The breast reconstruction procedure has changed quite a bit since its beginning and Dr. David Passaretti uses the most advanced and modern techniques to perform the surgery today. Oftentimes used for women who have undergone a mastectomy, breast reconstruction gives them a chance to restore their femininity and confidence.
In the last ten years, breast reconstruction has changed quite a bit. There
are a variety of new, advanced techniques which really can provide
excellent results for virtually all patients who are having breast
reconstruction. There are a variety of different techniques that we use.
One is not necessarily better than the other. We just need to choose the
right operation for the right patients.
The most common operation used to reconstruct breasts is called the tissue
expander. During this operation a tissue expander, a temporary implant, is
placed underneath the chest muscle. At the same time, a skin material,
generally [inaudible 0:31], is used to create a sling to extend from the
muscle down to the chest wall itself. The patient stays in the hospital a
few days and then goes home.
A few weeks later, they come back to the office, and we gradually build the
implant over time in the office. This really has several advantages. First,
the major concern during breast reconstruction surgery is the viability of
blood flow of the overlying skin which is reduced during the mastectomy.
The tissue expander allows us to leave the implant relatively empty the day
of the operation, thereby reducing the stress on the skin, and then filling
it as time goes on when the skin has had a chance to recover. It also
allows the patient the opportunity to live with the breast size, go home,
go shopping, try on her clothes, see if she likes the size and then come
back and have it adjusted before she makes her final decision about breast
size or implant size.
The tissue expander technique is often referred to as a two-stage
technique. The tissue expander is placed the first day during the
mastectomy. Then, three months later it is exchanged for the permanent
implant. You have two different implants which perform two different,
varied functions. The tissue expander, again, is designed to help us
minimize stress on the breast skin the day of the mastectomy which helps to
reduce the overall complication rate. It also, equally as importantly, acts
as a mold. The tissue expander is relatively firm, and relatively immobile
which means that over time, as your body contracts and heals around that
implant during the first three months, it will act as a mold to shape the
open skin envelope for the breast.
Three months later, once the wound healing process is completed, we can
then go back in through a much smaller incision, remove the tissue
expander, and replace with a permanent implant. Permanent implants are
generally made of silicone. They are very soft, smooth, and mobile which
provides a very natural breast.