Cairo Plastic Clinic 

Breast reconstruction surgery is performed to restore a breast that has been removed due to cancer or other diseases. A new breast is formed using tissue from the abdomen and/or back muscles or by using a tissue expander and inserting an implant. The reconstruction creates a breast that can be close in form and appearance to match the natural one. Surgery can also be performed on the other breast to improve the symmetry such as a reduction, a breast lift or insertion of an implant.

Am I a good candidate for the surgery?

Your visit with Dr. Wilson will determine if you are a good candidate. If you are in good physical and mental health and your breast surgeon has approved the timing for your breast to be reconstructed then more than likely you will be an appropriate candidate.

What should I expect from my consultation?

During your consultation, Dr. Wilson will evaluate your general health. You will learn about the surgery, its limitations and risks, and discuss your needs and concerns. He will explain which surgical techniques are the most appropriate, based on your desires, your body limitations and the condition of your breast(s). He will describe alternatives, risks and the limitations of each procedure. He will examine your body and will consider such factors as the quality of your skin tone and the contour of your abdomen, back and breast(s).

How is skin expansion performed?

Skin expansion is the most common breast reconstruction performed. It combines skin expansion and the subsequent insertion of a breast implant. An expander is inserted beneath your skin and chest wall muscle. Through a tiny valve that is part of the expander, injections of saline (saltwater) will gradually fill the expander over a period of weeks or months. This stretches the skin allowing room for a more permanent implant, either saline or silicone depending on your choice. Not all patients require a tissue expander before the insertion of an implant. In these cases the implant is inserted following your mastectomy.

A nipple reconstruction is performed on an outpatient basis as the third procedure. Many patients come back to have their areola and nipple tattooed in the clinic after their nipple reconstruction.

How are flap reconstructions performed?

The Flap breast reconstruction involves the creation of a skin and muscle flap using tissue from your back or abdomen. There are two kinds of flap reconstructions, the latissimus and the TRAM (Transverse Rectus Abdominis Myocutaneous Flap) .

The latissimus flap uses the muscle and skin from your upper back that is still attached to its blood supply but is repositioned to create a breast. This procedure may require an implant or expansion with an implant as well.

The TRAM flap uses tissue from the abdomen either leaving it attached to its blood vessels or reattaching it to blood vessels in the chest area. Another variant is the DIEP flap which onlu uses part of the muscle rather than sacrificing the whole part. Sometimes, skin and fat from the buttock area can be used to reconstruct the breast. The best option suited to your condition will be decided by Dr Wilson after he examines you. Sometimes the normal breast might be enlarged or reduced to match the newly reconstructed breast.

These procedures are more complex than tissue expansion. Scars will be left at both the donor site and on your newly constructed breast. Even though the healing phase takes longer, your results are more natural and in the case of the TRAM flap, you have the added benefit of an improved abdominal contour.

Breast Reconstruction Using  free TRAM flap: Following a modified radical mastectomy and radiotherapy, this patient was disease free and a free TRAM flap was used to reconstruct her left breast from the abdomen.

 Breast Reconstruction Using  TRAM flap: Following a modified radical mastectomy and radiotherapy, this patient was disease free and a pedicled TRAM flap was used to reconstruct her breast from the abdomen.

Breast Reconstruction Using  Silicone Implant:Following a subcutaneous mastectomy, an immediate reconstruction was performed by a silicone implant.

Breast Reconstruction by Tissue Expansion: This patient underwent a skin-sparing mastectomy, and a saline expander was inserted at the time of the surgery. It was gradually inflated until the desired size was attained, then replaced by a permanent silicone implant. 

Breast Reconstruction Using  Silicone Implant:Following a subcutaneous mastectomy, an immediate reconstruction was performed by a silicone implant, then the nipple was reconstructed 6 months later.

Breast Reconstruction Using  TRAM flap and reduction on the opposite side:  Following a modified radical mastectomy, chemotherapy and radiotherapy, this patient was disease free and a pedicled TRAM flap was used to reconstruct her breast from the abdomen. The normal right side was then reduced to match the reconstructed side, and a nipple was reconstructed.

Breast Reconstruction Using  TRAM flap: Following a modified radical mastectomy, chemotherapy and radiotherapy, this patient was disease free and a free TRAM flap was used to reconstruct her breast from the abdomen.