Breast reconstruction surgery is a common procedure for women who have had a mastectomy due to breast cancer. It can be done at the same time as your mastectomy or after your mastectomy. Breast reconstruction surgery can help you feel more confident about your body after breast cancer treatment.

Breast reconstruction surgery may be an option if you are having a simple mastectomy, which means only the tumor is removed and not your entire breast. You may also need breast reconstruction if you had a radical or modified radical mastectomy, which means the entire breast is removed because of the presence of cancer cells that could spread to other parts of your body.

If you’re thinking about having breast reconstruction surgery, here are some things to consider:

-You should know what kind of implant will be used for your reconstruction surgery before getting started on this process because this will determine how much it costs as well as how long it takes for things like swelling or bruising to go away after surgery has been performed on both breasts simultaneously so that there’s no visible scarring between them afterward! Here are some popular choices available today: silicone gel implants silicone gel implants have been around

Breast Reconstruction After Mastectomy Ireland

Flap Reconstruction

What is Flap Reconstruction?

Flap reconstruction is a surgical procedure that involves transferring healthy skin tissue from one location on your body to another.

Flap surgery can be utilized for procedures such as breast reconstruction, trunk, and extremity reconstruction, or for reconstruction of facial features or nerves.

Breast reconstruction with flap surgery is a complex procedure performed by a plastic surgeon to restore shape to your breast after a mastectomy (surgical removal of one or both breasts) by taking a section of tissue from one area of your body and relocating it to create a new breast mound.

What are the Types of Flap Reconstruction?

There are different types of flap reconstruction procedures that are classified based on the source of the skin flap obtained from your body to perform the flap surgery. These include:

• DIEP Flap Reconstruction: The DIEP (deep inferior epigastric perforator) flap is a newer procedure that uses fat, skin, blood vessels, and minimal abdominal muscle tissue to form a new breast mound with reattachment of blood vessels through microsurgery. This is a less painful and fast recovery procedure compared to TRAM flap and helps in preserving abdominal muscles to maintain strength and function in your abdomen.
• TRAM Flap Reconstruction: The TRAM (transverse rectus abdominis muscle) flap is a procedure that uses skin, muscles, and fat from your lower abdomen to form a new breast mound. The skin, blood vessels, fat, and at least one abdominal muscle are transferred from the abdomen to the chest.
• SIEA Flap Reconstruction: The SIEA (superficial inferior epigastric artery) flap procedure is a less invasive option that uses abdominal tissue as in DIEP and TRAM flaps, but relies on blood vessels that are located not as deep within the abdomen.
• Latissimus Dorsi Flap Reconstruction: In this type of reconstruction, your surgeon tunnels muscle, fat, skin, and blood vessels from your upper back, under the skin to the front of the chest. This approach is used for small and medium-sized breasts or for creating a pocket for a breast implant. This provides added coverage over an implant and makes a more natural-looking breast than just an implant alone.
• GAP Flap Reconstruction: The gluteal free flap or GAP flap is a reconstruction surgery that uses tissue from your buttocks to create a breast mound. The blood vessels, skin, and fat are cut out of the buttocks and then transferred to the chest. The GAP flap is an option for women who prefer not to use their abdominal site due to history of previous abdominal surgery, thinness, or aesthetic reasons.
• TUG Flap Reconstruction: The TUG (transverse upper gracilis) flap is a procedure where your surgeon uses muscle and fatty tissue from the bottom fold of the buttocks extending to the inner thigh to create a new breast mound. The muscle, skin, and blood vessels are then cut and transferred to the chest, and the tiny blood vessels are joined to their new blood supply.

Procedure for Flap Reconstruction

Flap reconstruction is a major procedure that is undertaken under general anaesthesia. Your surgeon will locate the tissue donor site and make an incision across the selected site for tissue extraction. Based on the site location, a flap of skin, muscle, fat, and blood vessels will be loosened and removed. Your surgeon will transfer the removed flap to your chest area to construct a new breast mound. Your surgeon will then undertake the complex task of connecting the flap’s blood supply to the tiny blood vessels under the arm or behind the breastbone. Your surgeon then shapes the extracted tissue to create a new breast mound and connects it to the blood supply. Your surgeon will close the incisions in your new breast and the tissue donor site with stitches.

Postoperative Care and Instructions

Flap reconstruction is a complex surgery that takes 8 to 12 hours to complete. Post-op care and instructions include:

• You will be shifted to the recovery room post surgery where you will spend a few days.
• You may have drainage tubes in place to remove excess fluid that may collect in the surgical site.
• You will experience some pain and discomfort and your doctor will prescribe pain medicines for pain control.
• You will have some soreness, swelling, and bruising for 2 to 3 weeks, and your doctor will provide adequate medications for faster healing and overall recovery.
• Your doctor will provide you with instructions on bathing, showering, and wound care.
• You will be able to resume normal activities within a couple of months but may have activity restrictions on strenuous physical activities.
• A series of follow-up appointments will be scheduled to monitor your progress.

Risks and Complications Associated with Flap Reconstruction

As with any surgery, flap surgery for breast reconstruction may involve potential risks and complications, such as:

• Poor wound healing
• Changes in breast sensation
• Bleeding
• Infection
• Abdominal wall hernia or weakness
• Fluid or blood accumulation
• Scar formation
• Tissue rejection
• Breast lumps
• Necrosis (tissue death)
• Loss of sensation at the tissue extraction site

Benefits of Flap Reconstruction

Flap surgery for breast reconstruction offers many benefits, including:

• Helps to have natural looking breasts
• Avoids the need for using external prostheses inside your bra
• Improves your body image and self-esteem

BREAST RECONSTRUCTION

The easiest way to build a new breast is to use a breast implant. However, often the tissue over the chest wall so tight that a single prosthesis implantation is not possible. You then need to have more skin in this area to allow the breast to be reconstructed and this can be achieved in a couple of different ways.

One method is to insert a tissue expander (a small silicone balloon) under the breast muscle, which will gradually get stretched out with saline solution by using a valve located under the skin. When tissues are stretched out, the balloon is replaced by a permanent implant. You can read more about breast augmentation here> Other options for providing the tissue needed for breast reconstruction is to take a flap of skin from another part of the body.

Breast Implants and Fat Grafting

The use of breast implants is the simplest method of breast reconstruction, however in recent years fat grafting using the patient’s own tissue to rebuild the breast has become increasingly more popular as a method of reconstruction among surgeons. If a small chest is to be built up so that an implant can be inserted or that one breast matches the size of the other, fat grafting may be an option. This can be done by using injections of fat cells taken from the stomach, to the breast area which bind and become part of the body again, thus increasing breast size.

One reason why choosing this method of reconstruction is increasing among surgeons is that the risk of complications from prosthesis implantation is significant enhancement of thoracic tissue has been irradiated after breast cancer surgery. This risk does not exist when using the woman’s own tissue. Another advantage is that the new breast is soft and has more symmetry with the natural non-surgical breast.

Nipple Restoration

If the nipple removed in relation to breast cancer surgery, a new nipple is created. Our actual knob can be done in different ways. Either half of our knob on the remaining breast moved to the operated side, or small skin tags can also be cut on the reconstructed breast at the site of our knob and swayed around each other in order to have a protruding knob. One can also build our bud of tissue from the ear lobe or a toe. 
 
 After our bud rebuilt themselves can areola is created, either with skin graft from the inner thigh, or by borrowing some of the skin from the second breast areola. More common today is the creation colored skin of the areola with tattooing techniques, medical tattooing, by adding brown colour of the areola area who then tattooed into the skin. This gives a very natural appearance of the new nipple and areola.

The Result

Unlike regular breast augmentation surgery are normally only built up one breast with an implant. This results many times in the new breast will be slightly firmer and rounder in shape than the natural non-surgical breast. Therefore, you always have a certain asymmetry after the reconstruction of only one side of chest.