A look at a single-stage breast reconstruction

Most women who are facing mastectomy choose to have immediate reconstruction for both emotional and physical reasons. When a patient chooses an implant reconstruction, she initially undergoes a two-step procedure. The first one is at the time of the mastectomy with insertion of an expander, followed by a period of multiple office visits to inject the expander with fluid. This is followed by a second stage surgery to remove the expander and exchange it with a permanent implant. Recently, multiple techniques have evolved to complete the reconstruction in one stage. Dr. Sami Bittar recently published a technique that completes the reconstruction at the time of the mastectomy in one approach. This technique involves breast reconstruction with anterior approach latissimus flap and placement of a permanent implant.

Any surgery takes an emotional, physical and financial toll on each patient. Converting a two-stage breast reconstruction into one stage has the obvious advantage: minimizing these tolls and keeping the patient focused on their cancer treatment without interruption. In Dr. Bittar's opinion, however, the anterior approach latissimus flap has the definite added advantage of receiving a better aesthetic outcome versus the older versions of breast reconstruction, including the DIEP.

No expanders needed

The known technique of breast reconstruction using a latissimus flap is traditionally done by recruiting the latissimus muscle from the back in order to cover the implant in the front by using an incision in the back. Additionally, expanders are used in the traditional technique. The single stage anterior approach latissimus flap with a permanent implant is done by harvesting the muscle through the same mastectomy incision and using a permanent implant instead of the expander, completing the reconstruction in one stage. What truly sets this approach apart is the ability to achieve the most aesthetic outcome in one setting without using any foreign biological material. With the increasing popularity of nipple-sparing mastectomy, a four-stage breast reconstruction, which usually includes insertion of the tissue expander, exchanging the expander to a permanent implant, nipple reconstruction and the tattoo of the areola and the nipple itself, can all be achieved in one stage, thus decreasing the number of procedures from one to four. When a patient is a candidate for a nipple-sparing mastectomy, there is no doubt the aesthetic outcome in some occasions is similar to breast enhancement surgery.

To learn if a single stage breast reconstruction with this approach is for you, please call Dr. Sami Bittar at his Chicago area practice. You can make an appointment online or by calling 708-354-4667. We look forward to hearing from you and becoming a part of your journey towards recovery.

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