Breast reconstruction post mastectomy is very important sector of reconstructive plastic surgery.
There are several ways to reconstruct a new breast. One of those is the transverse rectus abdominis flap reconstruction. The surgery can be done immediate, after the mastectomy where the plastic surgeon takes over from the breast surgeon, or delayed, months or years after the mastectomy, when the wound has healed and patient has completed all other therapies such as chemotherapy and radiotherapy.
In this type of reconstruction the new breast is created using the patient’s own tissue. Transverse rectus abdominis is one of the two major abdominal muscles.
During surgery the muscle, the subcutaneous fat and a relatively large skin paddle from the lower abdomen is dissected, lifted, swiveled and transferred through a small tunnel in the chest wall towards the mastectomy. This mound of tissue, muscle-fat-skin, is formed into a breast and the abdominal skin is used to replace the skin excised during the mastectomy. Quiet often a mesh is used to cover the muscle defect, to avoid a hernia formation.
The choice of this type of reconstruction is done by the plastic surgeon, after evaluation of the quantity and quality of the abdominal tissue and all the benefits and risks are fully discussed to the patient.
This procedure is done under general anesthesia and the patient is required to stay 4-5 days in hospital.
When reconstruction is done only to one breast, additional surgeries may be required to the other one, in order to achieve symmetry. These are breast augmentation, breast lift or reduction.
