Chandler | (480) 535-9867
Scottsdale | (480) 291-6895
#TorabiBrothers Podcast
Shop
Contact Us

Breast Reconstruction

in Phoenix & Chandler, AZ

A portrait of a woman with short dark hair in a rust-colored bodysuit, posing in front of an elegant vintage mirror. The warm, sophisticated setting represents a comprehensive approach to beauty. - Overview in Arizona

The History of Breast Reconstruction

Advancements in breast reconstruction have coincided with advancements in breast oncological (cancer) care. The goals of oncological care are to cure cancer, prolong survival, and reduce recurrence. Before modern research and advancements in surgical and medical care, more drastic procedures were believed to be required to “cure” a patient
of cancer.

As we have better understood and managed breast cancer, we have transitioned to less invasive methods while achieving the same goals. Radical mastectomies involve the removal of breast tissue, overlying skin, and subcutaneous tissue, underlying chest muscle, and lymph nodes. There has been a gradual yet significant change in this approach, where qualified patients are offered procedures such as skin or nipple-sparing mastectomies. These options can be discussed with your breast oncologic surgeons. This has allowed reconstructive breast surgeons to offer options to match a natural result better.

Meanwhile, breast reconstruction has also evolved. Pedicled muscle flaps (local muscle flaps with overlying skin and soft tissue), such as latissimus dorsi and rectus abdominis flaps, have provided natural options earlier in the evolution of breast reconstruction. A better understanding of skin and soft tissue anatomy, combined with progressive surgical techniques, including microsurgical procedures, has introduced perforator-based free flap options as a completely natural and reliable option for breast reconstruction using your own tissue.

Perforator-based free flaps provide reconstructive options using your own tissue while minimizing risks to the donor site (the site from which tissue is taken). The donor sites can also improve the contour of the body from which they are taken. Breast implants and surgical approaches have also improved in terms of their safety and reconstructive results. In addition to these advancements, fat grafting techniques have been well described and are a reliable option to improve outcomes when used in conjunction with other techniques.

A woman in black lingerie lies on white bedding in a sun-drenched room, showcasing a toned physique and a sense of overall aesthetic balance and wellness. - Overview in Arizona

The type of breast reconstruction that is ideal for you will depend on your condition and surgical goals. Generally, surgical goals center on returning to normalcy and restoring your self-identity by providing an optimal type of reconstruction for you. The breast mound, or breast size, will differ according to your body type and your desired shape and size. This is based on your comfort and the safety of the desired procedure. Your ideal breast shape and position will be based on the dimensions and measurements of the different aspects of a natural breast. This includes:

  • The natural slope that defines the upper part of the breast involves the transition of the chest wall to the breast mound.
  • The breast footprint, or part of the chest wall that the breast mound “sits” on
  • The inframammary fold, or crease underneath the breast,t is adherent to the chest wall.
  • Medial fullness or the middle portion of each breast, which provides “cleavage” and
  • The ratio of the upper portion of the breast compared to the lower portion of the breast

In addition to the reconstructed breast’s size, shape, and position, an important consideration for the reconstructed breast is the feel. Creating the nipple and areola is the last surgical step of breast reconstruction if you choose to do it. However, not all women can have nipple reconstruction surgery. You should openly discuss your surgical and cosmetic goals with our doctors during the consultation. Whether you want to learn more about your treatment options and their advantages and potential side effects, our plastic surgeons are here to help.

A minimalist shot of a small green plant with delicate leaves growing out of a textured white ceramic pot against a plain, light-colored background.

Breast Anatomy

The breast is a specialized gland in the soft tissue. Breasts serve to provide lactation for offspring. The overlying skin and nipple-areolar complex have well-described vascular and neural supplies (sensory innervation of the area).

The breast receives most of its blood supply from medial sources and a contribution from lateral and superior sources. This provides nutrition to the tissue and a simplified guideline for blood supply that can be used in microsurgical breast reconstruction.

Blood Supply

Internal Mammary Artery (IMA)

The medial source is the internal mammary artery (IMA), which runs along the deep surface of the ribs, typically along the sides of the sternum. In our practice, when performing free flaps, we typically perform an anastomosis (connection) to these vessels because of their reliable blood flow and size.

Lateral Thoracic and Thoracoacromial Artery

The lateral thoracic and thoracoacromial vessels provide minor contributions to the blood supply of the breast and are reserved for special circumstances.

Thoracodorsal Artery

The thoracodorsal vessel is another vessel in the area that can be used for anastomosis. The thoracodorsal vessels provide blood supply to the latissimus dorsi muscle. These vessels are reserved as a “backup” option to preserve the latissimus dorsi muscle flap as a “lifeboat” for failed breast reconstruction.

Nerve Supply

The medial and lateral intercostal nerves supply sensation to the breast. During mastectomies, the nerve supply is often disrupted.

This is due to the location of the sensory nerve course near or through breast tissue that needs to be resected to provide a safe oncological procedure. This can result in numbness of the overlying breast skin and/or preservation of the Nipple-Areolar Complex (NAC).

Skin and Soft Tissue

The skin and soft tissue in your body are supplied by small vessels called perforators. Perforator vessels generally branch off a source vessel before penetrating through the fascia and/or muscle to provide blood supply to the soft tissue. Perforator locations and sizes vary from person to person, but there are well-described locations.

Each perforator feeds an island of skin and soft tissue superficial to the deep fascia. This has allowed the description and use of various perforator-free flaps. Free flaps can also include sensory nerves, which can be preserved and connected to nerves in the chest to restore sensation.

Discover Elite Results

Schedule a consultation

Contact Us