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Breast Cancer

Learn more about Atlanta breast surgery from Board certified plastic surgeon, Dr. Franklyn Elliott with Atlanta Plastic Surgery, P.C.

Frequently Asked Breast Reconstruction Questions

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Breast reconstruction surgery is an emotionally charged process filled with a number of “what-ifs.” From basic questions regarding what to bring to the hospital to more complicated inquiries like what happens in surgery, we know that educating our patients is the first step to helping them feel comfortable with their decision to undergo breast reconstruction. Below are just a few of the common question we answer for our breast reconstruction patients.

What kind of clothes should I wear after surgery?

Many patients find that button-up and zip-up shirts are more comfortable the first week or more after surgery. Lifting your arms overhead may be difficult due to the nature of the surgery, so shirts with openings in the front will allow you to move more comfortably. Patients recommend soft, warm fabrics as many find hospitals on the chilly side. Some women say large camisoles that allow them to step into the shirt and pull it up or “bird-wing” their arms into the sleeves without raising them are also nice after surgery. Some companies make custom post-surgical shirts that are loose and even have pockets for drains.

What kind of scarring can I expect after breast reconstruction surgery?

Depending on the breast reconstruction technique used during your surgery, there are different incision placements. Some patients’ cases are less complicated and surgeons can try to hide scars. The flap procedures in which spare tissue is taken from the tummy can result in a tummy tuck like scar across the lower abdomen. Scars can be vertical, horizontal, straight, or curved. Each patient’s scars will be different because each woman’s medical needs are different. See Dr. Elliott’s breast reconstruction photo gallery to see the types of scars associated with specific surgical techniques.

Is breast reconstruction hard on the body? What is recovery like?

Each woman’s breast reconstruction situation is different. Some women undergo bilateral mastectomies of both breasts while others only have one removed. As such, each person’s recovery is different. Some breast reconstruction surgery techniques are less invasive than others. The TRAM procedures, for example, use tissue from another area of the body to replace the breast tissue lost during breast cancer removal surgery. Recovery from these surgeries generally takes longer. Dr. Franklyn Elliott provides all his breast reconstruction patients with specific aftercare instructions to ensure each patient’s recovery is as quick as possible.

Breast reconstruction surgery is never an easy choice. Some patients decide to have their surgery immediately after breast cancer removal, while some decide to wait or have to wait because of the need for radiation or other factors. We recommend you seek a consultation from a board certified plastic and reconstructive surgeon like Dr. Franklyn Elliott along with your oncologist and general surgeon. There, you and your doctors can formulate a plan that best suits your needs, and you can ask any questions you may have.

To stay up to date on the latest breast cancer and reconstruction news, make sure to follow Dr. Elliott on Facebook, Twitter, and Google+. You can also sign up for his monthly newsletter.

Can I Have Radiation Therapy for Breast Cancer after Breast Implant Reconstruction?

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dr elliottRadiation is meant to kill any remaining cancer cells in the body in order to prevent a recurrence of breast cancer. While it destroys cancer cells, radiation also affects blood supply to skin and deep tissues and even causes scar tissue. A breast implant would be subject to these changes since it would be directly within the radiation treatment area. Implants placed under the pectoral (chest) muscle would be subject to scarring that occurs in the muscle.

As the skin and muscle scars after radiation therapy, so does the scar capsule surrounding the implant. This puts patients at a greater risk for capsular contracture which occurs when a patient’s body reacts to a foreign object, forming a capsule around the implant. The extra scarring causes the capsule to tighten around the implant, creating a painful condition in which the breast looks hard and abnormal. While the implant itself remains normal, the tissue around it is affected.

Patients can have radiation therapy after TRAM flap reconstruction procedures with tissue expanders. However, it’s important to remember that the tissue will still be affected (i.e., scarring, changes in blood flow). This means the skin used in reconstruction will not be as soft as it would be if it were not part of radiation therapy.  Most surgeons will delay breast reconstruction if their patients need radiation so that they may use healthy tissue that hasn’t been affected by the treatment. Although each patient’s situation is unique, in general I prefer the TRAM flap procedure in any situation where radiation therapy is involved.

Stay up to date on the latest breast cancer and breast reconstruction news by following Dr. Elliott on Facebook, Twitter, and Google+.

What Are My Breast Reconstruction Options after Breast Cancer: Types of Reconstruction?

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As we mentioned in our previous blog on breast reconstruction options, reconstructing the breasts after breast cancer surgery can help women recover faster emotionally and restore the self-esteem of breast cancer survivors. While there are options as to when you choose to undergo breast reconstruction, there are also different types of reconstruction surgery. Patients can choose to have a reconstructed tissue flap to encase the breast implant, use their own tissue, or choose a combination of both. Patients can also choose between saline or silicone gel implants for their reconstruction.

Breast reconstruction can take place using the natural breast tissue if the general surgeon and oncologist deem it acceptable and safe to leave that tissue after removing the cancer.

Tissue flap procedures use tissue from another part of the body (abdomen, back, thighs, or buttocks) to reconstruct the breast. The two most common tissue flap procedures include the TRAM flap and latissimus dorsi flap techniques. The TRAM flap (transverse rectus abdominis muscle) procedure takes a section of skin, fat, blood vessels, and muscle from the abdomen to replace the breast tissue removed during a mastectomy. From there, a breast implant is inserted to rebuild the breast.

There are two different types of TRAM flap techniques. During a pedicled TRAM flap procedure, the tissue is not completely removed from the blood supply. While a free TRAM flap technique completely detaches the tissue and reattaches it to the blood vessels in the chest.

The latissimus dorsi flap procedure is similar to the pedicled TRAM except that the tissue, blood vessels, and muscle are moved from the upper back to the breast area creating a type of pocket for the implant.

The DIEP flap (deep inferior epigastric artery perforator) procedure works similarly to the TRAM flap technique except that it takes fat and skin from the lower abdominal area but does not use muscle. The effect on the stomach is the same as a tummy tuck since excess skin and tissue are removed from the lower abdomen except the excess tissue is used to rebuild the breast.

Breast reconstruction is an important choice for any breast cancer survivor. It takes careful deliberation and consulting with an oncologist and general surgeon, along with a reconstructive plastic surgeon like Dr. Franklyn Elliott, who actually worked to refine the TRAM breast reconstruction technique. For more information on breast reconstruction or to schedule a consultation, contact our office. Connect with us on Facebook, Twitter, and Google+ to stay up to date on the latest in breast cancer news.

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