Breast reconstruction with other technique
CPT4 code
Name of the Procedure:
Breast Reconstruction with Other Techniques (Common Names: Flap Reconstruction, Autologous Tissue Reconstruction, Microsurgical Breast Reconstruction)
Summary
Breast Reconstruction with other techniques involves rebuilding the breast shape using tissue from other parts of the patient's body, such as the abdomen, back, thighs, or buttocks. It's often performed after mastectomy (breast removal) due to cancer or other illnesses.
Purpose
The procedure addresses:
- Absence of breast tissue post-mastectomy
- Deformity or asymmetry following breast surgery
Goals:
- To restore the natural look and feel of the breast
- To improve the psychological well-being and self-esteem of patients
Indications
- Patients who have undergone mastectomy or lumpectomy
- Patients with congenital abnormalities of breast development
- Adequate donor tissue availability
- Good overall health to withstand surgery
Preparation
- Fasting: Usually required for at least 8 hours before surgery
- Medication adjustments: Stopping certain medications as advised by the surgeon (e.g., blood thinners)
- Diagnostic Tests: Blood tests, imaging studies (like MRI or CT scans), and medical clearance
Procedure Description
- Anesthesia: The patient is placed under general anesthesia.
- Donor Site Preparation: Tissue is harvested from a predetermined area (e.g., abdomen—DIEP flap, back—Latissimus Dorsi flap).
- Microsurgery: The blood vessels from the flap are meticulously reconnected to the chest wall using microsurgical techniques.
- Shaping & Positioning: The harvested tissue is molded and positioned to form the new breast.
- Incisions Closure: Both the donor and recipient sites are closed with sutures.
- Drain Placement: Surgical drains may be placed to prevent fluid accumulation.
Duration
The procedure typically takes between 4 to 8 hours depending on the complexity and technique used.
Setting
Performed in a hospital operating room specialized in plastic and reconstructive surgery.
Personnel
- Plastic and Reconstructive Surgeon
- Surgical Assistants
- Anesthesiologist
- Operating Room Nurses
- Microsurgeon (if required)
Risks and Complications
- Common risks: Infection, bleeding, scarring, and asymmetry
- Rare risks: Blood clots, flap failure, prolonged recovery, anesthesia complications
- Management: Close monitoring, antibiotics, possible surgical revision
Benefits
- Restores breast contour and appearance
- Can improve body image and psychological well-being
- Immediate or delayed reconstruction options available
Recovery
- Hospital stay: Usually 3-5 days post-surgery
- Drain care: Management of surgical drains if placed
- Activity restrictions: Avoid heavy lifting for 6-8 weeks
- Follow-up: Regular check-ups for wound care and monitoring healing
Alternatives
- Implant-based Reconstruction: Involves using silicone or saline implants (Pros: Shorter surgery, Cons: Risk of implant complications)
- No reconstruction: Opting for external prostheses or no reconstruction (Pros: Avoids surgery, Cons: Less natural appearance)
Patient Experience
- During: Under general anesthesia, so patient is unconscious and feels no pain
- After: Initial discomfort, pain at donor and recipient sites, managed with medications
- Long-term: Gradual improvement in comfort and aesthetic results over weeks to months
The road to recovery and final results can vary, but many patients find the procedure significantly beneficial for their quality of life.