Breast reconstruction is a complex procedure that aims to restore the shape, size, and appearance of a woman’s breasts after a mastectomy or other breast-related surgeries. While traditional breast reconstruction methods involve the use of implants, there has been a growing trend in recent years towards more natural, implant-free techniques. These procedures aim to rebuild the breast using the patient’s own tissue, resulting in a more natural look and feel.
Many women come to our practice and have read or heard about the risks associated with implant breast reconstruction. The media has given a lot of attention to the risks of breast implant illness and lymphoma that is associated with breast implant. Other women have had problems with their current implants or previous radiation therapy. Natural flap reconstruction is a great option for these patients.
Young women in their 30s and 40s are also great candidates for natural breast reconstruction with flaps. These patients are either diagnosed with breast cancer at an early age or are undergoing prophylactic mastectomies due to being at high risk with a BRCA or other genetic mutation. After learning that implants are not lifetime devices, and can potentially leak and need to be exchanged every 10 years, they often will choose flap reconstruction. With natural flap reconstruction, they will have less surgeries over their lifetime. Their own tissue will age with them better than implants.
Treatment Options for Natural Breast Reconstruction
There are several natural breast reconstruction techniques that do not require the use of implants. These include:
- TRAM Flap: This procedure involves removing skin, fat, and muscle from the abdomen and using it to rebuild the breast.
- DIEP Flap: This procedure is similar to the TRAM flap, but only the deep inferior epigastric perforator (DIEP) vessels are used to transfer the tissue, preserving the rectus muscle.
- PAP Flap: This surgery involves transferring skin and fat from the upper inner and back of the thigh area.
- TUG Flap: This procedure involves taking skin and fat from the inner area to rebuild the breast.
- GAP Flap: This procedure involves removing skin and fat from the buttocks and using it to rebuild the breast.
Conditions for Natural Breast Reconstruction
While natural breast reconstruction without implants is a viable option for many women, it is not suitable for everyone. Some of the conditions that may disqualify a patient from this procedure include:
- Obesity: Excessive body weight can make it difficult to find suitable tissue for transfer. There is only one small vessel supplying blood flow to the tissue that is transplanted, and too much tissue can outstrip the blood supply, leading to complications.
- Smoking: Smoking can impair healing and increase the risk of wound healing complications.
- Previous abdominal surgery: If a patient has had a previous abdominoplasty, it is not possible to use the abdominal tissue for reconstruction with a DIEP flap. Other scars on the abdomen are usually okay but would need to be evaluated by Dr. Jandali before surgery. Our office will also obtain a CT angiogram to evaluate the blood vessels before surgery.
Risks and Benefits of Natural Breast Reconstruction
As with any surgical procedure, natural breast reconstruction without implants carries a certain degree of risk. Some of the most common risks associated with this procedure include bleeding, infection, delayed healing, wound formation, and additional scarring. However, the benefits often outweigh the risks with this approach, including a more natural look and feel, improved self-esteem, and a lower risk of complications compared to implant breast reconstruction methods.
Ideal Candidate for Natural Breast Reconstruction
The ideal candidate for natural breast reconstruction without implants is a woman who has undergone a mastectomy and is looking for a more natural alternative to traditional implant breast reconstruction methods. She should be in good overall health, with no medical conditions that would disqualify her from surgery.
Frequently Asked Questions About Natural Breast Reconstruction
Is natural breast reconstruction without implants safe?
Natural breast reconstruction without implants is generally considered safe on an appropriate surgical candidate. In patients with previous radiation treatment of the breast, it is a much safer method of reconstruction compared to implant reconstruction. Dr. Jandali will be able to provide you with more information on the specific risks associated with your procedure.
How long does the recovery period last after natural breast reconstruction?
The recovery period for natural breast reconstruction without implants can vary depending on the specific flap technique used. In general, patients can expect to spend 2-3 days in the hospital followed by a few weeks of recovery at home. Most patients can return to any activities or exercise with no restrictions after 8 weeks.
Will I need additional surgeries in the future?
In most cases, one additional surgery is performed to fine tune the results and achieve the best symmetric outcome. This surgery is much shorter than the flap reconstruction surgery, with no drains and much less of a recovery. The revision surgery is an outpatient surgery with minimal discomfort. Further, some women will decide to undergo nipple reconstruction or potential 3D nipple/areola tattooing after healed.
Charting Your Personal Path to Wholeness
Natural breast reconstruction without implants is a growing trend in the world of plastic surgery, offering women a more natural alternative to traditional breast reconstruction methods. With the right surgeon and the right technique, patients can achieve a beautiful, natural-looking result that helps restore their self-confidence and sense of femininity after a mastectomy. Contact us today to schedule a consultation with Dr. Jandali and learn more about your options for natural breast reconstruction.
