Advances in Breast ReconstructionThree major surgical advances that have made implant-based breast reconstruction better.
Advances in Breast Reconstruction Have Improved the Results of Three Areas in Tissue-Expander and Breast-Implant Reconstruction: Acellular Dermal Matrix, Form-Stable Implants, and Autologous Fat Transfer
ACELLULAR DERMAL MATRIX IN BREAST RECONSTRUCTION
Acellular dermal matrix is a natural scaffolding derived from the inner, non-cellular portion of skin that has helped our patients in several important ways.
With immediate reconstruction, acellular dermal matrix allows the surgeon to place an implant or a tissue expander without restricting the curve of the lower pole of the breast. When I use this material I connect it to the bottom edge of the pectoral muscle and to the proper level of the breast fold.
Another important use of acellular dermal matrix is for the treatment of capsular contracture, the formation of a tight fibrous capsule that may occur around breast implants. For reasons that are not yet entirely clear, it is difficult for this fibrous tissue to form over the portion of an implant that is covered by acellular dermal matrix.
AUTOLOGOUS FAT TRANSFER IN BREAST RECONSTRUCTION
One of the significant challenges of implant and expander breast reconstruction is that there is just a thin layer of skin over the pec muscle after a mastectomy has been completed. We have known for years that our reconstructions would look much better if only we could somehow have more of a layer of fat to camouflage the implant. The results from a reconstruction might then be more like the results of a breast augmentation in a woman with very small breasts. Fat transfer opens up this possibility.
I have made use of fat transfer in my breast reconstructions for over five years. I routinely place fat in the plane between the skin and muscle in the second stage of my tissue expander reconstructions, which is when I remove the expander and place the breast implant. This allows for a softer look that is more like the natural breast.
I also use fat to prepare the breast for complex delayed reconstructions, particularly if there has been radiation. The beneficial effect of fat on irradiated skin can be quite dramatic.
FORM-STABLE IMPLANTS IN BREAST RECONSTRUCTION
Form stable breast implants help me to maintain a natural teardrop shape in the reconstructed breasts that I create. These implants, also referred to as anatomical breast implants or gummy bear implants, are made in such a way that they keep a greater degree of fullness in the lower portions of the breast, no matter what the position of the body. This keeps the reconstructed breasts from having a “top-heavy” look, which has been one of the frustrations of implant-based breast reconstruction surgery.
A HAPPY SYNERGY FOR BREAST RECONSTRUCTION PATIENTS
Each of the advances that I have just described has led to improved results with breast reconstruction. When these advances are combined, there is a powerful synergy that works to the patient’s advantage.
Acellular dermal matrix allows for an easier creation of a natural curvature to the lower portion of the breast; form-stable implants help the body to maintain that desirable shape; and fat transfer produces a soft, natural result.
Dr. John Q. Cook has more than 20 years of experience performing breast reconstruction surgery. He is committed to providing his patients with the very latest and safest treatment techniques, and stays ahead of the latest advancements in breast reconstruction surgery. If you would like to learn more about breast reconstruction at his Chicago practice, contact Dr. Cook today at 312-751-2112 or send an email.