for what breast reconstruction can accomplish for you.