Three Categories of Breast Reconstruction

Anthony Perrone
Anthony Perrone MD

A graduate of Dartmouth Medical School, Anthony Perrone, MD, began his surgical practice. After he completed his postdoctoral training, Dr. Perrone focused on plastic and reconstructive surgery. Currently, Anthony Perrone, MD, serves as chief plastic surgeon at Maine General Medical Center, performing surgical procedures such as breast reconstruction.

The purpose of breast reconstruction surgery is to recreate a breast using prosthetic implants and autologous tissue. It is most often conducted on patients who have undergone mastectomy or breast removal due to breast cancer. Breast reconstruction has three categories, namely:

Expander or implant reconstruction. Empty silicone packets called expanders are inserted under the patient’s pectoralis muscle. Over the succeeding weeks, surgeons gradually fill the expanders with saline solution through a valve, to allow the soft tissues to stretch. Implants, on the other hand, are filled with saline solution or silicone gel, taking the shape of the breast mound. An implant replaces the lost breast tissue as it is inserted over the chest wall once the tissue expander is removed.

Autologous tissue reconstruction. In this procedure, surgeons use tissue taken from a different part of the body, usually from the abdomen, and move it up to the chest to reconstruct the breast. When a patient has enough tissue, the use of an implant becomes unnecessary. Tissues from the buttocks or thighs can also be used as reconstructive breast tissue.

Combination of tissues and implants. When a patient is not qualified to receive either of the aforementioned procedures alone, surgeons can combine the two methods by inserting an implant and covering it with tissue. This method is commonly referred to as latissimus dorsi (LD) muscle flap plus implant, which gives the patient a more natural-looking breast, with the tissue layering the implant.

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