Most people know what a mastectomy is, but I've had people ask me what breast reconstruction is and how it's done. There are those who are shocked when I tell them I had a "free" tummy tuck when I decided to have my breast reconstructed. For the benefit of those who are intrigued by this procedure, let me try to illustrate what it is, based on how my very able Plastic Surgeon, Dra. Catherine (Yen) Asedillo, explained it to me.
First things first : you can choose to have breast reconstruction at the same time as the mastectomy. Meaning, your Breast Surgeon and Plastic Surgeon will act like a wrestling tag team in the operating room. Once the Breast Surgeon is done with the mastectomy, the Plastic Surgeon comes in to do her thing. Get it so far?
WHAT IS BREAST RECONSTRUCTION?
This is a kind of surgery that women who have had a mastectomy choose to have, to rebuild the breast that underwent the mastectomy. The procedure doesn't include restoration of the areola and nipple, which can be done at a later time. A mastectomy patient can choose not to undergo breast reconstruction.
The specific procedure that I had is called a TRAM Flap Reconstruction. TRAM stands for transverse rectus abdominus myocutaneous. Sounds so foreign. Anyway ... during the procedure, skin, fat, muscle from the abdomen will be moved up to the chest. They are all used to create the breast mound, where your breast was prior to the mastectomy. I'm so thankful I had enough tissue in my abdomen (a.k.a. TABA!) from giving birth to two children, because that was enough to create my new left breast. It wasn't so hard, considering I'm not well-endowed hehe!
WHAT ARE THE ADVANTAGES OF A TRAM FLAP?
First of all, it's a one-shot deal. You get everything done one time, big time. No more going back for a 2nd confinement, 2nd dose of general anaesthesia, etcetera. Next: the free tummy tuck that goes with it.
But not all women can benefit from a tummy tuck. If you're young and haven't had kids, chances are, your tummy is still flat as a pancake. In which case, the rest of you probably isn't fat either. In these cases, an implant is the only way to go. The next advantage would be, the mound will look just like your original breast. It will feel the same and move the same. Given these, breast reconstruction will likely restore your confidence in yourself after a mastectomy.
ARE THERE ANY DISADVANTAGES?
Yes, if you want to call them that. To me, they're very minor. As long as they don't limit my activities and make me feel like a totally different person, I'm fine. The first disadvantage would be the scarring. Unlike my C-section scar which is really small, the scarring from the tummy tuck stretches from one hip to another. That's like the entire tummy, from side to side. Really long. I thought I could go back to wearing a bikini because of the tuck. Turns out, I won't be able to because of the length and the positioning of the scar. I'd be happy with my tankinis and my maillots but atleast I'll have a lot less jiggling going on down there hahaha. Another disadvantage would be that your new breast will not have much sensation, because the nerves that were originally there have been removed. This is a really weird feeling that one needs to get used to. But it's no biggie, it doesn't bring tears to my eyes and make me regret that I had the reconstruction done. The recovery time from a Tram Flap is also supposedly longer than if you were to get implants. But if you ask me, I'd rather have the Tram Flap. An implant is a foreign object, there's also a risk involved there.
By the way, the surgery also takes about 5-6 hours, which is why my total downtime (with the mastectomy) was around 8-10? I don't remember, but I think it was around that long.
Lastly, here's the simplest illustration I could find to show how it's really done
So there you have it. This is half of what I had to go through on the operating table, and the reason I don't feel incomplete. Thanks to my wonderful Plastic Surgeon, Dra. Yen!
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