Breast Reconstruction

Personalized Breast Reconstruction for a Natural Look

Breast reconstruction can be done at the time of the mastectomy or it can be done any time after the procedure, even many years later. This empowering surgery restores a natural, symmetrical contour to the breasts, often providing much-needed closure for patients.

Mastectomy

The mastectomy procedure is performed by a general surgeon, and often includes removal of some of the lymph nodes in the armpit. In some cases, a nipple sparing mastectomy can be performed where the nipple is left intact as part of the breast skin. However, in most cases, the nipple is removed along with the underlying breast tissue. Our plastic surgeons typically work with your breast surgeon to come up with an ideal mastectomy and reconstruction plan for you. Together, this team of doctors can optimize the outcome of your reconstruction.

Our surgical team frequently treats patients with existing breast cancer as well as patients with genetic susceptibility to cancer such as those with BRCA positive gene testing. Our surgeons give BRCA gene positive patients the option of prophylactic (preventive) mastectomy procedures in order to minimize their chance of developing breast cancer. Fortunately, these patients are often eligible for nipple sparing mastectomy procedures leading to very satisfying cosmetic results from their breast reconstruction.

About Breast Reconstruction

Breast reconstruction can be a complicated topic and process. However, our highly trained surgeons will help guide you through breast reconstruction and help you to select the best approach for your unique needs. Breast reconstruction involves replacing the breast tissue to recreate the breast shape. Reconstruction can be performed using either a breast implant or your own tissue. Occasionally, some patients need to have a combination of both an implant and their own tissue.

It is important to keep in mind that breast reconstruction typically requires several surgical stages separated over 3 to 12 months, depending on whether you need other treatments in the meantime such as radiation and chemotherapy. Occasionally, breast reconstruction can be performed in one stage, but this often can lead to a less than optimal result.

DIEP Flap Reconstruction of the Breast

There are many options when using your own tissue to reconstruct your breast. The most common option is to use tissue from your lower abdomen since most people have some extra fat and skin in that area of the body. Traditional methods of using abdominal tissue to reconstruct the breast involved removal of some of the underlying muscles as well. This procedure is referred to as a pedicled TRAM flap or a free TRAM flap. More recent techniques allow our plastic surgeons to remove the skin and fat from your abdomen while preserving the underlying muscles. This procedure is referred to as a DIEP flap.

The acronym DIEP stands for Deep Inferior Epigastric Perforator, and it names the blood vessel which connects the skin and fat from your lower abdomen to the rest of the body. DIEP flap breast reconstruction is a modern technique of reconstructing the breast with your own tissue from your midsection without removing any of the underlying muscles from your abdomen. It requires a high level of skill and training, and it is performed by a limited number of plastic surgeons across the country, including surgeons at our practice. DIEP flap breast reconstruction can be performed at the time of your mastectomy or it can be done at any time after a mastectomy, even years later. It can be used to reconstruct one or both breasts. Recovery from DIEP flap breast reconstruction is typically 4 to 6 weeks.

Nipple Reconstruction

Reconstruction of the nipple is usually performed by folding the existing tissue on the breast into a raised structure, similar to the ancient technique of origami which folds a flat piece of paper into a three dimensional shape. In some patients with a large nipple on the opposite breast, a portion of this nipple can be used instead. Sometimes a skin graft is taken from elsewhere on the body to reconstruct the areola. Medical tattooing of the nipple and areola is then performed to match the color to the opposite side.

Many of our patients who have had or are facing mastectomy feel overwhelmed by the number of decisions they face. Our experienced, empathetic plastic surgeons will help you navigate your choices and choose the breast reconstruction option that is right for you.