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For most mastectomy patients, the loss of a breast is a severe emotional loss – a loss of self-esteem, femininity and self. Breast reconstruction strives to replace not just the breast, but the emotional loss as well. The breast reconstruction process may begin at the time of your mastectomy or can occur weeks to years afterward.
There are different approaches to reconstruction which vary according to the type of mastectomy and the condition of the breast skin. When there is enough skin and if it ís loose and thick enough, reconstruction may be achieved through a simple implant or prosthesis. When there is not enough skin to accommodate an implant, additional skin from another area is needed. This donor skin is called a “flap” which consists of not only skin, but the muscle and blood vessels that sustain it. Often the broad muscle in the back and its overlying skin is used as donor tissue. The flap is detached and moved underneath the skin (tunneled) to the breast area where it is sutured to the local skin forming a pocket for the implant.
Another technique uses a flap from the abdomen that is tunneled to the breast area, and folded on itself. If the mound is large enough, no implant will be needed. Another technique involves a skin or tissue expander placed beneath the chest muscle which over several weeks is filled with a saline solution. To reconstruct the nipple and areola, additional surgery may be necessary.
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