INTRODUCTION TO BAKERSFIELD BREAST RECONSTRUCTION

Breast cancer statistics show that one in eight (12%) women will experience breast cancer in her lifetime. Although a breast cancer diagnosis is frightening, recovery rates from this particular cancer have increased annually, due in part to early detection and better treatments.

Many women do not realize that breast cancer reconstruction is an integral part of recovery: if a woman feels better about herself, feels “whole again”, recovery is less daunting, less frightening. According to the statistics released by the American Society of Plastic Surgeons (ASPS) of which Dr. Dev is a candidate member, more than 79,000 breast reconstruction procedures were performed in 2008—a 39% increase over 2007. In spite of this, however, research shows that many breast cancer patients do not understand their reconstruction options. All health insurance companies, including Medicaid and Medicare, are required to pay for breast cancer reconstruction.

Dr. Dev firmly believes that every woman deserves the right to choose the reconstruction option to regain her natural breast shape and fullness. There are two options for the timing of breast reconstruction: immediate or delayed reconstruction. Immediate reconstruction is performed at the same time as the breast cancer surgery, which might be lumpectomy or mastectomy. Dr. Dev performs a skin-and-nipple-sparing mastectomy with immediate reconstruction using one of three techniques: (1) implants, (2) pedicled TRAM and (3) the DIEP flat procedure. For those women for whom a delayed reconstruction is preferred, due to the need for radiation and/or chemotherapy prior to reconstruction, he performs the TRAM flap and the DIEP flap, both of which are described below. Dr. Dev is one of very few US surgeons who perform the DIEP flap procedure.

GOOD CANDIDATES FOR BAKERSFIELD BREAST RECONSTRUCTION
It’s important that, immediately upon diagnosis, a woman discusses her reconstruction options with her oncologist. This ensures that the best reconstruction option is chosen. Since Dr. Dev can perform the mastectomy itself, his patients have the option of choosing both breast cancer surgery and reconstruction from the same surgeon. Another option is to have the oncology surgeon perform the breast cancer surgery and Dr. Dev perform the reconstruction, either immediately or following chemotherapy and/or radiation treatments.

HOW BAKERSFIELD BREAST RESTORATION IS DONE
Breast reconstruction is usually performed on an outpatient basis at a Bakersfield hospital or state-of-the-art surgical unit while you are asleep under general anesthesia. Occasionally, depending on the extent of the procedure or a patient’s preference, Dr. Dev may recommend that you stay overnight.

Breast Reconstruction with an Implant
For patients who have had a mastectomy and are appropriate for an immediate reconstruction, either a saline or silicone implant can be used. This assumes there is enough breast skin to accommodate an implant. If there is not, a tissue expander can be inserted to “grow” the skin to allow an implant to be placed. In general, a breast implant for reconstruction is the same procedure as a breast augmentation, which can be seen through this link.

Breast Reconstruction with the TRAM Flap Procedure
The acronym, TRAM, stands for Transverse Rectus Abdominis Myocutaneous, which describes the muscle that is used to replace the breast tissues removed at the time of cancer surgery. A portion of this muscle group, along with blood vessels, skin, fat and connective tissue, is removed from the patient’s abdomen and transplanted to the breast site. Some patients prefer this alternative to an implant. Although the result is similar to a tummy tuck, the abdominal strength will be somewhat decreased, as the transverse rectus muscle is removed.

Breast Reconstruction with the Pedicled TRAM Flap Procedure
Though similar to the TRAM flap procedure above, a pedicled TRAM flap procedure is different in this respect: the surgeon does not separate the blood vessels from the original abdominal area. Instead, the blood vessels remain intact, and the flap of skin, muscle and tissue is brought up under a “tunnel” beneath the chest wall and attached to the breast area, creating a new breast.

Breast Reconstruction with the DIEP Flap Procedure
The acronym, DIEP, stands for Deep Inferior Epigastric Perforators, which are the blood vessels in the abdomen. These vessels and the surrounding skin and fat are removed from the lower abdomen and transferred to the chest to reconstruct the breast tissue. The DIEP flap procedure is similar to the TRAM flap procedure, but does not use any abdominal muscle. This results in a smaller incision, less postoperative pain and a faster recovery compared to a TRAM flap, as no abdominal muscle has been used in the reconstruction. Abdominal strength is also maintained following surgery, and the results are similar to a tummy tuck in appearance. Two or three stages of this procedure are performed a few months apart to complete the reconstruction and obtain the most natural results. Because the DIEP flap is very complex microsurgery, requiring a highly skilled surgeon, few surgeons offer this option. Dr. Dev is one of only a handful of surgeons who perform DIEP flap in California.

In the DIEP flap procedure, the abdominal tissues mentioned above are detached from the abdomen and reattached to the small blood vessels in the breast area, after which the tissue is shaped to fit the mastectomy defect. A small skin patch is left, which will later be used to reconstruct the nipple.

RECOVERY FROM BAKERSFIELD BREAST RECONSTRUCTION
Generally, post-operative instructions call for plenty of rest and limited movement in order to speed up the healing process and recovery time. Bandages are applied right after surgery to aid the healing process and to minimize movement of your breasts. In the rare occasion that Dr. Dev has had to insert drains during your procedure, these are generally removed in just a few days.

Once the bandages are removed, a specialized surgical bra will need to be worn for several weeks. Although some patients report minor pain associated with breast augmentation, this discomfort can be treated effectively with oral medication; some women find that ice packs are also effective. While complications are rare, you can minimize potential problems by carefully following the directions given by Dr. Dev after surgery.

Of all plastic surgery procedures, breast reconstruction results in the quickest body-image changes. Patients are pleased with the elimination of physical pain caused by large breasts as well as a better-proportioned figure, an enhanced appearance, and better fitting clothes. Please call our office today to schedule your breast reconstruction consultation.