A breast cancer diagnosis and its accompanying treatment is often overwhelming, especially if it entails losing one or both breasts to a mastectomy. The physical changes involved can have a long lasting emotional effect and lead to a significant loss of confidence. This does not, however, need to be permanent.
Breast reconstruction can be done at the time of mastectomy or can be delayed until after cancer treatment is completed. There are numerous surgical options available to recreate the breasts, including single stage direct to implant reconstruction after nipple sparing mastectomies. Dr. Lickstein was one of the first surgeons in Florida to perform the procedure and one of the only surgeons who frequently performs the procedure using the “gummy bear” shaped implant. He is often asked to speak on the topic to peers, patients, and community groups.
Each individual patient’s individual unique circumstances and goals will determine which approach provides the greatest opportunity for success. Breast reconstruction is a highly personal decision, and Dr. Lickstein will help each patient consider their options and how to best approach their journey.
There are several procedures that can be used to reconstruct one or both breasts using your own tissue, fat grafting, implants, or a combination of techniques.
Implant vs. Tissue Flap
A tissue expander is temporarily inserted into the breast pocket to stretch the breast tissue so that it can adequately cover an implant. It is used when skin needs to be removed with the breast cancer, or a patient wishes to be a larger size. It may be used to preserve the shape of the breast until treatment is completed and an implant can be placed. Typically, the expander is progressively filled with a saline solution by accessing an internal port through your skin. This is done during your office visit every week. Once the breast tissue is stretched enough, the expander is replaced some period of time later by a breast implant.
Direct to Implant Reconstruction
An implant is placed into the breast pocket at the time of nipple or skin sparing mastectomy. This is typically done for patients with small to medium breasts, who wish to remain similar to their preoperative size.
Tissue Flap Reconstruction
This method of reconstruction uses tissue from another area of the patient’s body, such as the back, thigh, or abdomen, to reconstruct the breast mound or to provide enough tissue to cover an implant. The new breast tissue may remain connected to the original blood supply through blood vessels tunnelled beneath the skin to the donor site, or it may be detached and rely on the growth of new blood vessels (tissue graft). If the flap is being used to provide tissue coverage, an implant will be inserted beneath it.