Breast reconstruction restores a natural, symmetrical appearance to the bosom, maintains body proportion, allows clothes to fit better, and most important of all, boosts self-confidence for women who have lost one or both breasts to mastectomy or who lack breasts due to a congenital or developmental abnormality. Reconstructive surgeons strive to create a new breast and nipple that resemble the woman’s natural breast as closely as possible in shape, size and position.
Women whose cancer seems to have been eradicated with mastectomy are the best candidates for breast reconstruction. Those with health problems such as obesity and high blood pressure and those who smoke are advised to wait. Others prefer to postpone surgery as they come to terms with having cancer, consider the extent of the procedure, or explore alternatives.
The reconstruction itself consists of multiple operations, the first of which involves creation of the breast mound and is performed during or after mastectomy in a hospital under general anesthesia. Later surgeries, if necessary, may be done in the hospital or an outpatient facility, with either general or local anesthesia.
Male Breast Reduction (Gynecomastia)
Gynecomastia is a common condition that affects nearly half of all men, resulting in localized fat and/or glandular tissue in the breasts. For most cases of gynecomastia, the cause is unknown, but this condition may be linked to certain medications or diseases. Many men are embarrassed by this condition and seek treatment to achieve a smooth, contoured chest through male breast reduction.
Male breast reduction may be performed using liposuction, surgery or a combination of the two, depending on the amount and type of tissue found in the breasts. If the breasts consist of mostly fatty tissue, liposuction may be used to suction out fat from an incision in the nipple or underarm areas. For breasts with an excessive amount of glandular tissue, excision surgery may be performed, which requires cutting away the excess fat, skin and tissue through a larger incision. Your surgeon will determine which technique is best for you based on your individual goals for surgery.
After breast reduction surgery, patients will usually be able to return home the very same day. Post-operative symptoms may include swelling and discomfort, which can be managed through pain medication and compression garments worn for the first few days after surgery. Patients will be able to return to work once they feel well enough, but should avoid sexual activity and strenuous exercise for a week or two while the chest heals. For most patients, breast reduction surgery produces a flatter, more well-defined chest that can last for many years, as long as patients maintain a stable weight.
DIEP Flap Breast Reconstruction
Reconstructive breast surgery is an important option for women who have undergone breast cancer treatment that included the removal of breast tissue. Reconstruction can provide these patients with a sense of their return to health and well-being.
Breasts can be reconstructed either naturally, using your own tissue, or by placing an implant to shape the breast. The all natural method is the preferred type of breast reconstruction performed in the United States today. The version that is ideal for many women is called the DIEP flap, which stands for deep inferior epigastric perforator, named after the main blood vessel that runs through the tissue used to reconstruct the breast.
The DIEP flap reconstruction technique
This technique uses only your own skin, fat and blood vessels to reconstruct the breast. The tissue is removed from the lower portion of the abdomen, between the waist and hips. It is then transferred to the breast in order to create a new breast mound.
The DIEP is called a “free” flap because the tissue is completely detached from the belly and then reattached to the chest area. Connecting the blood vessels from the abdominal tissue to the chest blood vessels is delicate work. It requires the use of a microscope during surgery, which is why DIEP is known as microsurgery.
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