Breast reconstruction after a mastectomy due to cancer can improve self-image, self-confidence and quality of life. Using the newest techniques, a breast that is similar in appearance to that of the natural breast can be created. Although surgery can give you a relatively natural-looking breast, a reconstructed breast will never look or feel exactly the same as the breast that was removed. Scars will always be present on the breast as well as donor sites in certain techniques.

Breast reconstruction typically involves several procedures performed in stages. Procedures such as breast lift, breast reduction or breast augmentation may be required on the opposite breast to achieve symmetry of both breasts.

During your initial consultation with Dr. Wendy-Ann Olivier at Medical First New York Cosmetics, she will thoroughly discuss your desires and expectations for Breast Reconstruction with you. After a comprehensive history and physical examination, Dr. Olivier will review the surgical options and recommend the option that she thinks is best for you. Dr. Olivier will discuss specific instructions for preparing for surgery, including diet and medication requirements. She will also clearly explain your post-surgery needs so that you can prepare in advance.

Breast reconstruction surgery produces the specific goals of:

• Creating natural appearing breast
• Improving self confidence
• Improving quality of life
• Enhancing self-image

Breast Reconstruction Q & A

How is the procedure done?
Breast reconstruction can be performed at the same time as the mastectomy, or be delayed until complete healing from mastectomy and recovery from any additional cancer treatments. Breast reconstruction surgery is usually performed under general anesthesia. Breast reconstruction is often performed in stages and may include one of the following procedures:

TRAM Flap — repositions a woman’s own abdominal muscle, fat and skin to create a breast mound. The flap may either remain attached to the original blood supply and be tunneled up through the chest wall, or be completely detached and using microsurgical techniques be brought to the chest to create a breast mound.

Latissimus Dorsi Flap — uses muscle, fat and skin from the back to create a breast mound. Typically, an implant is placed under the flap to obtain adequate volume / size match to the other breast. This is a good option for women who have had radiation therapy on the chest wall to cover and support a breast implant.

Tissue Expansion / Breast Implant Tissue expansion — stretches healthy skin to provide coverage for a breast implant. Reconstruction with tissue expansion requires multiple office visits over 2-4 months after placement of the expander to slowly fill the expander to stretch the skin in order to accommodate a permanent breast implant. The permanent breast implant is placed in a second surgical procedure. Saline and silicone implants are available for reconstruction.

Nipple-Areola Reconstruction — the last stage of breast reconstruction is the creation of the nipple and areola. There are multiple techniques to reconstruct the nipple and areola.

What is the recovery time?
After your breast reconstruction procedure is completed, dressings or bandages will be applied to the incisions. A small, thin tube (drain) may be temporarily placed under the skin to drain any excess blood or fluid that may collect after breast reconstruction surgery. The drain is usually removed in the first post-operative office visit.

Although many factors are involved with determining your actual recovery time for breast reconstruction, you will likely experience a post-surgical recovery period of three to six weeks and an additional period of reduced-activity. You will likely experience soreness and swelling for a few weeks. Exercise and normal activity can resume at the direction of Dr. Olivier. Over time, post-surgical swelling will decrease and incision lines will fade.

You will be given specific instructions on how to care for your reconstructed breast, medications to take orally to reduce pain and the risk of infection. You will be given an appointment for your follow-up with Dr. Olivier.

Careful monitoring of breast health through self-exam, mammography and other diagnostic techniques is essential to your long-term health.