Breast Reconstruction in St. Louis, MO
Parkcrest Plastic Surgery is proud to offer breast reconstruction to patients in St. Louis, St. Charles, Chesterfield, O’Fallon, St. Peters, Creve Coeur, and surrounding areas. Our staff’s caring attitude and top-notch plastic surgery services are two main reasons women trust us to perform their breast reconstruction in St. Louis. If you would like more information, please contact us today to set up an evaluation so we can help find a procedure that works for you.
What Is Breast Reconstruction?
Breast reconstruction is an operation to return the shape of the breast after a mastectomy (removal of the breast) or lumpectomy (removal of part of the breast). Breast reconstruction offers hope to women who are losing a breast — or have already lost one — to cancer or other disease. This procedure can often be performed immediately after the mastectomy or lumpectomy; however, some health conditions may require the patient to wait before undergoing reconstructive surgery.
What Is a Breast Reconstruction Procedure?
Breast reconstruction usually involves more than one operation, and follow-up procedures may be performed on an outpatient basis. Sometimes surgery is performed on the natural breast to better match the reconstructed breast; however, this creates additional scars.
Options for Breast Reconstruction Procedures Offered in St. Louis
Tissue Expander with Breast Implant
This is the most common of breast reconstructions not only in St. Louis, but across the country. In this procedure, a silicone tissue expander is placed under the skin. Once sutures are removed, saline is added weekly to the expander, which gradually stretches the skin. When the skin has been sufficiently stretched, the tissue expander is removed and replaced by a silicone-gel or saline-filled breast implant. Nipple reconstruction, if desired, may be performed when appropriate.
Advantages: This procedure offers the simplest reconstruction and shortest recovery from surgery. This is often the favored procedure for people who have health problems or contra-indications to extensive surgery.
Disadvantages: Multiple trips to the office are required over several weeks or months to undergo expansion.
- Loss of breast skin, requiring removal of implant (if you have undergone radiation, this procedure may not be advisable as you are at increased risk for skin loss)
- Noticeable outlines of the implant due to capsule formation
- Breast firmness due to tight or thick capsule formation
- Thin breast skin
Latissimus Dorsi Myocutaneous Flap
This surgery involves moving the latissimus dorsi muscle and overlaying skin from the back to the chest to create a new breast mound. The incision is often made along the bra line so the scar may be concealed. Blood transfusions are not usually required for this kind of breast reconstruction. A breast implant can be placed under the flap, if necessary, to balance a difference in size. Nipple reconstruction is done later.
Advantages: This is a very reliable procedure, which provides a good environment for an implant. The chances of capsule formation around the implant are reduced.
Disadvantages: The procedure creates a scar across the back.
- Circulation problems with the flap
- Formation of a tight or thick capsule around the implant
- Symptoms from use of latissimus muscle, such as decreased strength
- Loss of back skin, requiring skin grafting
- Collection of fluid (seroma) under incision, requiring needle aspiration
Rectus Abdominis Myocutaneous Flap
This is the most complicated and the longest reconstructive procedure, involving about four to five hours of surgery. One of the abdominal muscles is tunneled, along with the overlying skin, up to the chest. The breast mound is created to match the opposite side. A blood transfusion may be required. You may donate your own blood prior to surgery to be reinfused during the procedure.
Breast implants are not usually required. The tissue is generally adequate to match the size of the opposing breast. If the opposite breast is large or pendulous, it can be decreased in size by a breast reduction or, when appropriate, the opposite breast may be enlarged or lifted. Breast reconstruction patients must stop smoking six weeks prior to and six weeks following surgery. Failure to comply may result in death of the flap. A synthetic mesh may be placed over the area where the muscle is removed to strengthen the abdominal wall and minimize the chance of hernia formation. Nipple reconstruction is done as a second procedure. Some further contouring of the new breast mound at the same time may be necessary.
Advantages: This procedure provides the most natural-looking breast reconstruction with the added benefit of a tummy tuck. No implant is needed, so capsule formation is not a risk. The scar is hidden with clothing.
Disadvantages: There is a risk of hernia formation resulting from moving the rectus abdominus muscle. Abdominal strength is diminished. This is the longest procedure for breast reconstruction and has the greatest risk for requiring a blood transfusion.
- Inadequate tissue, requiring the use of a breast implant
- Poor circulation to the flap, resulting in tissue loss
- Weakness or herniation of the abdominal wall
- Placement of the umbilicus off center
- Collection of fluid (seroma) under the skin, requiring needle aspiration.
- Infection, in particular of the mesh, requiring surgery for removal.
What Does Breast Reconstruction Recovery Entail?
Recovering from a combined mastectomy and reconstruction or from a flap reconstruction typically takes longer than recovery from an implant reconstruction or a reconstruction performed apart from the mastectomy. Although healing times vary depending on the individual, the soreness at the surgical sites should diminish about two weeks after your breast reconstruction. Sensation may return to some areas of the breast, but it is important to note that a reconstructed breast will never feel completely normal or have normal sensation. Most breast reconstruction patients can return to work within two to three weeks.
At the Parkcrest Plastic Surgery office, Dr. David A. Caplin, Dr. Melvin Maclin, and Dr. Patricia McGuire offer plastic and reconstructive surgery to patients across Eastern Missouri including St. Charles, Chesterfield, O’Fallon, St. Peters, and Creve Coeur. Contact the Parkcrest Plastic Surgery office today to schedule your breast reconstruction consultation!4:02 pm