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Breast reconstruction in Seattle is the rebuilding of a breast that has been removed due to cancer or other disease. This surgical procedure involves the use of implants or flaps of the patients own tissue relocated to the breast to create a natural looking breast and recreation of a natural looking areola and nipple. The reconstruction of the breast is possible immediately following breast removal except in individuals with medical conditions such as high blood pressure, obesity, diabetes, and individuals who smoke. The reconstruction surgery is delayed until healing of the initial removal of the breast is completed, as these patients are considered high risk candidates. Breast reconstruction normally requires multiple operations, which are spread out over a period of time, usually weeks or months.
There are many methods of breast reconstruction. The two most common are Tissue expander-breast implants and a technique called Flap reconstruction. The Tissue expander-breast implants technique is the most common reconstruction surgery technique used world-wide. During his type of reconstruction procedure, the surgeon inserts a tissue expander, a temporary implant, beneath the pectoral muscle of the chest wall and over a period of time, injects a saline solution(similar to the solution used for intravenous fluids during surgery) to slowly expand the over-laying tissue. Once the expander has reached an acceptable size, it may be removed and replaced with a more permanent breast implant. Reconstruction of the areola and nipple are performed in a separate operation after the skin over the breast has stretched to its final size.
Flap reconstruction is the second most common procedure where tissue is used from other parts of patient's body, such as the back, buttocks, thigh or abdomen. there are two main types of the Flap reconstruction technique; the latissimus dor muscle flap and the Abdominal flap. In the latissimus dor muscle flap the donor tissue used is on the back. It is a large flat muscle which can be used without loss of normal function. It can be moved into the breast defect area, still attached to its blood supply under the armpit. This flap is often used to recruit soft-tissue coverage over an underlying implant.
Tith the Abdominal flap the donor tissue is on the abdomen and used in TRAM flap breast reconstruction. The abdominal tissue between the umbilicus and the pubis is used. It requires an advanced microsurgical technique and is less common. This provides enough tissue to reconstruct large breasts. The contour of the lower abdomen is improved by this procedure but may possibly weaken the abdominal muscles. A piece of surgical mesh is placed over the defect and sutured in place to prevent any muscle weakness and hernias.
During the Nipple areola reconstruction, if the contralateral breast has not been constructed and the nipple and areola are sufficiently large, tissue may be harvested and used to recreate the nipple-areolar complex. Cosmetic result can be achieved using tattoos. With local tissue flaps, a nipple may be created by raising a small flap in the target area and producing a raised mound of skin. To create an areola, a circular incision may be made around the new nipple and sutured back again. The nipple and areolar region may then be tattooed to produce a realistic color match with the contralateral breast.
Recovering from implant based reconstruction is faster than with flap-based reconstruction, but both reconstruction procedures take at least three to six weeks to recover and both require follow up surgeries in order to construct a new areola and nipple. Breast reconstruction patients should avoid active sports, over head lifting and sexual activity during recovery period. TRAM flap patients can show abdominal muscle weakness but most patients resume normal activities after recovery.
If you are seeking a cosmetic surgeon in the Seattle area for breast reduction, breast lift surgery, breast augmentation, breast reconstruction
or other cosmetic procedure such as abdominoplasty (tummy tuck), facelift surgery, browlift procedures, and more we would be delighted to see you in consultation.
Alisa Rekow, MD - 1221 Madison St., Suite 1102 - Seattle, Washington 98104 - 206.682.2200
Cosmetic Surgery
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