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.View transcript
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.