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Choosing the Right Reconstruction For You

 

breast-reconstructionOne of the most difficult aspects of the breast reconstruction process is figuring out which type of breast reconstruction is the best fit for each patient. Unfortunately, there is no simple algorithm which can do this. With several options now available for reconstruction, and so many resources to obtain information on the topic, it can be difficult to arrive at a final decision.

 

 

As described throughout our website, there are many reconstructive options available to women these days. Put simply, they can be summarized like this:

  • No reconstruction at all
  • Reconstruction with the use of implanted materials
    • Two stages with tissue expanders followed by breast implants
    • Single stage or straight-to-implant
  • Reconstruction using only natural tissues
    • Pedicled flaps (generally require muscle)
      • Latissimus dorsi flap
      • Pedicled-TRAM flap
    • Free flaps
      • Require muscle
        • Full-muscle free TRAM flap
        • Muscle-sparing free TRAM flap
      • Muscle-sparing (perforator flaps)
        • From the abdomen
        • From other locations
          • Free GAP flap (buttock)
          • Free TUG or PAP flaps (thigh)
  • Reconstruction using natural tissue and implants
    • Can be done by adding implants under almost any of the natural tissue reconstruction listed above

 

While additional options may exist, this roughly summarizes the major types of breast reconstruction that are currently available.

The main point to understand when comparing these options is that every one of them has potential advantages and disadvantages. When I discuss these options with my patients, I encourage them to make a list of the “pros” and “cons” for each type of reconstruction. But I don’t think my opinion should be their only source. I encourage them to further refine this list by tapping into other resources, such as online communities and websites dedicated to educating patients about their breast reconstruction rights and options.

Another very important point to understand is that not all of these reconstructive techniques may be an option for every patient. One’s past medical history, past surgical history, current medical issues, and anticipated treatments for their breast cancer may significantly impact the outcomes of certain reconstructions, making other options more likely to succeed.

Since each patient presents a very unique set of variables and desires, it is critical that they spend time with their Reconstructive Plastic Surgeon to go through their options one-by-one. Discussing the risks and benefits of each option will help you eventually arrive at the reconstruction that is the best fit for you.

About the Author

Ergun Kocak

Dr. Ergun Kocak, MD, MS, is a board-certified plastic surgeon who specializes in plastic and reconstructive surgery of the breast using DIEP, SIEA GAP, TUG, PAP, and direct-to-implant, in Columbus and Cincinnati, OH.
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Copyright 2014 Midwest Breast & Aesthetic Surgery. Dr. Ergun Kocak*, Dr. Pankaj Tiwari*, Dr. Bianca Chin*, Dr. Shunsuke Yoshida. All Rights Reserved. | Disclaimer
*All doctors are certified by the ASPS, ABPS & ASRM.
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