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- Body Surgery
- Breast Surgery
- Facial Surgery
- Hand Surgery
- Plastic Surgery for Men
Reconstruction of the breast is one of the most rewarding surgical procedures for women today. Newer techniques and procedures make it possible to create a breast that is similar in form and appearance to a natural breast. Almost any woman who must lose a breast to cancer is a candidate for reconstructive breast surgery.
Breast reconstruction can:
- Balance the size and shape of your breasts
- Permanently restore the contours of your breast(s)
- Eliminate your need for a prosthesis
Although you can see the difference between a reconstructed and nonreconstructed breast, the breasts should appear even in shape and size when you are wearing a bra, bathing suit, and clothing.
Breast reconstruction can be performed at any time after a partial or full mastectomy, but it is most often performed immediately after the removal of a tumor. This approach enables you to awaken from mastectomy surgery with a new breast in place.
Reconstruction has no known effect on the recurrence of breast cancer, nor does it prevent recurrent cancer from being detected. Breast reconstruction also does not interfere with postoperative chemotherapy or radiation.
Breast reconstruction after mastectomy is not a simple procedure, but there are many options you and your doctor can explore to determine what is best for you. Because the surgery improves your appearance, breast reconstruction can have a dramatic impact on the quality of your life after a mastectomy or partial mastectomy.
Most insurance plans cover all stages of breast reconstruction.
A consultation for breast reconstruction usually includes all the physicians treating your breast cancer, including your primary care physician, surgeon, and oncologist.
Your consultation with the surgeons at Summit Medical Group will include a thorough discussion of your medical history, expectations, and concerns. You also will have a physical examination, including a careful evaluation of your breasts. Your surgeon will discuss reconstruction options, with considerations for your overall health, age, height, weight, body shape, and size and shape of your breasts. He or she also will explain advantages and disadvantages of the options and tell you what you can expect before, during, and after the surgery. Limits and risks of the surgery will be discussed, and you may see pictures to better understand the procedure and results.
The Procedure, Recovery, and Results
There are different types of breast reconstruction. Each technique involves slightly different recovery expectations. You will be given thorough written instructions about how to prepare for and recover from the type of breast reconstruction surgery you will have.
Implant and Expander Reconstruction
Implant reconstruction involves inserting a temporary balloon expander under the chest muscle to gently stretch the muscle and skin over several weeks or months. The size of the expander is increased at regular intervals in our offices through a tiny valve beneath your skin. After the skin over the breast area has stretched enough, the temporary expander is removed in a second operation, and a more permanent implant is inserted.
If you have implant reconstruction, you should expect to stay in the hospital overnight after your mastectomy and expander placement. You are likely to have some drainage tubes placed for a few days after surgery.
You should be able to return to normal activities after several weeks, depending on whether you need additional therapy. The second procedure to remove the temporary tissue expander and place a permanent silicone implant is usually performed on an outpatient basis.
TRAM and Latissimus Flap Reconstruction
Flap reconstruction involves creating a breast mound with your own tissue. The tissue usually comes from your abdomen, but in some cases, it may be taken from your back. When your own abdominal tissue is used to reconstruct your breast, it is called a transverse rectus abdominus muscle (TRAM) flap. A TRAM flap consists of skin, fat, and muscle attached to its blood supply from the abdomen. This tissue is tunneled beneath the skin to your chest to create a breast mound without the need for an implant. The abdominal incision is then closed with a procedure similar to a tummy tuck.
If tissue from your upper back is used, it is called a latissimus dorsi flap. In this case, an implant is usually also necessary. In this procedure, skin, fat, muscle, and blood vessels from the back are tunneled under the skin to the front of your chest to create a pocket. The implant is then placed within that pocket.
The hospital stay and recovery after flap reconstruction procedures are typically longer than with implant reconstruction, and they vary from patient to patient. More than one procedure may be necessary to achieve the best result. Your surgeon will fully explain what you can expect to experience after your surgery.
Bilateral reconstruction involves some reconstruction of both breasts so that they are as symmetrical as possible. This generally involves a series of procedures that occur over time and can include implants or flap reconstruction. The initial reconstructive operation is the most complex, with the final stage of reconstruction often involving the creation of a new nipple and areola.
In some cases, your surgeon will recommend an additional procedure to enlarge, reduce, or lift the natural breast to match the reconstructed breast.
Partial Mastectomy Reconstruction
After a partial mastectomy, the best options for you may include some flap reconstruction, breast implants, a breast lift, and/or a breast reduction. Your surgeon will discuss these possibilities with you to ensure that you fully understand what to expect.
With all types of breast reconstruction, you can expect some swelling, bruising, and pain. Your surgeon will give you a prescription for pain medication to help you through the recovery period. It also may take several months before you can see the final outcome of your breast reconstruction surgery. Most women are very pleased with the results.
Peter Hyans, MD, FACS, is Director of the Plastic Surgery Center and Chief in the Department of Surgery and Surgical Specialties at Summit Medical Group. Dr. Hyans has 15 years’ experience in plastic surgery. He is board certified. Dr. Hyans is listed in Castle Connolly’s Top Doctors in America.
In addition to his position at Summit Medical Group, Reza Momeni, MD, is Chairman of Plastic Surgery at Overlook Hospital in Summit, New Jersey. He has been listed in New Jersey Monthly’s “Top Doctors.” The Consumer Research Council lists him in “Top Plastic Surgeons in America.”
Daniel B. Schmid, MD, specializes in plastic surgery, breast care center, breast surgery, and cancer services. Dr. Schmid is the author or coauthor of articles about plastic and reconstructive surgery and has been a volunteer for many honorable causes. He is board certified with American Board of Plastic Surgery.
Call Summit Medical Group today at 908-277-8759 to make an appointment or for more information about how breast reconstruction can restore the normal appearance of your breasts.