About Breast Reconstruction
Reconstruction surgery for the breasts can be performed to restore them to an attractive appearance in size and shape following a lumpectomy or mastectomy. It's also available to reconstruct the chest if it has been damaged by a birth defect or trauma. New techniques in reconstructive surgery make it easier for breast cancer patients to feel fully healed and have breasts that look natural after removal or damage. This surgery may involve multiple procedures and different stages that may be done along with your breast cancer treatment or delayed until the treatment is complete. Lake Mary, FL plastic surgeon Dr. Raj Sawh-Martinez creates a unique surgical plan with compassion as we help you and your cancer team to restore your confidence and physical appearance at Craniofacial & Aesthetic Plastic Surgery.
Breast Reconstruction Ideal Candidates
Reconstruction of the breast(s) is an extremely customized surgery. Each patient will be required to have an in-depth consultation appointment with Dr. Sawh-Martinez to decide on their surgical plan from their concerns, needs, and suitable techniques. If you are thinking about reconstructive surgery, it's crucial that you understand realistic expectations for results. While Dr. Sawh-Martinez aims to give you an attractive, natural appearance, your reconstructed breast(s) may not have the same look, sensations, or feel like your original breast(s). You should get clearance from your oncology team to undergo reconstruction surgery and speak with Dr. Sawh-Martinez regarding other conditions that may affect your recovery.
Breast Reconstruction Surgical Technique
There are several surgical techniques available to reconstruct the breasts. There are also multiple factors that Dr. Sawh-Martinez looks at when deciding on the technique that will give you your best results. A few of these factors include your specific cancer diagnosis, when the reconstruction is performed, whether you will use implants or natural tissue, and if nipple reconstruction or nipple-sparing is a part of the treatment plan. To recreate the breast, you must have enough tissue to fully cover the breast mound. Flap methods accomplish this by using your own muscle, fat, and skin to build and cover the breast. The most frequent flap techniques are:
- TRAM Flap
This technique takes muscle, fat, and skin from your abdominal area to build the breast. The tissue selected to build the new breast may be removed from the stomach or the tissue may stay connected to the donor location, maintaining the original blood supply.
- DIEP Flap
Similar to a TRAM Flap, the DIEP Flap takes skin, fat, and blood vessels from the lower abdominal area; however, it does not use the muscle. The DIEP (deep inferior epigastric perforator) flap transfers skin and fat from the abdomen to create the new breast and uses microsurgery to reattach the blood vessels to the chest wall.
- Latissimus Dorsi Flap
This technique uses muscle, fat, and skin from your back. During this technique, tissue is taken from the back to the breast(s) via a surgically created path so it stays attached to the donor location, which keeps the original blood supply in place.
- PAP Flap
Another flap is the profunda artery perforator (PAP). This method uses fat, muscle, and skin tissue from your inner thigh to build your breast(s).
- LTP Flap
Although the TRAM flap is one of the most common techniques used for breast reconstruction, sometimes there isn't enough muscle, fat, and skin that can be taken from the abdominal area. In this case, the LTP flap technique may be performed, which uses tissue from the outer thigh.
- Composite Flap
Also called a composite stacked flap, this technique takes flaps from several sections of your body for breast reconstruction.
Additional Considerations for Breast Reconstruction
Although flap procedures are a common and highly successful method for breast reconstruction surgery, you may want to recreate your breast(s) with the tissue expansion method. This technique places a tissue expander below the breast wall and the newly expanded space will be gradually filled with a saline solution over 4 – 6 months to stretch the skin naturally. After you choose the flap method or tissue expansion, you may then decide whether you would prefer to use breast implants or a fat transfer to create the shape and volume of the breast(s). After your reconstruction mammoplasty, you can further improve the look of your breasts by having areola and nipple reconstruction. There are several options to restore the areola and nipple so that it appears more natural.
What to Expect with Breast Reconstruction
Surgical breast reconstruction is done in several steps. In some phases (like the flap creation, tissue expansion, or implant placement), general anesthesia is typically used. Some patients may need to stay overnight, but this is based on the treatment phase. When the last stage is completed for your breast reconstruction, you should wear a supportive bra and you may be prescribed medication by Dr. Sawh-Martinez to minimize bleeding, swelling, and discomfort. In time, the reconstructed breast(s) should appear more normal, allowing you to feel more comfortable. Regular checks with breast exams and mammograms are critical and highly recommended to check for new cancer growths.
Breast Reconstruction Frequently Asked Questions
How much does breast reconstruction surgery cost?
Breast reconstruction surgery can be complicated so to get the best results, you should focus on selecting a doctor who has years of training, like Dr. Sawh-Martinez, over the cheapest price. During your initial consultation, Dr. Sawh-Martinez will take time to understand your concerns and cosmetic goals before creating your personal surgical plan. After this, he will discuss costs, options for payment, and low-interest financing.
Does insurance cover my surgery?
Enacted in 1998, the Women's Health and Cancer Rights Act (WHCRA) requires health insurance policies that cover breast cancer surgery (mastectomy) to cover reconstruction surgery as well. If you have insurance, a team member at Craniofacial & Aesthetic Plastic Surgery will help explain your coverage. We can also assist you in collecting the necessary paperwork for your insurance carrier.
Which technique should I choose?
With so many options, there is no single reconstruction technique that works for every patient. The recommended method for you will be based on your concerns, wants, and physique. During your initial consultation, Dr. Sawh-Martinez will discuss your choices, including both flaps and implants so you understand the pros and cons before you decide. Whether you choose a flap or implants, Dr. Sawh-Martinez will do his best to give you great results.
What about nipple reconstruction?
Reconstruction of the nipple and areola are typically done using cosmetic tattooing. If you're interested in nipple and areola reconstruction, you should ask Dr. Sawh-Martinez at your initial consultation. He will discuss your options to help you decide whether you'd like cosmetic tattooing of your nipple-areola complex to be included in your surgical plan.
Should I have reconstruction with my mastectomy or wait?
The timing of your breast reconstruction is dependent on many factors. Some patients decide to get their breast(s) reconstructed along with their mastectomy, while other patients decide to defer reconstruction surgery. Dr. Sawh-Martinez suggests you make an appointment for a consultation following a diagnosis of breast cancer so you can start considering your choices, including when you want to have breast reconstruction surgery. If you want to undergo reconstruction in conjunction with your breast cancer treatment, Dr. Sawh-Martinez will collaborate with your oncology team to plan your care.
Breast Reconstruction Reclaim Your Self-Confidence
Although the process of breast reconstruction can take time, it's probably one of the top beneficial procedures for our Lake Mary, FL patients at Craniofacial & Aesthetic Plastic Surgery. This procedure can help improve the physical and emotional impact of breast cancer treatment while also allowing you to restore your figure and self-confidence. If you have breast cancer, have had an injury to the chest, or have a congenital defect that affects the look of your breasts, we encourage you to contact our Lake Mary, FL office and make an appointment with Dr. Raj Sawh-Martinez.