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Breast Reconstruction Options for Breast Cancer Patients

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Every breast cancer diagnosis is different, and treatment plans are designed for each patient’s unique case.  According to the American Cancer Society’s most recent estimates for breast cancer in the United States, about 226,870 women will be diagnosed with new cases of invasive breast cancer in 2012. If a woman has a mastectomy, or breast cancer removal surgery during which one or both of the affected breasts are removed, she may consider breast reconstruction surgery. Board certified plastic and reconstructive surgeon, Dr. Franklyn Elliott has performed breast reconstruction for the last 25 years and understands the importance of educating every patient about their breast reconstruction options.

Although there are several breast reconstruction options, the American Society of Plastic Surgeons reports that only 33 percent of eligible women undergo breast reconstruction. Dr. Elliott’s passion for breast reconstruction extends beyond educating his own patients. He often attends breast symposiums to teach other plastic surgeons the most advanced breast reconstruction techniques so they can educate their own patients.

Breast reconstruction surgery may be performed immediately or sometime after cancer removal depending on the patient’s situation. Immediate reconstruction occurs at the same time as the breast cancer removal procedure. Delayed reconstruction is an additional surgery performed after a mastectomy, even years after the breast cancer has been removed. Dr. Elliott offers a variety of breast reconstruction options including breast reconstruction with breast implants, reconstruction using tissue expanders, tissue flap reconstruction techniques, and breast reconstruction using acellular dermal matrices.

In tissue flap reconstruction procedures, the breast is reconstructed with the use of tissue from another part of the body such as the abdomen, back, thighs or buttocks.  There are many flap procedures including the TRAM flap, DIEP flap, and latissimus dorsi flap. The TRAM flap (transverse rectus abdominis myocutaneous  ) uses a section of skin, fat, blood vessels, and muscle to replace the breast tissue that had been removed. There are two techniques for TRAM flap procedures: free and pedicled. A free TRAM flap removes the tissue from the body to reattach it to the blood vessels in the chest, while pedicled TRAM flap uses tissue that maintains its original blood supply. The DIEP flap (deep inferior epigastric artery perforator) procedure is very similar to TRAM flap, but does not use muscle from the abdomen (only skin and fat).  Finally, the latissimus dorsi flap procedure is similar to the pedicled TRAM procedure, but uses tissue from the back rather than the abdomen. This procedure has the advantage of leaving minimal scarring on the back.

Acellular dermal matrix (ADM) is another breast reconstruction technique that Dr. Elliott uses with his breast patients.  ADM uses soft tissue replacements (either synthetic or animal based) to provide additional coverage and support for tissue expanders or implants used in breast reconstruction.

If you are interested in learning more about breast reconstruction options please contact our office today. Be sure to connect with us on Facebook, Twitter, and Google + to stay updated on the latest breast technology news and information.

 

TRAM Flap Breast Reconstruction Dissected

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After a woman has had a mastectomy or breast cancer removal she may choose to have a breast reconstruction procedure. There are several different techniques for breast reconstruction.  A common technique is the TRAM flap, or transverse rectus abdominis myocutaneous surgery, which utilizes a portion of a woman’s abdominal fat, muscle, and skin to reconstruct a breast.  Many women prefer using their own tissue for their breast reconstructions because it can produce a more natural looking result. While other breast reconstruction techniques like reconstruction with a breast implant can also yield natural looking results, some women may not have enough healthy breast tissue after cancer removal to be candidates for such methods.

The first TRAM flap reconstruction was performed over 25 years ago and has gained popularity among women and reconstructive surgeons over time. Retired Dr. Carl Hartrampf, co-founder of Atlanta Plastic Surgery, originated the TRAM flap method for breast reconstruction after a mastectomy.  Since then Dr. Franklyn Elliott has significantly refined the TRAM technique and has performed the procedure live in a number of centers worldwide. As one of his specialties, Dr. Elliott is passionate about breast reconstruction and often travels around the world discussing and teaching fellow plastic surgeons the latest reconstruction techniques.  As the former director and current co-director of the Atlanta Breast Surgery Symposium, Dr. Elliott remains on the cutting edge with advancements in breast reconstruction technologies and has written numerous articles discussing TRAM flap reconstructions.  To prevent breast surgery complications he uses a well designed surgical plan and consistent technique when performing a TRAM flap surgery on his patients.

The TRAM flap technique is helpful for patients who do not wish to or are unable to undergo reconstruction with implants or tissue expanders. There are two types of TRAM flap techniques, the pedicled TRAM flap and free TRAM flap. During a pedicled TRAM flap procedure the tissue maintains its original blood supply while the free TRAM flap completely removes the tissue from the body and reattaches it to the blood vessels in the chest.

To learn about more about the TRAM flap procedure and other types of breast reconstruction please contact our office and connect with 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 and Twitter to stay up to date on the latest in breast cancer news.

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