Breast Reconstruction Denver
Breast reconstruction is a very important surgery that can help you restore your self-esteem following undergoing a mastectomy. You may elect to have an immediate breast cancer reconstruction following your mastectomy or you may wish to wait until your treatment regimen is completed. Either way, Dr. Conrad Tirre will meet with you prior to your mastectomy to talk to you about the various options available to you based on your general surgery plan and possible chemotherapy or radiation treatments.
We encourage you to view our breast reconstruction videos which are very helpful in explaining the various techniques for breast reconstruction procedures. Additionally, we recommend the Mentor Breast Reconstruction Patient Education Booklet and the BRA Day USA guide.
We have detailed out some of the main options for breast reconstruction. It is important to remember that most reconstruction options are staged procedures, meaning that there are almost always more than one surgery involved. Even when explained there is one reconstructive surgery (such as with a TRAM reconstruction) there is often at least one revisionary surgery that is needed. We most commonly perform Tissue Expander followed by a Breast Implant.
Tissue expander followed by a breast implant – This is the most commonly performed breast reconstruction procedure. In our experience, this method typically achieves a natural breast result without the extensive healing required in some of the other reconstruction methods.
In nearly all cases of a delayed reconstruction and many cases of immediate reconstruction, a tissue expander will be placed at the time of the initial reconstruction. This allows the skin to recover following the mastectomy, prior to stressing it further with the full volume of the implant. For larger reconstructions or when the nipple is removed, this also allows us to stretch the skin and underlying pectoralis muscle to better accommodate the implants. Patients visit our office weekly for tissue expansion where we fill the tissue expander with a sterile saline solution. This is done in the office with little to no discomfort for the patient. This process may take several weeks to months as we create a new pocket for your breast implant. Additional things that may delay the tissue expansion process are radiation and/or chemotherapy treatments.
Once optimum expansion has occurred, Dr. Tirre will take you back to the operative room and place the permanent silicone (or saline) breast implant to complete the reconstruction of your breast. If symmetry with the other breast is needed, we may perform a breast lift and /or breast reduction in order to give you the best symmetry and match to your reconstructed breast.
Latissimus flap – This is most commonly performed now to help correct post-radiation problems such as asymmetry, capsular contracture or infection. This procedure utilizes the latissimus muscle on your back and a small to medium portion of the skin overlying it. The muscle and skin are then rotated through a tunnel high in your armpit and brought around to replace a portion of the damaged radiated tissue on the breast. This may also require an initial tissue expander in order to have adequate volume for the breast reconstruction. Typically after a few months, the tissue expander will be exchanged out for the silicone (or saline) breast implant to complete your reconstruction.
TRAM or DIEP flap – Some patients may opt for or be a good candidate for an autologous tissue reconstruction. The recovery time for these autologous tissue reconstruction procedures is extensive and typically longer than the tissue expander to implant method.
This reconstruction option utilizes your lower abdominal tissue to recreate the breast mound. A TRAM flap will utilize a portion or all of the rectus abdominis muscle. This may be performed as a pedicled flap (the muscle is rotated), or free flap (the blood supply is detached and then re-attached onto the chest under a microscope). A DIEP flap will not use the rectus muscle and just utilize the blood vessel which is re-attached at the chest under a microscope. Depending on your cancer treatment care plan, which may include radiation therapy, this method of reconstruction may not be the optimum plan for your reconstructive course of treatment. Dr. Tirre does not perform the TRAM or DIEP flap reconstructions even though he has his Fellowship in Microsurgery. We find that the extensive recovery time for these procedures does not best suit most of our patients. If you are interested in learning more about autologous tissue reconstruction, we are happy to refer you to a list of colleagues that Dr. Tirre works with that can speak to you directly regarding this.
Post Reconstruction Revisionary Procedures:
Fat Grafting to Reconstructed Breasts – Fat grafting has become a popular procedure in the cosmetic and reconstructive world. Fat can be harvested (similar to liposuction) and then this fat can then be re-injected over the implant or within a flap in order to smooth contours, help correct wrinkling or dimpling that may occur from your mastectomy and reconstruction.
Nipple Creation and Areolar Tattooing – If your mastectomy removed your nipple and areolar complex, we are able to re-create a nipple once your reconstruction has been completed. This is done as a simple, in-office procedure and we can discuss this with you during your reconstruction process.
Dr. Conrad Tirre is a member of the American Society of Plastic Surgeons as well as board certified by the American Board of Medical Specialties for Plastic Surgery. Dr. Tirre has been performing breast reconstruction surgery in Denver for more than 20 years. We participate with most insurance companies and can coordinate with most breast surgeons in the Denver metro area. Call our office today and learn more about breast reconstruction options – 303-832-3965.