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Breast Reconstruction Surgery - Introduction |
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Breast reconstruction surgery restores breast appearance
for women who have had their breast(s) removed to treat
breast cancer. A plastic surgeon rebuilds the breast so
it is about the same size and shape as it was before the
mastectomy. The nipple and the darker area surrounding
the nipple (the areola) can also be surgically
reconstructed.
Some women will have breast reconstruction done at the
same time as the mastectomy, while others may wait a
requisite period of time.
With immediate breast reconstruction, the chest tissue
is undamaged by radiation therapy or scarring. Also,
immediate reconstruction means one less surgery.
Delayed breast reconstruction may be advised if
radiation to the chest area is needed after the
mastectomy. Radiation therapy that follows breast
reconstruction can increase complications after surgery.
The reconstruction process may require one or more
operations. The final surgery is typically the nipple
and areola reconstruction. |
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Breast Reconstruction Surgery - Procedure |
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Plastic surgeons can perform several types of breast
reconstruction surgery. Options include a newly shaped
breast with the use of a breast implant, your own tissue
flap, or a combination of the two. A tissue flap is a
section of your own skin, fat and muscle that is moved
from your stomach, back or other area of your body to
the chest area.
Breast reconstruction with breast implants The most
common implant is a saline-filled implant. These
implants have an external silicone shell and are filled
with salt water. Silicone gel-filled implants are
another option for breast reconstruction. Due to the
more natural feel and texture of silicone implants, many
breast cancer survivors who undergo breast
reconstruction choose these over saline implants.
Current breast reconstruction clinical trials are
looking at new types of implants that may be beneficial
for breast reconstruction.
Whatever implant you and your surgeon decide on, it is
placed between layers of chest muscle, under breast skin
that will be saved during the mastectomy.
Some women can have the implant placed immediately if
they have relaxed muscle tone and stretchy skin and your
cancer surgeon is able to do a skin- and tissue-sparing
mastectomy. Women with tight chest skin and muscles,
however, may need an expandable implant or a tissue
expander, which is followed by a permanent implant in a
two-stage operation.
Breast reconstruction with tissue flap. Tissue flap
procedures use tissue from your stomach, back, thighs or
buttocks to reconstruct the breast. The two most common
types of tissue flap surgeries are the TRAM flap
(transverse rectus abdominis muscle flap), which uses
tissue from the stomach, and the latissimus dorsi flap,
which uses tissue from the upper back.
The TRAM flap procedure can be done in one of two ways.
The pedicle flap involves leaving the flap attached to
its original blood supply and tunneling it under the
skin to the breast area. In contrast, a free flap means
that the surgeon cuts the flap of skin, fat, blood
vessels and muscle free from its original location and
then attaches the flap to blood vessels in the chest
area.
The latissimus dorsi muscle flap procedure removes a
large muscle in the back, along with skin and underlying
fatty tissue. The surgeon uses these tissues to
reconstruct the breast. Including fatty tissue helps
create a more natural-looking breast, but the flap
itself is usually only about one inch thick, so an
implant is also required.
These tissue flap operations require two surgical sites
and thus scars where the tissue was taken and on the
reconstructed breast. Tissue flap breast reconstruction
procedures usually cannot be offered to women with
diabetes, connective tissue disease or vascular disease,
or to smokers, because blood vessels are involved, and
these can all damage blood vessels.
A newer type of flap procedure, the deep inferior
epigastric artery perforator (DIEP) flap, uses fat and
skin from the same area as the TRAM flap, but does not
use the muscle to form the breast mound. This procedure
results in a tightening of the lower abdomen,
essentially a "tummy tuck." The procedure is done as a
"free" flap, which means the donor tissue is completely
removed and then reattached.
Another newer type of tissue flap surgery is called the
gluteal free flap. This surgery uses tissue from the
buttocks to create the breast shape. It is an option for
women who cannot use the stomach sites because they are
too thin.
Nipple and Areola
Reconstruction
Nipple and areola reconstructions are the final phase of
breast reconstruction. This separate surgery is done to
make the reconstructed breast resemble the original
breast more closely. It can be done on an outpatient
basis with local anesthesia. It is usually done after
the new breast has had time to heal, which may be three
or four months after surgery. Occasionally, however,
nipple reconstruction can be done at the time of the
flap surgery.
The tissue used to rebuild the nipple and areola is
taken from your own body, such as from the newly created
breast, opposite nipple, ear, eyelid, groin, upper inner
thigh or buttocks. Tattooing may be done to match the
color of the nipple of the other breast and to create
the areola. |
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What To Expect After
The Surgery |
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May take
about 6 weeks to recover from a combined mastectomy and
reconstruction or from a flap reconstruction alone. Most
scars fade over time, but may take a few years to
lighten. |
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Risks |
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Bleeding,
fluid collection, excessive scar tissue, infection, and
problems with anesthesia. The implant can shift or leak,
requiring its removal. Using an implant carries a remote
risk of infection or capsular contraction, a condition
that makes the scar, implant, and breast feel hard.
Capsular contracture may be treated with additional
surgery to remove the scar tissue. With any flap
procedure, there is risk that it may not reattach well
to blood vessels, block blood flow and reject the flap. |
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Recovery |
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You may feel tired and sore for a week or two after
implant reconstruction and longer after flap procedures.
Medications can control most of your discomfort. Most
people can go home from the hospital in one to six days.
You may be discharged with a surgical drain to help
remove excess fluids from the site while it heals.
You should be up and around in six to eight weeks. If
implants are used without flaps, recovery time may be
shorter. Your plastic surgeon will give you more
specific details about your recovery from breast
reconstruction. |
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Pre-Surgery Medical checkup
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Blood pressure, BUN, CBC, prothrombin & partial
thromboplastin times, EKG & HIV tests prior to the
surgery. |
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Cost |
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Average cost of Breast Reconstruction Surgery in Thailand is
US$ 4,000 . But this cost may vary individually
depending on the patients medical history and the
surgeon and facility you chose to get the surgery done.
Please mention about your
insurance coverage if you may have when you request for
this procedure, as health insurance policies typically
cover most or all of the cost of reconstruction after a
mastectomy.
"You
are required to send a Photograph of your chest area
frontal , sideways to the surgeon for the initial
consideration and approval. Without the photographs
Surgeons will not approve and schedule the consultation
appointment."
All the costs quoted by the Hospital / Surgeon includes
the following
- Pre-Surgery Consultation
- Doctors Fee
- Surgery fee
- Hospital room charges
- Nursing fee
- All medications required
- Post-Operative Follow Up
In addition to the cost of the surgery, you will
need to be prepared for the following additional
costs.
Stay
For this procedure you are required to stay in
Bangkok for at least 8 days of which you will be
spending the first night at the hospital, and then you
can choose whether to stay in the serviced apartment at
the hospital or a hotel outside until the post surgery
follow up appointment 7 days after the surgery. Surgeon
will allow you to fly only after the follow up
appointment, and therefore you need to plan accordingly.
Serviced apartment at the Hospital : Piyavate hospital provides a serviced
apartment manned 24/7 by registered Nurses within the
hospital complex, with prices ranging from US$ 45 - US$
195 /
night depending on the type of room you choose.
Hotel: If you wish to stay in a Hotel outside the
hospital it could cost you anywhere between US$
40 - 300 / night depending on the hotel you choose.
There are many Quality / Clean entry level hotels that
offer rooms for as little as US$ 40 in the near vicinity
of the hospital and the Up market hotels near the
Sukhumvit (10 mins in taxi) or Silom (25 mins in taxi)
Shopping districts, the rate could go as high as USD 300
/ night.
BMT Concierge Service : If you wish to have us
arrange you received at the airport and arrange the
round trip airport transfer, and Transfer to all of your
appointments and the surgery by one of our patient
co-coordinators, there will be an additional Fee of US$
169 which is to be paid after you confirm the surgery
plan. This fees only applies if you choose our
Concierge service. There are no additional fee if you
choose only the Surgery planning service.
All the fees
due for the surgery has to be paid directly to the surgeon or the hospital before undergoing the procedure.
There are no fees to be paid to us apart from the
fee for the Concierge service if you wish to have us
arrange all of your transportation.
If you are HIV+ve, there will
be an additional 60% fee will be levied to cover the
cost of additional equipment and personnel expenses.
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Hospital |
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This Surgery will be performed at the Plastic
Surgery center at Piyavate
International Hospital. piyavate Hospital is
ISO 9001 certified and
HA accredited International
Hospital in Bangkok, Thailand.
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REQUEST FOR MORE
INFORMATION |
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FACIAL PLASTIC SURGERY |
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FACE LIFT SURGERY
Improves sagging facial skin and loose neck skin. |
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EYELID SURGERY
Corrects sagging or drooping eyelids, as well as bags below the eyes. |
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EAR PINNING SURGERY
Reduces the size of large ears or sets ears back closer to the head. |
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NOSE SURGERY
Reshapes the nose by reducing or increasing size. |
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CHIN AUGMENTATION
Reshapes the chin by inserting an implant shaving the bone. |
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CHEEK AUGMENTATION
Restore the fullness to your cheeks if
it has been lost with aging. |
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FOREHEAD LIFT
Forehead lift is often performed to
treat conditions associated with aging. |
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BREAST PLASTIC SURGERY |
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BODY PLASTIC SURGERY |
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LIPOSUCTION
Surgical procedure that vacuums fat
deposits from under the skin. |
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ABDOMINOPLASTY
Flatten the abdomen by removing excess skin and fat. |
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CALF IMPLANTS
Performed to enlarge the calves,
resulting in a more defined appearance. |
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BUTTOCKS AUGMENTATION
Procedure to surgically enhance buttocks size with implants. |
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ARM LIFT
Reduces or removes loose, sagging skin
from the upper arm. |
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BODY LIFT
Body lift aims to improve the shape and
tone of the underlying tissue that
supports fat and skin. |
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OTHER PLASTIC SURGERY |
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WEIGHT LOSS SURGERY |
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GASTRIC BYPASS SURGERY
Gastric Bypass, Roux en-Y (Proximal) is
the most commonly employed gastric
bypass technique. |
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ADJUSTABLE GASTRIC BANDING
b Johnson, generally known as Swedish
Bandy Realize Adjustable Gastric Band
from Johnson & or SAG-BAND Surgery |
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