Many women seek breast reconstruction after undergoing a mastectomy or surgery to remove a breast lump. A misconception of this procedure is that it will make your breast(s) look normal while nude. In some instances, this is possible if your reconstruction is completed at the same time as your mastectomy. In most all circumstances, this procedure will make your breast(s) look normal while wearing a bra. No matter which type of breast reconstruction you choose, your affected breast will differ from your unaffected breast. That being said, most women are satisfied with their breast reconstruction finding that it restores their confidence and makes life easier. At Ponte Vedra Plastic Surgery we work closely with you, offering support and information to help you make decisions and to make the process as easy as possible for you during this difficult time.
Things to Consider
During your first consultation to discuss reconstruction surgery, it is important to disclose where you are in the treatment process and which cancer surgeon is treating you, as well as provide any necessary pathology reports. The reconstruction process may take place in multiple steps if the breast tissue needs to be stretched to make room for implants. This discovery phase will help guide the reconstruction process so patients end up with a new breast that is the size, shape and look they want.
Each reconstruction technique will be tailored according to the patient’s physical health, aesthetic goals, and personal preferences. There are many factors playing into the approach that will be taken. The ultimate goal is to ensure the patient is healthy and happy with their final breast results.
There are two primary categories of breast reconstruction techniques:
- Procedures that involve using a breast implant
- Procedures that are autologous (use the patient’s own body’s tissue to reconstruct and recreate the breast)
Reconstruction With Implants
Breast reconstruction using silicone or saline implants is a common approach that generally starts with the use of a tissue expander to help form a suitable pocket for an implant. The expander may be inserted after the mastectomy procedure or during the same operative session. Over the course of several months, the expander will slowly be enlarged using a sterile solution injected through a port residing under the skin. During the scheduled reconstruction surgery, the expanders are removed and replaced with permanent implants.
If there is limited tissue inside the breast, or limited skin on the outside, tissue may be used from another part of the patient’s body to supplement this loss. The most common areas to support this process are the buttocks, thigh or abdomen. This is an autologous approach to breast reconstruction. The TRAM flap (Transverse Rectus Abdominus Myocutaneous), the DIEP flap and SIEA flap techniques involve taking skin and fat from the abdomen and relocating it to the breast. The Latissimus Dorsi Flap is another common method using tissue from the patient’s back.
During a mastectomy, the nipple and areola often cannot be saved. The loss of one’s nipple and areola can be as unnerving as the removal of the breast itself. However, reconstruction techniques have advanced greatly, allowing plastic surgeons the opportunity to recreate these areas of the breast to give a natural, aesthetically appealing appearance. In a separate procedure, the nipple is created using existing breast skin or from the abdominal or latissimus flap. Using a tattoo technique, the areola is recreated with a skin graft taken from the thigh, abdomen or back.
Breast reconstruction surgery is performed under general anesthesia at an accredited surgical facility. Some patients may be required to stay in the hospital to be monitored for complications. Patients who have had reconstruction using a flap technique will usually be required to stay in the hospital for 2-5 days. The recovery process can be somewhat lengthy, but many view it as the final step in their cancer journey thus the experience can be very rewarding. Most women are thankful to have had the opportunity to restore their breasts and are satisfied with their results.
Breast Reconstruction FAQs
This is a very specialized surgery that requires extensive knowledge, skill and experience. It is very important to research and find a qualified and reputable plastic surgeon who has experience with breast reconstruction surgery.
Can I Delay This Surgery?
In many situations, it is recommended to start the reconstruction process at the same time as the mastectomy. Therefore, it is a good idea to have your breast cancer surgeon and your plastic surgeon begin communicating about the steps that will follow. An advantage of doing the procedure immediately is waking up from your mastectomy surgery with the reconstruction process in place. The soft tissue that surrounds the breast will heal simultaneously with the reconstruction, which can enhance the final results.
A reconstructed breast will not have the same sensation as the breast did before the mastectomy. However, over time, some of this sensation will return to normal. This will depend on the extent of the reconstruction process and will vary by patient.
Breast Reconstruction Reviews
"Dr Rumsey is very professional and very professional. He does great reconstructive work. He's honest about procedures that aren't needed. The staff are all kind, professional and empathetic. They offer skin products, as well as all plastic surgery and reconstructive surgery needs. I never feel like they try to "sell" me on products. I've gone in twice and Dr Rumsey told me straight out ,"No," because he thought I'd be disappointed with results. What an honest doctor. I highly recommend him and his practice to anyone in need of a plastic surgeon!"- D.C. / Yelp / Jun 25, 2014
"In January, 2009, I was diagnosed with breast cancer; after making the decision to have a bilateral mastectomy, I needed to find a plastic surgeon for the breast reconstruction phase of this journey. I was given three recommendations to plastic surgeons; after doing some research, I crossed my fingers and chose Dr. Brett Snyder of Ponte Vedra, FL. From the first appointment (where we had SO many questions)to present day (I'm almost done!), Dr. Snyder and his staff have been extremely patient and kind, generous with their time, understanding and supportive. The first couple of weeks after the mastectomy/tissue expander implant surgery were "rough" - not knowing whether the physical aches/pains I was experiencing were "normal" coupled with a desire to NOT depend upon the pain meds sent my already over-extended emotions out of control. I contacted Dr. Snyder's answering service over a weekend; he called back right away and assured me that what I was feeling was normal and that I really WAS okay. Another time, I panicked and convinced myself I was retaining fluid around the tissue expanders; Dr. Snyder's staff went out of their way to get me into the office immediately to be checked. Of course, there was nothing PHYSICALLY wrong with me and although I was really embarassed for making such a big deal out of nothing, Dr. Snyder assured me that he'd "rather be safe than sorry" and everyone was very understanding. In my experience, the tissue expansion was the most physically difficult part of my breast cancer experience. However, I didn't go through it alone - Dr. Snyder and his staff were with me every week, empathetic to the discomfort I was experiencing while continually encouraging me toward the end-goal that would help me to STOP feeling like a cancer patient, raise my self-image and begin to see myself as a whole woman again. We were told that my "support team" would be vital to my recovery - I was truly one of the "lucky ones" when Dr. Snyder and staff became part of that support team."- C.W. / Vitals / Sep 25, 2009
"I am in my early 40's, BRACA positive, and have been living under the dark cloud of my fate since 2003. Every 3 mos I have been alternating the Diagnostic Mammogram, than the Bilateral MRI. I have been fortunate to of had my Breast Cancer caught very early in 2003 and have had 3 lumpectomies since. In May of 2010, 3 of my Doctors strongly suggested I have a Bilateral Mastectomy. I have had an ongoing issue in my right breast for the past 11 mos. and my emotions along with my Doctors care and concerns were nearing the end. My fate ran out and here I was in a daze having to choose a Plastic Surgeon to assist my surgeon during my proceedure. I was given a sheet a paper with a few Plastic Surgeons listed and was told to choose so we could proceed forward.I was still in shock, numb and felt like a walking zombie. I was definately not in any mental shape to make such an important decision. With the list in hand, and some referrals from friends, I set up 3 appointments with 3 Plastic Surgeons in the hopes that I would "just know" when I met the right one. Dr. Sternberg was my 1st appointment. Due to my Surgeons recommendations and another good feeling I had prior to meeting him, I felt he would be the perfect one to start off with.I just wanted to tell a little of my story so you can truly understand what I am about to disclose.I made my appointment with such a "Professional and Caring" member of his team. Ok, now onto the appointment. I arrived at Dr. Sternberg's office and what a "- C.(. / Vitals / Jun 28, 2010
"I am one week post op for a tt and reconstruction for breast cancer and bilateral mastectomies. The first surgeon I had (in another state) did a disastrous job on my reconstruction and after living with it moreI am one week post op for a tt and reconstruction for breast cancer and bilateral mastectomies. The first surgeon I had (in another state) did a disastrous job on my reconstruction and after living with it for several years, I sought out Dr. Snyder for a consultation to see if there was anything that could be done. I could not be happier with the immediate result! It is astounding to me, considering what he had to work with, that Dr. Snyder was able to restore my breasts to this degree, along with my self esteem. He is professional and excellent at what he has been trained to do. His facilities and staff are excellent. I spent the night and the nurses were wonderful. I am looking forward to watching the rest of my transformation as my tt and reconstruction heal. Thank you!"- A. / Yahoo / Aug 27, 2012
"Wonderful experience with TruYou! I had breast reconstruction in 2011 and love Dr. Sternberg! Everyone in this office is friendly and helpful! I recommend them to anyone I know who needs this specialty."- T.T. / Google / Jun 19, 2014
The Women’s Health and Cancer Rights Act of 1997 has made it possible for many women to undergo breast reconstruction surgery without the burden of a heavy financial cost. The act states that insurance companies and managed care organizations are required to pay for breast reconstruction for women who have had a mastectomy. It supports all phases of the cancer treatment and reconstruction process. Our insurance and billing office will work with the provider to understand exactly what the coverage may be.