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Breast Reconstruction

Breast Reconstruction Surgery - Vancouver, WA

34 Procedures ( View All )

Overview

PeaceHealth Medical Group works with PeaceHealth Southwest’s Kearney Breast Cancer Center to educate patients in Southwest Washington and the Portland area on their options before their breast cancer surgery (mastectomy) and develop their best reconstruction plan. Dr. Gabriel and Dr. Champaneria will collaborate with every member of a patient’s mastectomy treatment plan to deliver the optimal results throughout the process. This seamless collaboration and increased reconstruction options are instrumental in helping patients better deal with their diagnosis and treatment. Breast reconstruction surgery is an extremely personal choice and whether the patient decides to proceed with reconstruction immediately following their mastectomy or wait until they are more comfortable moving forward, the PeaceHealth Medical Group Plastic Surgery team will be there to help along the way. Dr. Gabriel and Dr. Champaneria have vast experience in many traditional breast reconstruction techniques, as well as newer, innovative treatments.

Things to Consider

The surgical planning for a breast reconstruction typically begins at the same time as the planning for the mastectomy. There are points to consider such as how soon the patient will have the reconstruction and what type of reconstruction technique is best per the surgical case. It will need to be decided whether implants or tissue grafts are used, what type (if any) nipple and areola reconstruction will be used, and other techniques that are specific to the patient’s circumstance. The general goal is to help the patient regain a normal appearance of the breasts as part of the final phase of breast cancer treatment.

Surgical Technique

Surgical techniques vary and today, patients are getting more options that can match their personal preferences. It is important to find a highly specialized plastic surgeon to perform breast reconstruction and one who will work with the cancer surgeon to achieve a natural result.

Musculocutaneous Flaps

Musculocutaneous flaps take muscle from other areas of the body, like the abdominal muscles, to reconstruct the breast that has been removed. Since muscle does not grow back, muscle flaps can create weakness in the donor site that may limit actions. While muscle flap breast reconstruction may be best for some patients, others may consider microsurgical breast reconstruction techniques that use perforator flaps. These options can be reviewed on the page for microsurgical breast reconstruction.

TRAM Flap
TRAM flap (Transverse Rectus Abdominis Myocutaneous) reconstruction procedure uses donor muscle, fat and skin from a woman’s abdomen to reconstruct the breast. The flap may either remain attached to the original blood supply and then tunneled up through the chest wall, or be completely detached, and then formed into a breast mound. This breast reconstruction technique is beneficial because the tissue and skin transferred from the abdomen is very similar in softness and look to the breast. Additionally, due to the removal of abdominal skin and tissue, the patient will also receive a tummy tuck, resulting in a tighter stomach.

MS-TRAM Flap
MS (Muscle Sparring) TRAM uses less muscle than a standard TRAM to create the new breast. The needed muscle, skin, and fat will still be removed from the lower abdomen, but much less muscle is taken. The surgical procedure is similar to a standard TRAM flap surgery.

Latissimus Dorsi Flap
A latissimus dorsi flap procedure uses the skin, fat, muscle, and blood vessels from an area on the back, just below the shoulder. The latissimus dorsi flap breast reconstruction often looks very natural and it is best for women with small to medium sized breasts. If needed or wanted, an implant can be added to the latissimus dorsi flap for additional size and an improved shape.

Reconstruction With Implants

A breast implant can be an addition or alternative to flap techniques. Saline and silicone implants are available for reconstruction. Dr. Gabriel or Dr. Champaneria will help each patient decide their best treatment plan. Reconstruction with an implant alone usually requires tissue expansion. Reconstruction with tissue expansion allows an easier recovery than flap procedures, but it is a lengthier reconstruction process. It requires many office visits over 4-6 months after placement of the expander to slowly fill the device through an internal valve to expand the skin. A second surgical procedure will be needed to replace the expander if it is not designed to serve as a permanent implant.

AlloDerm® Regenerative Tissue

AlloDerm Regenerative Tissue Matrix is made from carefully screened donor tissue to help provide extra support that may be needed during breast reconstruction. AlloDerm can be used in a one-stage implant reconstruction or in a two-stage implant reconstruction with tissue expansion. The use of AlloDerm during breast reconstruction helps the new breasts look more natural and feel comfortable. The added framework allows the plastic surgeon more control when forming the breast shape and size.

During/After Surgery

Breast reconstruction uses general anesthesia, and the patient is often required to stay in a hospital if done simultaneously with the mastectomy. Patients who have flap surgeries sometimes stay up to 5 days for monitoring. There will be discomfort and pain within the first week, and the patient may feel disoriented with the newly formed chest. Temporary drain tubes and bandages are placed to assist in healing. It can be unnerving to go through a major body change; however, patients find it gratifying and relieving that they are able to once again look and feel normal as they start their new journey towards becoming a cancer survivor.

Botox for Pain Reduction

 Dr. Gabriel and Dr. Champaneria developed a method that uses BOTOX to decrease the pain created by a breast expansion implant. After noticing the pain in their patients' chest from the contracts and spasms of the expansion implants, Dr. Gabriel and Dr. Champaneria began using BOTOX injections to temporarily paralyze the affected chest muscles and minimize the pain. Dr. Gabriel and Dr. Champaneria published a paper in the Aesthetic Surgery Journal that details their work and findings. The full paper can be found at asj.oxfordjournals.org/content/35/4/402.long.

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Recovery Time  
2-3 Weeks
Average Procedure Time  
2-3 Hours
Post-op Follow-up  
Varies
Procedure Recovery Location  
Out-Patient
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Breast Reconstruction FAQs

Which Surgeon?

With breast reconstruction, a plastic surgeon will work alongside the cancer surgeon and be primarily involved and responsible as it pertains to restoring the appearance. It is a highly specialized surgery so it is critical to choose a plastic surgeon that has years of successful experiences in this type of surgery.

Delayed Reconstruction?

If a patient knows she will want to restore her breasts with a reconstruction procedure, it is recommended that this process begins at the time as the mastectomy. During the breast removal portion, the tissue expanders can be put into place, which eliminates a new surgery. This ultimately decreases the risk for complications.

Breast Sensation?

Because the breast is completely removed and a new one is formed, there will be a loss of sensation. Over time, there is a possibility that this sensation can be slowly regained. This is different for every patient. While some patients regain their sensitivity, there is no guarantee that this will be the case for everyone.

BOTOX for Pain Reduction?

Dr. Gabriel and Dr. Champaneria recently did a pilot study in which they evaluated the role of BOTOX in tissue-based breast reconstruction which can often be painful and discomforting after the procedure. Conclusions based on the study showed that BOTOX can be beneficial in expander-based reconstruction in reducing pain and aiding in expansion.

Read the pilot study: http://asj.oxfordjournals.org/content/35/4/402.long

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* All information subject to change. Images may contain models. Individual results are not guaranteed and may vary.