Breast Reconstruction

Breast reconstruction after mastectomy is not a simple procedure, but there are many potential options.

Overview

Reconstruction of the breasts is one of the most rewarding surgical procedures for women today, and at Summit Medical Group, it is a significant part of our practice. We are passionate about this procedure and how it can restore the lives of women who have endured the ordeal of breast cancer. As a result, we have performed thousands of successful breast reconstruction surgeries, including the most advanced techniques like DIEP Flap – a method that few surgeons in the northeast perform. Read more about DIEP Flap Breast Reconstruction.

These newer techniques and procedures make it possible to create a breast that is similar in form and appearance to a natural breast. No two breast reconstructions are the same, and we have extensive experience with evaluating your case and determining the best method to bring you an excellent result.

Breast reconstruction after mastectomy is not a simple procedure, but there are many potential options. Because the surgery improves your appearance, breast reconstruction can have a dramatic impact on the quality of your life, whether you must have double mastectomy reconstructive surgery or breast reconstruction after a partial mastectomy.

Almost any woman who must lose a breast to cancer is a candidate for reconstructive breast surgery. Breast reconstruction can:

Permanently restore the contours of your breasts
Eliminate your need for a prosthesis
Balance the size and shape of your breasts so that they are as symmetrical as possible
Restore your self-confidence
Help you feel that cancer is behind you

Although you can see the difference between a reconstructed and non-reconstructed breast, the breasts should appear even in shape and size when you are wearing a bra, bathing suit, and clothing.

Breast reconstruction can often be performed immediately after the removal of a tumor. This approach enables you to awaken from mastectomy surgery with a new breast(s) in place. In some cases, this is not possible, but we will continue with reconstruction as soon as is medically advisable. If the cancer involved was very extensive, it is better to delay the reconstruction for a period of time, but this is a rare occurrence.

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 post-operative chemotherapy, but patients who have radiation therapy under the arm(s) or chest should postpone having breast reconstruction to optimize radiation therapy. The flap techniques can tolerate radiation better than an implant.

Most insurance plans cover all stages of breast reconstruction,

“After I was diagnosed with breast cancer, I made an appointment with Dr. Schmid to get reconstruction. When I was in his office talking to him, I started to cry. He stopped what he was doing and came over and hugged me, and so did his nurse, Michelle. Dr. Schmid made me
feel comfortable and less scared. He always took the time to answer any questions that I may have had. Dr. Schmid is a caring, kind, compassionate doctor. He made me feel comfortable through the entire reconstruction process.”

– Patient on ratemds.com

Your Breast Reconstruction Consultation at Summit Medical Group

At Summit Medical Group, the patient experience is of primary importance to us. A consultation for breast reconstruction usually includes all of the physicians treating your breast cancer, including your primary care physician, surgeon, and oncologist. When you meet with us for your breast reconstruction consultation, we will have an honest discussion about your desires, expectations, and concerns, as well as the limits and risks of the surgery. We will review your medical history and recommend options that can best help you achieve your goals. We will give you thorough written instructions to prepare for your surgery and will answer any questions you have.

Careful consideration will be given to the technique used for your breast reconstruction. You will have a say in this, of course, but we will be honest with you about the limitations of your case. Not all women are candidates for every technique.

“I was diagnosed with breast cancer at the age of 35. I had both breasts removed and reconstructed by Dr. Peter Hyans. I cannot rave enough about him and his staff... It is an awful thing to go through, but with his talent, knowledge, and his caring staff, I got through it. My breasts are beautiful and healthy now. I can't thank him enough for being so patient, understanding, and capable. I still feel as beautiful and womanly as I did before the surgeries. Thank you, Dr. Hyans and Summit Medical Group!”

– Patient on ratemds.com

Different Techniques

What are the different types of Breast Reconstruction techniques?

There are several techniques for breast reconstruction. Each method includes 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 Breast Reconstruction

Implant reconstruction is a two-stage process that involves inserting a temporary balloon tissue expander under the chest muscle to gently stretch the muscle and skin over several weeks or months. The expander is placed within a pocket created by Aloderm donor dermis tissue.

For a period of 1 to 3 months, fluid is infused into the expander to create a pocket for a permanent implant. After the skin over the breast area has stretched enough, the temporary expander is removed in a second operation, and a permanent implant is inserted. Read more about Breast Augmentation, including the types of breast implants that are available to you.

If you have implant reconstruction, you should expect to stay in the hospital overnight after your mastectomy and expander placement. Drainage tubes will be placed within the breast for a few days after surgery to collect fluids. We will provide you with instructions for caring for the drains and will remove them during a follow-up visit.

You should be able to return to normal activities within 3 to 4 weeks after the expander has been placed, depending on whether you need additional therapy. Please do not lift anything heavy for 1 to 2 months. After the final implant placement, recovery is just 5 to 7 days.

After each procedure, bruising, swelling, and soreness are inevitable for a period of time. We will provide antibiotics and pain medication to help you through the healing process, and we will see you for several follow-up visits.

“Dr. Schmid possesses a wealth of knowledge, professionalism, a sense of humor, and a very calm demeanor, which I found comforting while dealing with my breast cancer diagnosis. He and his nurse, Michelle, were excellent at managing my care and guiding me through the entire breast reconstruction process.”

– Patient on Realself.com

TRAM and Latissimus Flap Breast 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 or DIEP flap.

A TRAM flap consists of skin, fat, and muscle attached to the 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 tissue is not disconnected and reconnected to the blood supply. Rather, the tissue remains connected and is rotated. The abdominal incision is then closed with a procedure similar to at tummy tuck.

If tissue from your upper back is used, it is called a latissimus dorsi flap. In this case, a breast 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 after a flap reconstruction procedure is generally 3 to 4 days, and recovery takes 6 to 8 weeks. Please do not lift anything heavy for 1 to 2 months to avoid the risk of hernia. Drains will be placed in the breasts and the stomach (or back) for a few days to 2 weeks after surgery. We will provide you with instructions as to how to care for the drains, and they will be removed during one of your follow-up visits.

Soreness, bruising, and swelling are inevitable after surgery. We will provide antibiotics and pain medications to help you manage the discomfort. Your surgeon will fully explain what you can expect to experience before, during, and after your TRAM or Latissimus Flap surgery.

“Dr. Hyans was my plastic surgeon who worked with my oncologist in treating me for breast cancer: double mastectomy with reconstruction over time. He is supremely confident and very skilled in his work. I could not be happier with my results, and I trust him to help me make smart choices when facing difficult decisions. His office staff is warm, helpful, and his primary nurse would see me (sometimes without an appointment) to answer questions and provide comfort. I highly recommend him.”

– Patient on ratemds.com

Bilateral Breast Reconstruction

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 reconstruction 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 Breast 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.

DIEP Flap Breast Reconstruction

DIEP flap breast reconstruction or reconstructive microsurgery is a technique that few surgeons offer. We have extensive experience with this method, which has many advantages for the women who are good candidates for it. Read more about DIEP Flap Breast Reconstruction.

Your Recovery

Recovering from Breast Reconstruction

With all types of breast reconstruction, you can expect some swelling, bruising, and pain.

We will provide you with antibiotics and pain medication to help reduce discomfort, and you will see us for several post-surgical follow-up examinations so that we can ensure that you are healing properly.

It may take several months before you can see the final outcome of your breast reconstruction surgery. Most women are very pleased with the results and feel that it was worth the wait.

“Dr. Hyans and his staff treated me with the utmost care. They knew this was a traumatic event in my life, but they had me focus on how wonderful it will all be once the cancer was removed and my breast would be reconstructed. The quality of Dr. Hyans work is remarkable. Doctors that have examined me subsequent to my surgery have commented on how wonderful the outcome is. He is a master. His staff is the friendliest group of nurses/administrators that I've met. They made me feel a part of their family. Three years later and I still feel that way if I see them at Summit Medical Group. They are truly a remarkable group of individuals who have allowed me to sustain my confidence and continue to feel good about myself. Their level of service is the highest. They truly cared about me and gave me all the attention that I needed. If you ever consider any type of breast reconstruction or any type of plastic surgery, please consider the SMG plastic surgery team. They are truly the best.”

– Patient on Realself.com

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