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Breast Reconstruction Overview

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Those diagnosed with breast cancer or with a genetic predisposition (such as the BRCA gene mutation) to developing it may undergo a procedure to remove all or a portion of their breast tissue. These procedures are known as mastectomies and lumpectomies.

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What Is a Mastectomy?

Mastectomy surgery removes all of a patient’s breast tissue. Depending on your needs and the extent of your breast cancer, one or both breasts may need to be removed. Typically, the breast skin, nipple, and areola are spared if it does not interfere with the oncologic safety of the procedure.

What Is a Lumpectomy?

For some patients whose breast cancer is more localized, only the cancerous cells and a portion of the surrounding tissue in the breasts needs to be removed. This technique is known as a lumpectomy or partial mastectomy. Breast-conserving lumpectomy techniques can be used to preserve as much tissue as possible. However, radiation therapy is frequently needed following a lumpectomy.

During this emotional time, being left without one or both breasts can be a constant reminder of the trauma you’ve been through. Many patients feel as though part of their femininity was taken with their breast tissue and struggle to feel whole again after their procedure.

If you have already had a mastectomy or lumpectomy or will need to undergo one, you have options for restoring the breast appearance and femininity you desire. Immediate breast reconstruction techniques are available at the time of lumpectomy or mastectomy.

Patient Before & After
Patient Before & After

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What Is Breast Reconstruction Surgery?

Breast reconstruction is a procedure that rebuilds the breasts using tissue from another area of the patient’s body, implants, or both.

Am I a Candidate for Breast Reconstruction Surgery?

You are a candidate for breast reconstruction if you have already undergone or will be undergoing mastectomy or lumpectomy surgery to remove breast tissue.

Women with BRCA gene mutations have a high chance of developing breast cancer and may choose to undergo a prophylactic mastectomy. DNA testing is available to determine if you carry this gene.

If you will be undergoing a preventive mastectomy or need a mastectomy after being diagnosed with breast cancer, knowing all your options for breast reconstruction ahead of time can help you make the best decisions for you.

Even if you had a mastectomy years ago, you can still benefit from breast reconstruction if it’s something you desire.

A consultation with Dr. Sadeghi can help determine if this reconstructive surgery is right for you and help you understand your options.

What Are the Benefits of Breast Reconstruction?

Breast reconstruction surgery is beneficial for women who wish to restore their breast size and shape.

Some of the many benefits of this procedure include:

Improved Physical Appearance

Reconstructing your breasts can improve your appearance and create a balanced figure. After a woman’s breast tissue is removed, she may feel like some clothing and swimsuits appear awkward on her. Breast reconstruction surgery works to provide natural-looking breasts that can help you feel beautiful and complete.

Increased Confidence

Women who have lost their breasts may be self-conscious about the appearance of their chest. Breast reconstruction can increase your confidence by restoring natural, attractive breasts. Others don’t need to know that you’ve had your breasts reconstructed unless you want them to.

With breast reconstruction surgery, we hope to empower our patients with courage and confidence.

Improved Emotional Health

An absence of breast tissue after mastectomy may be a constant reminder of the pain and stress you once went through. While there is no doubt you will remember your breast cancer journey, breast reconstruction takes away some of the physical reminders.

Breast reconstruction rebuilds the shape and look of your breasts so you can feel whole again and not have a constant reminder of what was once taken from you.

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Mastectomy Options

Nipple-Sparing Mastectomy

A nipple-sparing mastectomy removes all underlying breast tissue while leaving the breast skin, nipple, and areola intact. This technique can only be performed on patients whose cancer is at least two centimeters from the nipple, measures less than four centimeters in size, and does not affect the breast skin.

Skin-Sparing Mastectomy

A skin-sparing mastectomy works to keep as much breast skin as possible, including the areolar skin. This procedure provides more natural results than more extensive mastectomies.

Immediate Vs. Delayed Breast Reconstruction

Depending on your specific needs, breast reconstruction can be performed at the same time as your mastectomy (immediate reconstruction) or a later date (delayed reconstruction). Oftentimes, the best results are obtained during immediate reconstruction.

Immediate Breast Reconstruction Options

With immediate breast reconstruction, mastectomy and breast reconstruction can be performed in a single operation, which allows for a shorter recovery time and only one surgical appointment.

Recovery and Results After Immediate Reconstruction:

Recovery from immediate breast reconstruction is extensive since both procedures are performed back to back. You will need to spend one or two nights in the hospital for observation. Recovery is roughly six to eight weeks of only participating in light activities.

Oncoplastic Surgery

Oncoplastic surgery (oncoplasty) is a type of immediate reconstruction that involves breast-preserving lumpectomy and reshaping the remaining tissue to restore the breasts in one procedure. This will give the appearance of a breast that has been lifted, with precise symmetry between breasts.

Lumpectomy and Breast Lift

A lumpectomy and breast lift are often performed simultaneously to remove breast cancer and achieve symmetry. Breast cancer can be removed using the breast lift incision, and the remaining breast tissue is lifted and tightened.

Breast lift surgery can also be performed on the opposite breast to achieve symmetry.

One-Step Implant Reconstruction

One-step implant reconstruction uses implants and a regenerative tissue matrix or absorbable mesh to reconstruct the breasts in the same operation as the mastectomy.

Delayed Breast Reconstruction

Unfortunately, some patients are not informed of their immediate reconstructive options. Therefore, breast reconstruction surgery scheduled for a later date allows patients to heal from their mastectomy or lumpectomy and undergo radiation therapy, if needed.

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Breast Reconstruction Options

Natural Tissue Flap Reconstruction Options

Natural tissue (autologous) flap reconstruction uses skin and excess fat from another area of the body to reconstruct the breasts. This surgical technique restores a balanced, natural breast appearance without causing damage to the underlying muscles in the donor area.

Natural tissue flap reconstruction options are named according to the donor area where tissue is taken from.

Recovery and Results After Flap Reconstruction:

Full recovery from natural flap reconstruction takes one to two months. During this time, you should avoid strenuous activities and restrict significant movement. Results are visible almost immediately. However, temporary bruising and swelling will affect the appearance of your breasts.

The types of autologous tissue flap reconstructions include:

DIEP Flap Surgery (Tummy Tuck Flap)

A deep inferior epigastric perforator (DIEP) flap uses skin and fat from the lower abdominal wall to recreate the breast mound. The abdominal muscle remains intact so that the patient’s core strength is not weakened.

The DIEP flap is sometimes called the “tummy tuck flap” because it provides a more slender abdominal contour, similar to a tummy tuck.

DIEP Flap and Implants

The DIEP flap and implants uses abdominal skin and fat as well as implants to recreate the breasts. This is beneficial for patients who do not have enough excess abdominal tissue. Breast implants can be placed at the same time that DIEP surgery is performed, or the implants can be placed in a subsequent procedure after you have healed.

PAP Flap (Posterior Thigh)

The profunda artery perforator (PAP) flap uses excess fat and skin from the posterior thigh, directly below the buttock crease, to restore the breasts. This allows for a thigh lift at the same time as breast reconstruction.

GAP Flap (Buttocks Area)

The gluteal artery perforator (GAP) flap reconstructs the breasts using a blood vessel from the buttocks as well as skin and fat from the butt (near the crease) or from the “love handles.”

SIEA Reconstruction

The superficial inferior epigastric artery (SIEA) flap uses fat and skin from the lower abdominal wall to reconstruct natural breasts. The difference between this technique and the DIEP is that blood vessels are used to harvest the tissue.

Stacked Flap

A stacked flap procedure uses excess fatty tissue from various areas of the body to create a natural breast appearance. Fat can be taken from any combination of the abdomen (DIEP flap), thighs (PAP flap), buttocks (GAP flap), back (TDAP flap), and/or hips (SGAP flap).

Additional Breast Reconstruction Techniques

Breast contouring procedures work to improve the appearance of breasts after breast cancer tissue removal surgery (mastectomy or lumpectomy).

Fat Injections to Breasts

Breast fat transfer can be performed to correct minor asymmetry issues after breast reconstruction. This procedure uses liposuction to remove fat from the donor areas and then injects the purified fat into the breasts.

Lumpectomy Defect Reconstruction

With a lumpectomy, only part of the breast is removed. This can lead to breast asymmetry and disfiguring scarring that can be corrected with surgery. Lumpectomy defect reconstruction is used to correct scars and deformities left on the breasts after a lumpectomy.

Vascularized Lymph Node Transfer (VLNT)

The VLNT procedure is performed to reduce the risk of fluid collection due to lymphatic obstruction. After a patient has undergone axillary lymph node surgery, which removes lymph nodes from the axilla (armpit), VLNT can be performed during breast reconstruction to replace the removed lymph nodes in the armpit.

Second Stage Surgery

Breast reconstruction can be performed in stages. This is often done for patients who need chemotherapy or radiation after their mastectomy or lumpectomy. Second stage breast reconstruction is performed at least 12 weeks after the first stage reconstruction surgery.

The goal of a second stage surgery is to correct and contour the breasts once they have healed. Second stage surgery can reconstruct the nipples, revise scarring, and lift the reconstructed breast. It may also include a procedure on the opposite breast for symmetry.

Revision Breast Reconstruction

Revision breast reconstruction surgery corrects unsatisfactory results from previous breast reconstruction procedures. Dr. Sadeghi specializes in restoring patients in need of revision breast surgery.

Interested in Other Plastic and Reconstructive Surgeries?

Dr. Sadeghi offers various body sculpting surgeries, facial procedures, and cosmetic breast enhancement surgeries. Call us at 504-322-7435 or fill out our online contact form to schedule a consultation.