Different techniques for reconstructing breasts after mastectomy

Hi, I'm Dr. Erica Anderson at the Nadiri center and I am the breast and body specialist. And one of my main areas of focus is breast reconstruction. And I wanted to just review with you today a brief overview of what breast reconstruction means and the types of reconstruction that we classically do. I'll start from simple to more complex. So a simple way to reconstruct a breast is with a tissue expander to implant based reconstruction. And so at the time of mastectomy, a tissue expander or a temporary device is placed, placed in the area where the breast has been removed, that is then serially inflated over time and exchanged from that temporary device to a more permanent device, a breast implant. That's a very simple way to approach breast reconstruction and actually can be very successful for most women and get a good aesthetic outcome as it gets more complicated, whether that's based on anatomy or preference. There are ways to use your own tissue to reconstruct the breast after mastectomy. Areas that we typically borrow from include the abdomen, the back, some microsurgeons are even using the inner thigh or the bottom of the butt basically to reconstruct a breast. All of those are more technically challenging and are reserved for the ideal case, truthfully. Probably the area that's utilized most frequently of those choices, however, is the abdomen. And the abdom based reconstructions has gone through a trend of trying to make it less hurt, less hurtful to the abdomen, for lack of a better way to describe it. So it began 20 years ago with what was called a pedicled tram flap, tram T, R, a M, transverse rectus abdominis myocutaneous flap. And it was basically tunneled underneath the chest in order to bring that to the reconstructed area. It's gone through the evolution where now that tissue can actually be removed from the body and using microvascular technique can be transplanted onto the chest. And that is referred to as a deep flap, D, I, E P or deep inferior epigastric perforator flap, and has gotten a lot of press recently. I would say in the last five years that's become a very interesting way for people to approach the reconstruction, thinking that there's improvement with that approach and it's in the right hands. It's very well done. But there are complications related to it, which I'm happy to discuss with you further if you are a good candidate for that approach. But that's just a little overview of what we can do implant based to the extreme of the abdominal based flap. And there's a bunch in between that I'd be happy to discuss with you for a consultation. So please come and see me about breast reconstruction here at the Nadiri Center.