Breast Reconstruction

Treatment of breast cancer through mastectomy is the most common reason women undergo breast reconstruction. Other reasons include women who underwent “lumpectomy and radiation therapy” for breast cancer and those with congenital breast deformities that result in an underdeveloped breast.

One technique on the forefront of clinical investigation involves the use of fat grafting in breast reconstruction patients and other patients with cosmetic and reconstructive breast shaping challenges.

Breast reconstruction is the re-creation and restoring of a woman’s breast through surgery, either with an implant or her body’s own tissue.  Breast reconstruction surgery is an important part of the overall care plan for women affected by breast cancer. A wide variety of breast reconstruction options exist, and it is important for women to consult with a plastic surgeon early in their treatment process. 

Why choose Crystal Clinics Plastic Surgeons?

At Crystal Clinic Plastic Surgeons, we work closely with our patients to offer compassionate and individualized care along with state-of-the-art reconstruction.  We believe it is important to give our patients choices and to help them understand their options. We are dedicated to restoring the lives of women facing mastectomy with state-of-the-art advanced surgical techniques to preserve and restore the shape and form of the breast.

Breast Reconstruction Surgery Options

Women with breast cancer have two choices when considering breast reconstruction surgery – when to have surgery and what type of surgery to have.

When to have Breast Reconstruction Surgery

Your breast surgeon and your plastic and reconstructive surgeon will help you to decide whether to have simultaneous breast reconstruction, in which immediate breast reconstruction is done at the same time as a mastectomy. This is an option for patients who do not need radiation. Staged breast reconstruction is advised for women who require radiation therapy. Delayed breast reconstruction surgery is an option if a woman has already had cancer surgery without reconstruction.

What Types of Breast Reconstruction Surgeries are Available

Patients can achieve excellent cosmetic results whether they choose to have implant breast reconstruction or the newer Deep Inferior Epigastric Perforator (DIEP) flap reconstruction surgery. These procedures are universally covered by health insurance, improve quality of life, and leave patients with a better body image and less susceptible to depression.

Implant Breast Reconstruction

Most patients are familiar with implant reconstruction, which is the most common form of breast reconstruction surgery and uses either a silicone or saline implant to rebuild the breast.  Using the pre-pectoral approach, the implant is placed on top of the chest muscle in one stage.  The patient experiences less pain and has fewer complications.  

Good candidates for implant surgery include patients who tend to be thinner and have a smaller cup size, or patients who may not be as healthy, or have other health issues such as respiratory or circulatory problems that require a less invasive procedure.

What are the benefits of implant reconstruction surgery?

  • Implants restore breast volume and shape immediately after a mastectomy
  • Most patients can have direct implant surgery and avoid the two-stage process
  • Implant reconstruction is usually a slightly shorter surgical procedure then natural tissue reconstruction surgery and has a shorter hospitalization stay
  • Only a single scar under or on the breast
  • Implant reconstruction does not require additional healing in a separate donor site such as the abdomen
  • Time back to activities is usually 3-4 weeks compared to 4-6 weeks with most natural tissue reconstruction surgery

What are the disadvantages of implant breast reconstruction?

As implants are foreign bodies, they can become infected, develop scar tissue around them, and can fail (leak or break). The other breast may require a “balancing procedure” such as an implant, breast lift, or breast reduction to achieve breast symmetry. And, while the implants may need to be replaced after 15 years, replacing them is an outpatient procedure

Deep Inferior Epigastric Artery Perforator (DIEP) Flap

Considered the gold standard for autologous breast reconstruction, the DIEP flap surgical technique uses the patient’s own abdominal skin and fat to reconstruct a natural, warm, soft breast after mastectomy.  In a DIEP flap, the blood vessels, along with the skin and fat from the lower abdomen below the belly button, are removed and then transplanted to the chest to give back volume and shape without sacrificing abdominal muscles.

What are the benefits of a DIEP flap?

  • A breast that feels natural because it is made from natural body fat
  • An improved contour of the abdomen, similar to a tummy tuck
  • Preservation of all the abdominal muscles, which is ideal for patients with an active lifestyle
  • Avoids the maintenance issues inherent in implant reconstruction
  • DIEP flap surgeries are ideal for both immediate and delayed breast reconstruction
  • A low surgery complication rate

What are the disadvantages of a DIEP flap?

Patients with poor blood flow, smokers, extremely thin, or with respiratory or circulatory problems may not be a good candidate for DIEP Flap reconstruction surgery. Compared to implant reconstruction, DIEP flap surgery takes longer to perform, including a longer hospital stay of three or four days, with a slightly longer recovery time.

Oncoplastic Breast Surgery

Oncoplastic surgery combines the latest plastic surgery techniques with breast surgical oncology.  When a large lumpectomy is required that will leave the breast distorted, at the time of the lumpectomy plastic and reconstructive surgeons then sculpt the remaining breast tissue to realign the nipple and areola and restore a natural appearance to the breast shape.  The opposite breast is also modified to create symmetry.  Oncoplastic technique is especially useful in D cup and larger breasts.

Oncoplastic breast reconstruction treats the cancer, decreases complications from radiation, helps with asymmetry issues, and improves the quality of life for patients.

What are the advantages to having oncoplastic breast reconstruction at the time of a lumpectomy? 

  • Allows for a larger amount of tissue to be removed, which is helpful is cases where the tumor is larger or when there is a concern about the ability to get negative margins.
  • When a larger amount of tissue has to be removed, performing a matching procedure on the other breast provides better symmetry. 
  • Involves only one surgery.
  • Surgery is completed prior to radiation, so you avoid the risks of wound-healing problems that can occur with a post-radiation surgery.
  • Relief of symptoms of large breasts, if this was a problem before surgery.

If you would like to learn more about your options, schedule your consultation with our breast reconstruction specialists at Crystal Clinic Plastic Surgeons at (888) 284-1488.