Breast Reconstruction


Do you have breast cancer? Are you going to need a mastectomy to eliminate the cancer? Or have you already lost a breast, or both breasts, to breast cancer? Losing a breast- and in some cases, both breasts- can have a severe, emotional impact on the patient, drastically affecting her self-image as well as her self-confidence. Not long ago, women who have had mastectomies in order to win their battle against breast cancer had no choice but to live with the permanent physical alterations that mastectomies inherently create.

BEFORE & AFTER

But thanks to recent developments within plastic surgery techniques and procedures, several options currently exist with which to help a woman who has lost a breast (or both breasts) or is going to lose a breast (or both breasts) to recreate her lost breast or breasts, empowering her self-image, self-confidence, and most importantly, her femininity. If you have lost a breast or both breasts, or will soon be losing a breast or both breasts, to breast cancer, please read on to learn more about breast reconstruction in Beverly Hills- it may very well be just what you need.

 

     
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What is Breast Reconstruction?

 

Breast reconstruction, as mentioned above, is a plastic surgery procedure designed to help women who have lost a breast, or both breasts, to breast cancer to recreate her breasts after a mastectomy. More specifically, breast reconstruction is a surgical reconstruction of a lost breast using either the patient’s own the patient’s own tissues or breast implants to create the most natural-looking breast possible.

 

Breast reconstruction is often combined with breast augmentation of the other breast (to correct any problems with breast symmetry) and/or nipple and areola recreation to bring about the most optimal post-mastectomy breast profile and figure. There are rare cases in which a male can develop breast cancer- it has been estimated that less than 1% of all breast cancer cases occur in men- but the vast majority of breast cancer cases happen to women.

 

Because breast reconstruction in Los Angeles is considered a reconstructive plastic surgery procedure, not an aesthetic plastic surgery procedure, and therefore may be covered partially or wholly by your insurance, although coverage can greatly vary. Federal and state legislation have mandated that insurers provide coverage (partial or whole) for breast reconstruction after a mastectomy if the insurer covers mastectomies, but mastectomies themselves are not mandated by law to be a procedure covered by insurance.

 

Breast Implants vs. Flap Reconstruction

 

There are two main options with which to perform breast reconstruction after mastectomy: using breast implants or using flap reconstruction.

 

There are two different types of breast implants that can be used when performing breast reconstruction using breast implants: the saline implant and the silicone implant. Although women have tended to claim that silicone breast implants look and feel more like actual breast tissue than saline implants, the decision to use one type of implant over the other is a matter of the patient’s personal preference.

 

There are a few different options when it comes to breast reconstruction via flap reconstruction: the transverse rectus abdominis muscle (TRAM) flap, the latissimus dorsi flap, the deep inferior epigastric artery perforator (DIEP) flap, the gluteal artery perforator (GAP) flap, and the transverse upper gracilis (TUG) flap. Each of these flap reconstruction procedures involves the relocation of a section of skin and fat tissue as well as the blood vessels from a predetermined area of the body to the patient’s breasts.

 

The TRAM flap describes a breast reconstruction procedure that uses the muscle and tissue from the abdominals and the latissimus dorsi flap describes a breast reconstruction that was performed using the muscle and tissue from the upper back area. The DIEP flap procedure is much like the TRAM flap procedure, but does not use muscle tissue to recreate the breast. The GAP flap procedure uses the tissues from the buttocks to shape the patient’s new breast and the TUG flap means that the tissue between the bottom crease of the buttocks and the inner thighs were used.

 

The most common flap reconstruction procedures are the TRAM flap and the latissimus dorsi flap as the other listed procedures are much more specialized; the TRAMP flap and latissimus dorsi flap procedures can relocate the tissues and blood vessels while keeping the blood vessels intact and attached to their original blood source, but with the other procedures, the only way to relocate the tissues and blood vessels is to completely sever the blood vessels from the area and reattaching them to vessels in their new location within the breast area.

 

Depending on the level of how much the patient’s breast needs to be reconstructed, a tissue expander may be needed. If a patient’s breast reconstruction procedure involves large breasts or if a patient does not have much skin and muscles on the chest to comfortably accommodate breast implants or transplanted flap tissue, a tissue expander can be inserted in order to slowly create a pocket in which to place the implant or flap tissue. If a tissue expander is used, the patient will need to periodically visit the plastic surgeon over the course of several weeks to get injections that will slowly expand the tissue expander to the necessary size.

 

Whether or not breast implants or flap reconstruction is used, whether one flap reconstruction procedure is better over the other, and whether or not a tissue expander is needed is all determined on a case-by-case basis, tailored according to each patient’s individual needs. For more in-depth information about the pros and cons between the different types of procedures and techniques, please visit or contact your plastic surgeon.

 

What to expect during Breast Reconstruction recovery?

 

After the plastic surgeon has closed up any incisions made during the breast reconstruction procedure, gauze or bandages that help minimize bruising and swelling may be applied around the incision sites. The plastic surgeon may require that you also wear an elastic bandage/bra in order to temporarily support the newly reconstructed breast or breasts. The patient will be required to take a regimen of antibiotics to ward off any post-op infection and to manage pain and discomfort, the patient may be prescribed pain medications.

 

If the patient had a flap reconstruction instead of breast implants, it is likely that she will need a longer recovery period; it will, on average, take a little longer for any pain and discomfort to subside, and full results- the disappearance of bruising and swelling as well as the healing and fading away of post-op scars- will also, on average, take a little longer to be realized. Most patients stay at the hospital for one or two days following a breast implant procedure and most flap reconstruction patients require a five to six day post-op hospital stay.

 

Depending on whether or not the patient’s breast reconstruction procedure occurred immediately after her mastectomy or after some time has passed after the mastectomy, the patient’s recovery period is likely to be altered. If a patient has her breast reconstruction immediately after her mastectomy, her recovery period is likely to be longer and more uncomfortable than if she had waited to get her breast reconstruction. However, the advantage of getting breast reconstruction immediately following a mastectomy is that costs are reduces and any emotional experiences stemming from the lack of a breast or breasts are avoided.

 

It is encouraged that patients slowly move their arms after their breast reconstruction after breast cancer procedure in order to lessen the risk of post-op blood clot formation, but highly advised that patients refrain from any lifting or using their arms for any forceful activity for the first week of their recovery period. Most women find that they can completely resume their normal pre-op activities within six weeks of their procedures. Any strenuous exercise is discouraged during the first few weeks of breast reconstruction recovery.

 

Depending on the type of breast reconstruction procedure and technique used, patients may only need one to two weeks of recovery before feeling well enough to return to work or they may need as much as six to eight weeks of recovery before they are able to return to work.


Dr. Vishal Kapoor MD is a Board Certified plastic surgeon who performs facial and body procedures in
Beverly Hills & Los Angeles, California in his fully accredited cosmetic surgery center.
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