Breast Reconstruction Tampa FL

 

Tissue Expander With Implants

This two stage breast reconstruction begins after the mastectomy has been completed. The expander is placed above or below your chest muscle along with mesh acting to support the expander on the same day of the mastectomy. Over the next six to ten weeks, the expander is filled with saline every 1-2 weeks. The expander stretches the breast skin and prepares the chest for breast implants at a second surgery. 

In a second surgery, the expanders are removed and either saline or silicone breast implants are placed. Dr. Ambay will help you to understand the pro and con of each implant type, shape and profile. You will then be in a better position to make an informed decision that is right for you.  

 

Surgery length: Multiple Stage, First Stage; 3-4 hours when done with mastectomy. Second Stage: Replace with implant, 2 hours

Hospital stay: 1-2 days

Amount of pain: Narcotic pain medication for approximately 2 weeks

Recovery: No strenuous exercise until the final implant has been placed and 4 weeks has passed.

Latissimus Dorsi Flap

The latissimus dorsi is the large muscle that runs along the back giving body builders that "V" shape and helps us pull down things from overhead. In this reconstructive breast surgery, the muscle is cut along with its overlying skin and fat (LD flap). The LD flap is then rotated from the back to the front of the breast. There is usually a lack of volume in this flap and thus it is commonly used in conjunction with an expander and implant in patients who have undergone radiation or had previous failed reconstruction.   

 

Surgery length: 3-4 hours and usually is performed months after a mastectomy

Hospital stay: 3-4 days

Amount of pain: Narcotic pain medication for approximately 2 weeks

Recovery: Most women require 6 weeks before they are able to return to unrestricted activity. 

TRAM Flap

The TRAM flap uses one or both of the stomach muscles commonly referred to as the "six pack", along with the overlying skin and fat to recreate the breasts. The muscle(s) is cut and tunneled under the skin to replace the breast. An artificial mesh is used in the abdomen to help protect against the risk of hernia and bulges. This reconstruction does not need an implant to create breast volume. It is also used as a primary reconstruction, or in cases of failed reconstruction and radiation. 

 

Surgery length: 6-8 hours when done with a mastectomy

Hospital stay: 5 days 

Amount of pain: Narcotic pain medication for approximately 2-3 weeks

Recovery: Expect 6-8 of relative inactivity. You may begin by walking and gradually increasing activity over time.

DIEP Flap

This reconstruction does not involve any cutting of muscle or placement of anything artificial. The patients skin and fat is used from the abdomen. Essentially, a patient uses excess tissue that would have been discarded in a tummy tuck to recreate a breast.  The tissue is carefully dissected along with its blood supply. Then, under a microscope, we hand sew the artery and vein from the tummy tuck tissue into the vessels of the chest that were cut during the mastectomy. Essentially creating a living breast from abdominal tissue. 

 

Surgery length: 8-10 hours for both breasts and 4-6 hours for one breast when done with a mastectomy

Hospital stay: 3 days

Amount of pain: Usually Tylenol or other non-narcotic pain medication 

Recovery: Expect to be walking the day after surgery, showering the second say and at home the third. There are no restrictions on the amount of walking. You may drive and perform most activities of daily living after the first week.