Breast reconstruction at Evolve Plastic Surgery aims to restore breasts to near-normal shape, appearance, symmetry, and size following mastectomy or lumpectomy. Performed by our board-certified plastic surgeons, this process can involve implant-based or flap techniques tailored to each patient’s needs. We are dedicated to providing first-class patient care and helping you regain your confidence and feel like yourself again.
Reconstruct Your Breasts and
Feel Like Yourself Again
Breast reconstruction is a surgical procedure aimed at restoring the shape, appearance, symmetry, and size of one or both breasts following mastectomy, lumpectomy, or congenital deformities. At Evolve Plastic Surgery, our board-certified plastic surgeons specialize in creating natural-looking results tailored to each patient’s unique needs. This process can involve multiple stages and may begin at the time of mastectomy or be delayed until a later date, depending on individual circumstances and preferences.
There are two primary types of breast reconstruction: implant-based reconstruction and flap reconstruction. Implant-based reconstruction uses breast implants to form a new breast mound, while flap reconstruction utilizes the patient’s own tissue from another part of the body. The choice between these options depends on several factors, including the type of mastectomy, cancer treatments, and the patient’s body type. Our dedicated team will help you understand your breast reconstruction options and make informed decisions.
Breast Reconstruction Treats:
- Post-mastectomy breast loss
- Post-lumpectomy breast deformities
- Congenital breast abnormalities
- Loss of breast symmetry due to cancer treatment
- Aesthetic concerns after traumatic breast injury
- Loss of symmetry due to breast lift, reduction, or augmentation
Implant-Based Breast Reconstruction
Implant-based breast reconstruction involves using breast implants to recreate the breast mound after mastectomy or lumpectomy. This procedure can be done immediately during the mastectomy or at a later time. Implants are placed either above or below the pectoral muscle, often with the support of a biological mesh called acellular dermal matrix (ADM). This method is suitable for patients with sufficient chest wall tissue and offers a quicker recovery compared to flap techniques. Our surgeons will help determine the best approach for your needs.
Benefits of Implant-Based Breast Reconstruction:
- Shorter surgery and recovery time compared to flap reconstruction
- Less invasive than flap procedures
- Immediate results, often performed during mastectomy
- No need for tissue harvesting from other body areas
- Reduced risk of complications associated with flap techniques
- Can be adjusted or replaced if necessary
- Maintains natural breast contour with acellular dermal matrix (ADM) support
- Minimal scarring compared to tissue flap methods
Your Implant-Based Breast Reconstruction Options:
- Immediate Reconstruction Above the Pectoral Muscle: This option involves placing the breast implant above the pectoral muscle at the time of mastectomy. Our plastic surgeons will use a biological mesh known as an acellular dermal matrix (ADM) to support the implant and maintain its anatomical position. This technique often results in a quicker recovery since the chest muscle is not disturbed, and it avoids muscle contractions that could affect the implant.
- Immediate Reconstruction Under the Pectoral Muscle: In this approach, the breast implant is placed under the pectoral muscle during the mastectomy. The surgeon elevates the pectoral muscle to create a pocket for the implant, which is supported by ADM. This method can provide a more natural contour and prevent upper pole wrinkling. Due to the elevated muscle, it typically involves a slightly longer recovery period.
- Immediate Tissue Expander Placement: This procedure involves inserting a tissue expander beneath the chest wall muscle during the mastectomy. The expander is gradually filled with saline over several weeks to stretch the skin and muscle, creating space for a permanent implant. This staged approach allows for gradual adjustment to the desired breast size and shape, accommodating the patient’s comfort and healing process.
- Immediate Reconstruction Using Latissimus Dorsi Muscle: For patients with limited soft tissue or who have undergone radiation therapy, using the latissimus dorsi muscle can be an effective option. This technique involves moving the latissimus muscle from the back to the chest, creating a pocket for the implant. This method brings new blood supply to the area, which is beneficial for patients with compromised chest tissue, ensuring better healing.
Abdominal Flap Breast Reconstruction
Abdominal flap breast reconstruction uses tissue from the lower abdomen to recreate the breast mound after mastectomy. This technique, known as autologous reconstruction, involves transferring skin, fat, and sometimes muscle from the abdomen to the chest. Common types include the DIEP, TRAM, and SIEA flaps, which differ based on the blood vessels used. This method offers a natural look and feel, and it can be an excellent option for patients who prefer not to use implants or lack sufficient chest tissue for implant-based reconstruction.
Benefits of Abdominal Flap Breast Reconstruction:
- Uses the patient’s own tissue for a more natural look and feel
- Can recreate the breast without the need for implants
- Lower risk of implant-related complications
- Provides a simultaneous tummy tuck effect from tissue removal
- Often has better long-term durability and aging compared to implants
- Reduced risk of rejection since no foreign materials are used
- Ideal for patients with insufficient chest wall tissue for implants
- Brings new blood supply to the chest area, beneficial for those with radiation damage
- Potential for a more natural breast contour and movement
Your Abdominal Flap Breast Reconstruction Options
Pedicled TRAM Flap:
The pedicled TRAM (transverse rectus abdominis myocutaneous) flap reconstructs the breast using muscle, fat, and skin from the lower abdomen. This tissue remains attached to its original blood supply through the rectus abdominis and is tunneled under the skin to the chest. While this technique provides reliable blood flow, it may result in some abdominal weakness since the entire muscle is utilized.
Free TRAM Flap:
The free TRAM flap also uses tissue from the lower abdomen but involves microsurgery to detach and reattach the tissue to the chest blood vessels. Only a portion of the rectus abdominis is taken, which can reduce the risk of abdominal weakness. This requires a highly skilled team to ensure proper blood vessel connection and tissue viability.
DIEP Flap:
The DIEP (deep inferior epigastric perforator) flap utilizes the same abdominal skin and fat as the TRAM flaps but spares the rectus abdominis muscle. Only the necessary blood vessels are harvested, leaving the muscle intact. This technique minimizes the risk of abdominal weakness and hernias while providing a natural-looking breast.
SIEA Flap:
The SIEA (superficial inferior epigastric artery) flap also uses lower abdominal skin and fat but without the muscle. The blood vessels used for this flap run through the fat, not the muscle, which can lead to less postoperative pain and a quicker recovery. However, not all patients have adequate SIEA vessels, making this option less commonly performed.
Breast Reconstruction Before & Afters
Breast Reconstruction FAQs
What Factors Should I Consider When Choosing a Breast Reconstruction Method?
When choosing a reconstruction method, consider your overall health, body type, cancer treatment plan, and personal preferences. Discuss with your surgeon the pros and cons of each method, the potential impact on your recovery, and any long-term considerations. Your surgeon will also evaluate factors like your available tissue for flap reconstruction, your likelihood of tolerating an implant, and any additional surgeries that may be needed for symmetry.
Is Breast Reconstruction Safe After Radiation Therapy?
Yes, breast reconstruction is possible after radiation therapy, but it requires careful planning. Radiation can affect the quality of the skin and tissue, making implant-based reconstruction more challenging. Flap reconstruction, which uses your own tissue, often provides better results in radiated areas by introducing new, healthy tissue with a good blood supply. Your surgeon will assess your specific situation and recommend the best approach for optimal outcomes.
How Long is the Recovery Period After Breast Reconstruction?
Recovery time varies depending on the type of reconstruction. Implant-based reconstruction typically involves a shorter recovery period, with most patients resuming normal activities within 4 to 6 weeks. Flap reconstruction involves more extensive surgery and longer recovery times, often requiring 6 to 8 weeks or more for full recovery. Your surgeon will provide detailed post-operative care instructions and monitor your progress to ensure a smooth recovery.
Will My Reconstructed Breast Feel Like My Natural Breast?
A reconstructed breast will not have the same sensation as your natural breast. While it can achieve a similar shape and appearance, the lack of natural breast tissue and nerves means it will feel different to the touch. Over time, some sensation may return, but it will not be identical to your original breast. The goal is to restore appearance rather than replicate the sensation.
Embrace Your Most Evolved Self
Evolve Plastic Surgery is dedicated to helping you restore confidence and achieve your best self through expert breast reconstruction. Our board-certified, fellowship-trained plastic surgeons specialize in personalized care to meet your unique needs. Whether you choose implant-based or flap reconstruction, our team will guide you every step of the way. Schedule a consultation to discuss your options and start your journey towards a renewed sense of self.
