Breast reconstruction rebuilds a breast that has been removed because of cancer or other illnesses. This is done through the use of implants or relocating flaps of the patient’s own tissues. The result is a natural looking breast, with a reformed areola and nipple. The surgery is available immediately after breast removal and usually takes multiple operations over the course of weeks or months. The two most common techniques of breast construction are tissue expander breast implants and flap reconstruction. Reconstruction of the areola and nipple are performed in a separate operation after the breast has been formed, through either a nipple areola graft or the use of local tissue flaps.
TISSUE EXPANDER BREAST IMPLANTS
Tissue expander breast implants are the most common worldwide. An implant is placed beneath the pectoralis major muscle and over time is injected with a saline solution that expands the over laying tissue. Once the appropriate size is reached, the tissue expander breast implant is replaced by a more permanent implant.
Flap reconstruction uses tissue from other areas of a patient’s body, such as the back, buttocks, thigh or abdomen, to recreate the patient’s breast.
NIPPLE AREOLA GRAFT
If the contralateral breast has not been constructed and the nipple and areola are sufficiently sized, tissue can be used to recreate the nipple-complex. Tattoos can be used to increase the cosmetic result.
LOCAL TISSUE FLAPS
A nipple may be created by raising a small flap on the newly created breast, producing a raised mound of skin. To create an areola, a circular incision may be made around the new nipple and sutured back again. Tattoos can be used to increase the cosmetic result.