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Breast Reconstruction Surgery
The breast reconstruction team at UT Southwestern Medical Center has pioneered a number of techniques that preserve muscle, minimize recovery time, and reduce pain.
Our plastic surgeons work with our breast cancer specialists at UT Southwestern's Harold C. Simmons Comprehensive Cancer Center – the only National Cancer Institute-designated comprehensive cancer center in North Texas – to help patients make the best decision for reconstruction after breast cancer.
Restoring a Natural Look and Feel
The decision to have breast reconstructive surgery goes far beyond what happens in surgery. At UT Southwestern, our goal is to help each patient look and feel her best, long after surgery – applying safe, highly innovative techniques to create breasts that look and feel natural.
Our surgeons have pioneered a number of techniques that preserve muscle, minimize recovery time, and reduce pain. In North Texas, many of the newest muscle-sparing procedures, such as autologous tissue-based reconstruction, as well as a combination implant-autologous tissue reconstruction, are performed only at UT Southwestern Medical Center.
"We combine a unique, artistic perspective with groundbreaking surgical solutions to help us create breasts that look and feel natural."
Individualized Options and Reconstruction Plans
We offer a broad spectrum of breast reconstruction options. Surgeons talk to each patient about options to help her make the best decision based on her health, future breast cancer treatments, projected recovery time, body shape, and other factors.
One area in which UT Southwestern has gained distinction involves the use of flaps, where tissue is transplanted from other parts of the body to reconstruct the breast. Basically, “flap” means any tissue with a blood supply or that is connected to a main artery and vein. By using flaps, patients should expect less downtime and more natural, aesthetic results.
The main types of flap procedures we perform to create a new breast include:
- Deep inferior epigastric perforator (DIEP): Uses tissue from the lower abdomen
- “Efficient” deep inferior epigastric perforator (eDIEP): Uses tissue from the lower abdomen efficiently
- Profunda artery perforator (PAP): Uses tissue from the back of the upper thigh (upper posterior thigh area)
- Stacked Flaps: Uses tissue from different parts of body in combination – generally two areas
- 4-Flaps: A type of stacked flap generally using DIEP, PAP, or LAP flap in combination
- Double-Pedicle DIEP flap: Uses tissue entirely from the lower abdomen for one side breast reconstruction
- Lumbar artery perforator (LAP): Uses soft tissue of the waistline (flank/ ‘love handle’ area)
- Lateral Thigh Flap (LTP): Uses tissue from the upper side of the thighs
Also, if a patient has one breast surgically removed, we can suggest additional procedures to reshape or lift the natural breast. The goal is to match the existing breast with the reconstructed breast. We can perform reconstruction procedures in conjunction with a mastectomy or years after breast cancer treatment.
The procedures include:
- Immediate breast reconstruction after a mastectomy, which offers the advantage of preserving as much of the breast skin envelope as possible, maximizing cosmesis and retaining as much of the breast’s own skin as possible
- Delayed reconstruction, where the final results can be very comparable to immediate reconstruction
- Surgery to revise a previous procedure
Types of Breast Reconstruction
There are three main types of breast reconstruction:
- Autologous tissue-based reconstruction: This procedure offers the newest advancements to sculpt and shape breasts that look and feel natural. It can allow for sensation to the reconstructed breast. We create a fat graft or flap using tissue transplanted from elsewhere on the patient’s body. If tissue is taken from the abdomen, the patient also receives a tummy tuck. This procedure is suitable for women who do not have enough skin to cover an implant.
- Implant reconstruction: During the initial surgery, a tissue expander is placed under the pectoralis muscle. It’s then filled with saline until the proper volume is achieved. Our surgeons then use either a saline or silicone implant for the reconstruction. Implant reconstruction offers the shortest operative time and is the simplest breast reconstruction surgery. The typical candidate includes women:
- With an adequate skin pocket to hold an implant
- Who do not have adequate tissue for reconstruction or who do not want to use their own tissue
- Without a history of radiation treatment
- Combination implant and autologous reconstruction: This technique combines both implants and flaps, where tissue from another part of the body is used in the reconstruction.
Breast Reconstruction: What to Expect
The time it takes for breast reconstruction varies. Breast reconstruction typically happens in three phases. Initial reconstruction for patients with breast cancer begins in combination with (or after) surgery to remove the cancer. Refinements are made after the initial reconstruction. A nipple and areola are added as a final step.
Our plastic surgeons are key members of the breast cancer team at UT Southwestern. We partner with medical and surgical oncologists. Patients can be referred to our breast reconstruction experts by physicians practicing at facilities outside UT Southwestern. Women who have received breast cancer treatment outside UT Southwestern can also choose our experts to perform their reconstructive surgery.
“My philosophy is simple: I’m not satisfied until my patients really understand their diagnosis, and the pros and cons of each option. Each patient is unique, and there are no cookie-cutter solutions.”