Mastectomies are life-saving surgeries designed to remove breast cancer. While effective, these surgeries often leave women feeling incomplete. Houston plastic surgeon, Dr. Leo Lapuerta, is a breast reconstruction specialist that works with cancer patients in the greater Houston, Pearland, and Katy areas to help them regain their self-confidence. His goal is to surgically rebuild the breasts to restore an original appearance by creating a natural shape and contour, while at the same time, ensuring they are symmetrical. Dr. Lapuerta will work with the cancer surgeon towards a mutual goal so that the best surgical outcome can be achieved.
During the first consultation to discuss breast reconstruction surgery, it is important for patients to disclose where they are in the treatment process and which cancer surgeon provided treatment. Our office will require patients to provide any necessary pathology reports. The reconstruction process may take place in multiple steps if the breast tissue needs to be stretched to make room for implants. This discovery phase will help guide the reconstruction process so patients end up with a new breast that is the size, shape and look they want.
Each reconstruction technique will be tailored according to the patient’s physical health, aesthetic goals, and personal preferences. There are many factors playing into the approach that will be taken. The ultimate goal is to ensure the patient is healthy and happy with their final breast results.
There are two primary categories of breast reconstruction techniques:
Procedures that involve using a breast implant
Procedures that are autologous (use the patient’s own body’s tissue to reconstruct and recreate the breast)
RECONSTRUCTION WITH IMPLANTS
Breast reconstruction using silicone or saline implants is a common approach that generally starts with the use of a tissue expander to help form a suitable pocket for an implant. The expander may be inserted after the mastectomy procedure or during the same operative session. Over the course of several months, the expander will slowly be enlarged using a sterile solution injected through a port residing under the skin. During the scheduled reconstruction surgery, the expanders are removed and replaced with silicone or saline implants.
If there is limited tissue inside the breast, or limited skin on the outside, tissue may be used from another part of the patient’s body to supplement this loss. The most common areas to support this process are the buttocks, thigh or abdomen. This is an autologous approach to breast reconstruction. The TRAM flap (Transverse Rectus Abdominus Myocutaneous), the DIEP flap and SIEA flap techniques involve taking skin and fat from the abdomen and relocating it to the breast. The latissimus dorsi flap is another common method using tissue from the patient’s back.
During a mastectomy, the nipple and areola often cannot be saved. The loss of one’s nipple and areola can be as unnerving as the removal of the breast itself. However, reconstruction techniques have advanced greatly, allowing plastic surgeons the opportunity to recreate these areas of the breast to give a natural, aesthetically appealing appearance. In a separate procedure, the nipple is created using existing breast skin or from the abdominal or latissimus flap. Using a tattoo technique, the areola is recreated with a skin graft taken from the thigh, abdomen or back.
Breast reconstruction surgery is performed under general anesthesia at an accredited surgical facility. Some patients may be required to stay in the hospital to be monitored for complications. Patients who have had reconstruction using a flap technique will usually be required to stay in the hospital for 2-5 days. The recovery process can be somewhat lengthy, but many view it as the final step in their cancer journey thus the experience can be very rewarding. Most women are thankful to have had the opportunity to restore their breasts and are satisfied with their results.
The Women’s Health and Cancer Rights Act of 1997 has made it possible for many women to undergo breast reconstruction surgery without the burden of a heavy financial cost. The act states that insurance companies and managed care organizations are required to pay for breast reconstruction for women who have had a mastectomy. It supports all phases of the cancer treatment and reconstruction process. Our insurance and billing office will work with the provider to understand exactly what the coverage will be.