Breast Reconstructionin Portland, Oregon
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What is Breast Reconstruction?
Breast reconstruction is a surgical procedure that is done to enhance the size and shape of a patient’s breast following mastectomy. Volume is added with the use of breast implants, which come in a variety of shapes, sizes, and materials to choose from, or with the patient’s own tissues. Dr Fichadia feels honored to be a part of your journey to fight cancer. She understands that a new diagnosis of breast cancer can be overwhelming. Her goal is to ensure that you are well-informed without feeling overwhelmed as you process all the treatment options. She is a regular presence at the Providence St Vincent’s multidisciplinary breast conference where individualized cancer treatment plans are formulated.
Who is a Candidate?
Breast reconstruction has been shown to have tremendous psychologic benefits after a mastectomy. In order to be considered for a breast reconstruction, you should be cleared by your oncologist and have realistic expectations for the best possible outcome.
A patient may consider a breast reconstruction if:
- They have recently been diagnosed with breast cancer that has resulted in a mastectomy.
- A patient is left with breast asymmetry and they are looking for breast reconstruction regain balance.
- They are looking to regain a sense of normalcy or femininity to their body that they may have lost due to breast cancer.
Breast Reconstruction Using Implants
Dr. Fichadia offers a few different breast reconstruction options using implants. The right surgical plan for you will be determined during your consultation. The breast reconstruction with implants options include:
Immediate reconstruction above the pectoral muscle: This procedure is performed with a mastectomy and results in an immediate breast mound. The implant is placed above the pectoral muscle and wrapped in mesh to ensure it stays in the correct position.
Immediate reconstruction below the pectoral muscle: The breast reconstruction procedure also takes place along with a mastectomy and results with an immediate breast mound. Dr. Fichadia will elevate the pectoral muscle and place the implants below it.
Delayed tissue expansion: With this breast reconstruction, Dr. Fichadia will first insert a tissue expander under the skin. This will make room for the eventual implants. Once enough space is created, she will then insert the implants in the pocket created by the expander.
Immediate tissue expansion: With immediate tissue expansion, Dr. Fichadia will place the expander under the skin, and the device is expanded right away instead of over time. This will quickly stretch the skin and underlying tissue and create a pocket for the breast implant.
Breast Reconstruction Using Flap Procedures
With breast reconstruction using flap procedures, Dr. Fichadia uses your own tissue to create a breast mound after a mastectomy. The tissue can be taken from the abdomen, thighs, or glutes, depending on the amount of tissue available.
Abdominal Flaps
Some of the abdominal flap breast reconstruction options we offer include:
- Pedicled TRAM flap
- Free TRAM flap
- DIEP flap
- SIEA flap
Thigh Flaps
The thigh flap breast reconstruction options Dr. Fichadia regularly performs include:
- TUG flap: Transverse Upper Gracilis flap
- VUG flap: Vertical Upper Gracilis flap
- DUG flap: Diagonal Upper Gracilis flap
Gluteal Flaps
The gluteal flap breast reconstruction options you have at Hetal Fichadia, MD, FACS include:
- SGAP flap: Superior Gluteal Artery Perforator
- IGAP flap: Inferior Gluteal Artery Perforator
Breast Reconstruction Alternatives
With the advancements in medical knowledge and technology, there are a wide variety of breast reconstruction alternatives. From a breast form or prosthesis to the Goldilocks procedure that uses the remaining fatty tissue left after a mastectomy, there are a number of options. During your consultation, Dr. Fichadia will walk you through each option and give you the information you need to make the right decision for you.
What to Expect During a Breast Reconstruction Consultation
During your breast reconstruction consultation, Dr. Fichadia will go over your medical history and list of medications and then perform a thorough physical exam. This is the perfect time to ask questions, bring up concerns, and learn about your options. Dr. Fichadia will walk you through the benefits and risks and build a custom treatment plan that fits all your needs and helps you in the next steps of your journey.
Preparing For Breast Reconstruction
To prepare for your breast reconstruction, you’ll want to follow all of Dr. Fichadia’s pre-op instructions. You’ll want to quit smoking if you’re a smoker, stop taking certain medications like aspirin or blood thinners, arrange for a friend or family member to drive you to and from surgery and watch over you for 24 hours, and prepare an area in your home for your recovery. The night before your surgery (typically around midnight), you’ll want to quit eating and drinking.
The Procedure
During your consultation with Dr. Fichadia, she will review your reconstructive options as well as provide her recommendation to help you achieve your specific aesthetic goals. Just like for breast augmentation, there are a variety of implants that can be used to address a patient’s unique aesthetic concerns. In addition to these factors found in a normal breast augmentation, Dr. Fichadia can also reconstruct the breast or breasts using a patient’s own fat, skin, and muscle.
Initially, Dr. Fichadia may feel that a tissue expander is necessary to insert underneath the skin and muscle to help create space for a breast implant. This allows the skin and muscle to expand gradually to form a pocket for the implant. If you have an adequate amount of space for the implants without needing a tissue expander first, you may be able to have implants inserted right away. Dr Fichadia has experience with nipple sparing mastectomies, and prepectoral reconstruction in the right candidate.
The most common types of breast implants used for augmentation and reconstruction are saline and silicone. Saline allows the option for changing breast size without surgery while silicone would require surgery to change the implant size.
Results and Recovery
The results you can expect to experience with a breast reconstruction are the renewal of the physical normalcy that you may have been missing as a result of a single or double mastectomy. It is important that you prepare your home and coordinate with a friend or family member to help you while you recover. Dr. Fichadia will review your recovery instructions with you before you are released. It will be important for you to follow these instructions carefully for a smooth recovery.
If you are interested in learning more about the breast reconstruction process, contact Dr. Fichadia’s office today to schedule a consultation.