Dallas, Texas Breast Reconstruction Surgeon Performing Corrective and Post-Mastectomy Reconstruction
Breast reconstruction is appropriate for two classes of patients: those who have breast deformities from prior cosmetic breast surgery and those who have undergone mastectomy (breast removal) for cancer treatment. Dr. Mark A. Deuber strives to create the most natural-appearing and symmetrical breasts possible in each of these circumstances. Women seeking breast reconstruction have several options at our Dallas, Texas practice, as Dr. Deuber demonstrates mastery in a number of advanced breast reconstruction techniques, including latissimus flap, free TRAM flap, DIEP flap, and SIEA flap surgeries.
Correction of Cosmetic Deformities
Breast reconstruction, or secondary breast surgery, may be necessary if problems or deformities have resulted from prior breast augmentation surgery. These could include:
- problems related to capsular contracture (excessive scar tissue causing an unnatural breast shape, feel, and appearance)
- implant rippling
- implants placed over the muscle
- excessive bottoming out of implants
- implants placed in circumstances that may have necessitated a breast lift.
Dr. Deuber has extensive experience in improving the appearance of breasts that have been altered with prior cosmetic surgery at other practices. Women who are unhappy with their results come to Dr. Deuber’s Dallas, Texas office, knowing he is a breast reconstruction expert able to utilize advanced techniques to improve patients’ results.
Correction of cosmetic deformities is frequently complex, involving longer, more complicated surgeries than primary breast surgery or breast augmentation. Frequently, Dr. Deuber may recommend the use of silicone breast implants. In addition, it may be necessary to divide the correction of certain deformities into stages with two or more separate surgeries spaced three to six months apart.
Post-Mastectomy Reconstruction
Breast reconstruction after mastectomy is usually performed in stages that can span three to six months or longer. There are two basic options for reconstruction: reconstruction with breast implants (with or without a latissimus flap) and reconstruction with a patient’s own tissue. There are many issues for a patient to consider, so Dr. Deuber will explain your options and unique circumstances to enable you to make the best decisions. In order to achieve optimal results with breast reconstruction, Dr. Deuber must meet with each patient during an initial consultation to create a customized surgical plan. Patients may choose to undergo implant-based breast reconstruction or tissue-based breast reconstruction (without implants).
Implant-based Breast Reconstruction
Breast reconstruction with implants is usually performed in two operations. The first surgery expands the patient’s tissue to accommodate the new implant. If supplemental tissue is needed from another area of the body, Dr. Deuber can perform a latissimus flap reconstruction.
Breast Implant-based Reconstruction with Tissue Expander
At the time of mastectomy, a tissue expander is placed beneath the skin and muscle to stretch the overlying skin. Beginning two to three weeks after surgery, saline solution is injected into the expander to recreate the appropriate breast volume and shape. Three to six months later, the expander is removed during an outpatient procedure and a permanent saline-filled or silicone-gel-filled implant is placed.
Breast Implant-based Reconstruction with Latissimus Flap
In many cases, a patient’s tissue is thin after mastectomy. This condition leaves too little tissue to cover an implant, resulting in a less-than-ideal cosmetic result. To achieve the best cosmetic result, the breast skin and tissue can be supplemented with a “flap” of skin and some additional tissue from the side of the body. In a latissimus flap breast reconstruction, a small amount of skin and underlying muscle from the side of the body is transferred to the breast area. The skin from the side replaces the skin of the areola removed during the mastectomy and the muscle supplements the tissue that covers the implants. This method yields very natural breast reconstruction results for our patients. The resulting scar on the side is usually hidden in the bra line.
Microsurgical Breast Reconstruction (without Implants)
Dr. Deuber is experienced in all of the latest surgical reconstruction techniques and offers his patients from Dallas, Texas and beyond only the most effective breast reconstruction procedures. A number of techniques have been developed that can achieve natural-looking breast reconstruction without the use of breast implants.
TRAM Flap Breast Reconstruction Without Implants
The most well-known technique is the TRAM (transverse rectus abdominus myocutaneous) flap procedure. This technique transfers skin, fat, and muscle from the abdomen to the chest to reconstruct the breast. The downsides of this technique include pain; a prolonged recovery; the possible development of abdominal weakness, bulge, or hernia; the loss of abdominal strength; and a poor shape for the reconstructed breast.
Free TRAM Flap Breast Reconstruction Without Implants
A number of improvements over the traditional TRAM flap procedure have been developed. The most well-known of these is the free TRAM flap technique, in which skin, fat, and muscle are completely detached from the abdominal wall and microsurgically reattached at the chest. This technique generally produces a superior cosmetic result but still carries risks, such as abdominal wall morbidity (possible weakness, bulge, and hernia).
DIEP and SIEA Flap Breast Reconstruction Without Implants
Other techniques have recently been developed that involve removing skin and fat from the lower abdomen without damaging the underlying muscles. These include the DIEP flap (deep inferior epigastric artery) and the SIEA flap (superficial inferior epigastric artery). These types of reconstruction have several benefits: patients receive completely natural breast reconstruction with their own tissue and without breast implants, there is little or no possibility of abdominal weakness after surgery, and patients experience less pain and a shorter recovery time than is traditionally associated with TRAM flap reconstruction. These flaps are extremely difficult to elevate and transfer to the chest successfully, so it is important to find an experienced breast reconstruction surgeon to perform your DIEP or SIEA flap breast reconstruction.
Dr. Deuber is one of a handful of surgeons in the country with extensive experience using both the DIEP and the SIEA flap techniques for breast reconstruction. You may visit our Dallas, Texas practice for a breast reconstruction consultation to learn which type of breast reconstruction might be appropriate for you. Schedule a consultation with Dr. Deuber today and learn more about your breast reconstruction options.
