Options for Breast Reconstruction in Monterey

Breast reconstruction helps thousands of women each year who are faced with the prospect of losing one or both breasts due to cancer or other disease. Women in Monterey can have a breast reconstruction through several reconstructive plastic surgery techniques. All of them attempt to restore a breast to near its normal shape, appearance, and size following a mastectomy.

Tissue Expanders

Post-mastectomy breast reconstruction with a tissue expander and an implant requires a staged approach. Dr. Sunde will place a tissue expander on the chest wall, deep to the pectoralis major muscle, as a temporary device. This step may take place immediately following the mastectomy, or during a subsequent surgery—when tissue expanders are placed later, it is called a delayed procedure. The expander is designed to create a pocket to contain the permanent breast implant. Tissue expanders are available in a variety of shapes and sizes.

Over the next several months, the patient will return to Dr. Sunde’s office periodically. At each visit, he will add a small amount of saline solution to the temporary implant to gradually stretch out the tissues. When this process is complete, Dr. Sunde will perform a second surgery to place the permanent implant.

TRAM Flap Breast Reconstruction

A TRAM (transverse rectus abdominis myocutaneous) flap breast reconstruction procedure relies on using a patient’s own tissues, taken from the abdomen, to build a new breast following a mastectomy. The result of using a patient’s own skin is a natural-appearing breast reconstruction. The TRAM flap can be used for reconstructing one or both breasts. For women undergoing unilateral reconstruction, the TRAM flap can potentially offer better symmetry than using an implant.

Monterey plastic surgeon Dr. Douglas Sunde uses the entire rectus abdominis muscle to carry the lower abdominal skin and fat up to the chest wall. Dr. Sunde then creates a breast shape using this tissue. In order to transfer the flap to the chest, the muscle is tunneled under the upper abdominal skin, remaining attached to its healthy blood supply.

After the surgery, Dr. Sunde provides an elastic bandage or support bra for the patient to wear. These compress the surgical area and should minimize swelling while supporting reconstructed breast. Dr. Sunde may insert a thin tube under the skin to drain excess blood or fluid. This tube is removed within a few days. The doctor may recommend that the patient use a pain pump and/or prescribe medication to relieve any post-surgical pain.

A TRAM Flap is an involved procedure that is best suited for non-smokers who are in otherwise good health. Typically, this surgeyr requires several days of recovery in the hospital, and healing will take several weeks. Over time, the breast shape should normalize and improve.

Latissimus Flap

The latissimus dorsi flap method is a standard procedure for breast reconstruction that has been in use for more than thirty years. This method uses skin from the patient’s body. This breast reconstruction procedure is commonly combined with a tissue expander and breast implant. The latissimus flap technique offers Dr. Sunde additional options with regard to the appearance of the reconstructed breast. The skin flap can create a more natural-looking breast shape when compared to a breast restored through use of tissue expanders and breast implants alone. Thinner patients with small breasts can sometimes rely on a latissimus dorsi flap by itself for reconstruction—no implants needed.

Schedule a Personal Consultation

The best way to learn which breast reconstruction option is best for you is to meet with an experienced, board certified plastic surgeon. Dr. Sunde has been practicing cosmetic and reconstructive breast surgery in Monterey since 1994. He is trained and experienced in multiple breast reconstruction techniques, and works closely with a patient’s cancer surgeon and oncology team to design the safest breast reconstruction plan that will achieve the most aesthetically pleasing, natural appearing results possible. Please contact our office to schedule your personal consultation.