Breast Reconstruction History
Like many reconstructive procedures, some type of breast reconstruction has been performed for hundreds of years. Similarly, since the early days of surgery, medical and surgical advances have brought about significant innovations in the field of breast reconstruction. The following is a brief history illustrating significant medical and surgical advances that have led to the development of breast reconstruction techniques that can completely recreate natural-looking breasts.
History of Breast Cancer
Hundreds of years ago, breast cancer may have been treated with a number of procedures with harmful results, and often went untreated due to the fact that women who found lumps in their breasts often did not seek treatment. Until the 1800’s, when the development of anesthesia radically improved the possibilities of staving off disease and saving lives through surgery, many breast cancer patients either went without treatment or suffered terrible complications from attempts to eradicate tumors. Dr. William Halsted is credited as leading the way in making radical mastectomy the most effective treatment for breast cancer in the 19th century; however, as other breast cancer surgeons started performing the procedure, a number of women were left disfigured due to the lack of information, expertise, and experience with breast cancer and breast reconstruction. The rise of feminism in the 1960’s and 1970’s gave way to significant changes in the treatment of breast cancer and methods of mastectomy, leading to innovations in breast conservation such as lumpectomy without total breast removal, radiation, and full breast reconstruction after radical mastectomy.
History of Breast Implants
Breast reconstruction techniques underwent rapid improvement in the mid-20th century, coinciding with the development of silicone breast implants. In 1962, after the first silicone breast implant procedure for cosmetic breast augmentation was performed, a number of companies began designing the implants for use in both breast enlargement and breast reconstruction procedures. By 1992, the popularity of silicone implants, said to be more natural in appearance and feel compared to their saline counterparts, bred complaints from some patients that the silicone had leaked out of the implant and caused painful scarring and disfigurement. The U.S. Food and Drug Administration then pulled silicone breast implants from the market for further study. However, after a 14-year moratorium on silicone gel-filled breast implants, the FDA approved them for use in 2006 after finding them to be safe and effective for breast enhancement procedures, as well as breast reconstruction procedures for patients of any age, following a variety of studies conducted during the moratorium.
History of Flap Reconstruction Techniques
Over the years, a number of different breast reconstruction techniques have been tested, applied, and performed, including tissue reconstruction, or flap surgery. This technique utilizes the body’s own natural tissues and skin to form a new breast, rather than a breast implant. Early tissue reconstruction techniques such as the Latissimus Dorsi Flap reconstruction – using muscles, skin and fat taken from the back and recreated to form a new breast mound – have been in use since the 1970’s. The transverse rectus abdominus myocuaneous flap procedure (TRAM Flap) – a method of taking skin, fat and muscle from the lower abdomen and relocating it to the chest – was first performed in the early 1980’s and is still one of the most popular breast reconstruction techniques.
Breast Reconstruction Innovations
In the last 30-40 years, breast reconstruction has seen some of the greatest innovations in the field of surgery, leading to results that give patients full, contoured, natural-looking breasts. Options for breast reconstruction have never been more plentiful, and patients have a full range of choices for reconstruction procedures to consider with one of our surgeons and determine which path can best meet their physical needs and aesthetic goals.
Advances in microsurgery (microscopic surgery used to connect small blood vessels) have paved the way to procedures that do not require the relocation of muscles. Microvascular procedures, such as the DIEP Flap and Free TRAM Flap, transplant skin and tissue from one area of the body, typically the abdomen, to the chest without the need to maintain a blood flow connection to the donor site. Blood vessels are then connected to the chest area microsurgically, establishing a new source of blood to the reconstructed breast. These procedures can reduce complications from the donor site and help patients recover more easily. A relatively recent breast reconstruction technique called S-GAP Free Flap reconstruction allows patients who do not have sufficient amounts of tissue in the abdominal region to use donor skin from the buttocks.
In addition to tissue reconstruction, major advances in breast implants have also played a significant role in reconstructive breast surgery. Saline or silicone implants have become one of the standard options for breast reconstruction, particularly for women who are not candidates for, or who are uncomfortable with, tissue reconstruction from a donor site on their body. Breast implants can now also be used in a combination of tissue reconstruction and implant reconstruction, and often result in very natural-looking results. Techniques in nipple reconstruction and nipple tattooing have also made huge advances over the years, with procedures that can put the final touch on a successful breast reconstruction.
Oncoplastic surgery is typically used with lumpectomy, this emerging technique combines tumor removal and plastic surgery during the same operation to maximize aesthetic outcome. A standard lumpectomy may create contour irregularities or unfavorable scars on the breast, so patients may choose corrective surgery at a later time. However, breast surgeons and a few innovative plastic surgeons are now working together to use cosmetic-style incisions during a combined tumor removal and breast reconstruction surgery.
Contact the Breast Reconstruction Center at LIPSG
Please contact the Long Island Plastic Surgical Group to schedule a consultation for breast reconstruction surgery. One of our surgeons will meet with each of our patients and go over all available options, and together, determine the next step in treatment. Many of the plastic and reconstructive surgeons at the Long Island Plastic Surgical Group are trained and experienced in highly-specialized procedures, such as microvascular surgery and tissue reconstruction. Our surgeons have attended some of the most prestigious medical institutions and cancer centers in the world, including the Cleveland Clinic and Memorial Sloan Kettering Cancer Center. Doctors at LIPSG are skilled with all of the major breast reconstruction techniques, and can successfully blend the worlds of science and art to create a new, natural-looking breast.