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Spring 2007
Choices Offered for Breast Reconstruction After Cancer
New
surgical techniques have dramatically improved the results of breast
reconstruction following mastectomy. For patients who are appropriate
candidates, microvascular surgery makes it possible to transfer tissue from the
lower abdomen or buttocks to reconstruct the breast at the time of the
mastectomy. This procedure has become the predominant technique for breast
reconstruction at the Revlon/UCLA Breast Center. Under the magnification of a
microscope, tissue from elsewhere on the body is connected to a blood supply in
the breast.
Prior to
the advent of microvascular surgery, breast reconstruction using the patient’s
own tissue (autologous tissue transfer) was significantly more invasive. “When
we were moving tissue around, we sometimes had to take a small piece of muscle,”
explains Andrew Da Lio, M.D., UCLA plastic surgeon. “Now that it’s almost solely
fat and skin, the functional downside has been reduced dramatically, to the
point where patients rarely notice any difference.” In most cases, the
reconstruction can be done in conjunction with the breast removal, improving the
cosmetic outcome, Dr. Da Lio says.
Implants still represent an attractive option for many patients. “Our results are getting better not only with autologous tissue transfers, but also with the use of implants,” Dr. Da Lio says. There are now multiple types of implants, using both saline and silicon, with a variety of shapes and textures. Women for whom mastectomy is the best choice should fully understand the pros and cons of microvasuclar surgery or implants for breast reconstruction, says Helena Chang, M.D., director of the Revlon/UCLA Breast Center.
“It comes down to individual choice, the ability to tolerate the surgery, and whether the patient will need radiation as a subsequent breast cancer treatment,” Dr. Chang notes.
Prior to
the advent of microvascular surgery, breast reconstruction using the patient’s
own tissue (autologous tissue transfer) was significantly more invasive. “When
we were moving tissue around, we sometimes had to take a small piece of muscle,”
explains Andrew Da Lio, M.D., UCLA plastic surgeon. “Now that it’s almost solely
fat and skin, the functional downside has been reduced dramatically, to the
point where patients rarely notice any difference.” In most cases, the
reconstruction can be done in conjunction with the breast removal, improving the
cosmetic outcome, Dr. Da Lio says.
Implants still represent an attractive option for many patients. “Our results are getting better not only with autologous tissue transfers, but also with the use of implants,” Dr. Da Lio says. There are now multiple types of implants, using both saline and silicon, with a variety of shapes and textures. Women for whom mastectomy is the best choice should fully understand the pros and cons of microvasuclar surgery or implants for breast reconstruction, says Helena Chang, M.D., director of the Revlon/UCLA Breast Center.
“It comes down to individual choice, the ability to tolerate the surgery, and whether the patient will need radiation as a subsequent breast cancer treatment,” Dr. Chang notes.
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