Modern approaches to breast reconstruction began with silicone implants in the 1960s, first with insertion after mastectomy and then in a single surgery immediately following mastectomy.
"Over several decades, there have been significant advances in restorative surgical techniques," says Constance M. Chen, a board-certified plastic surgeon.
With many options for breast reconstruction now available, Dr. Chen believes "every woman should make an educated decision about what is best for her to bring back her health, confidence, and quality of life."
In addition to her boutique surgical practice focusing on restorative breast and body surgery, Chen is a Clinical Assistant Professor of Surgery at Weill Cornell Medical College and Clinical Assistant Professor of Surgery (Plastic Surgery) at Tulane University School of Medicine.
"Implants have continued to improve," says Dr. Chen. "But many women suffer complications, such as pain, infection, and hardening. And many women are unhappy with their implants."
At the end of the 1970s, surgery that uses a woman's own tissue to form a breast mound became popular with the refinement of techniques that initially used skin, fat, and muscle from the back and then, in the early 1980s, with skin and fat from the lower abdomen to form the breast.
"The TRAM flap was the gold standard for many years," Dr. Chen explains. "It created a soft, natural-looking breast but its disadvantage was the subsequent destruction of the muscle in the abdominal wall. New techniques have made it unnecessary to sacrifice muscle from the donor site to create the new breast."
Usually, microvascular techniques are used to sew together the blood vessels from the donor site to blood vessels in the chest wall so that the transferred soft tissue stays alive and healthy in its new position on the chest wall.
Preserving the muscle also reduces the postoperative recovery time. The resulting breast reconstruction is soft, warm, and living, and replaces the fat and skin that was lost to mastectomy.
"We are now crossing the next frontier in breast restoration," says Dr. Chen, "by microsurgically reconnecting nerves that are cut during mastectomy and restoring sensation to the breast.
"We can not only create a soft, warm breast that looks and feels natural to others but one that feels like her own breast to the woman herself."
In October 2009, Dr. Chen was featured in Sophisticated Women Magazine discussing her role as a female plastic surgeon in a male-dominated profession. Click here for the full article.
