About Breast Reconstruction
Breast reconstruction surgery is performed to restore one or both of the breasts to a normal size, shape, and appearance after a mastectomy or lumpectomy. It is also used to repair a breast damaged by trauma or a birth defect. New techniques in breast reconstruction surgery make it possible for you to feel whole again and obtain natural-looking breasts even after they have been removed. This surgery generally involves several procedures and various stages that can either be performed at the beginning of your cancer treatment or delayed until a later date. Dartmouth, MA plastic surgeon Dr. Caroline Plamondon creates a personalized treatment plan and uses a compassionate approach as we work with you to restore your physical appearance and confidence at Caroline J. Plamondon, M.D. Cosmetic and Reconstructive Plastic Surgery.
Breast Reconstruction Reviews
Breast reconstruction is a very individualized procedure. Every patient will have a thorough consultation with Dr. Plamondon to determine their treatment plan based on their needs, concerns, and available options. If you are considering reconstruction, it is important that you have realistic expectations. While Dr. Plamondon strives to create a natural appearance, your newly reconstructed breast(s) will not have the same look, sensations, or feel as your original breast(s). You should be cleared by your oncology doctor to have surgery and tell Dr. Plamondon about any other medical conditions that could impair healing.
At our Dartmouth, MA practice, Dr. Caroline Plamondon often recommends breast reconstruction with the use of tissue expansion and implant placement. Reconstruction with tissue expansion allows for an easier/faster recovery than flap procedures. This involves placing a tissue expander under the breast wall as the first step and then slowly filling it with saline over the course of 4 – 6 months until the skin is properly stretched. The process of slowly filling the device is an easy and quick in-office procedure. After the skin is stretched through an expander, stage two is to use breast implants to create the volume and shape of the breast(s). During stage three, you may want to improve the appearance with nipple and areola reconstruction. There are numerous options to restore the nipple and areola so that it looks natural, including micropigmentation and/or surgical techniques.
There are many techniques available today for breast reconstruction. There are also several factors that Dr. Plamondon considers when determining the technique that will produce your best results. Some of these factors include cancer diagnosis, reconstruction timing, whether you will use natural tissue or implants, and if nipple-sparing or nipple reconstruction is a part of the process. In order to rebuild the breast, there must be enough tissue to adequately cover the breast mound. Flap techniques accomplish this by using your own muscle, fat, and skin to create, cover, and build the mound. The most common flap techniques are:
- TRAM Flap
This method uses muscle, skin, and fat from your abdomen to rebuild the breast. The tissue used to create the new breast can be detached from the abdomen or it may remain attached to the donor location, keeping the original blood supply.
- DIEP Flap
Like a TRAM flap, a DIEP flap uses fat, skin, and blood vessels from the lower stomach, but it doesn't take the muscle. The DIEP (deep inferior epigastric perforator) flap moves fat and skin from the stomach to build the breast mound, then uses microsurgery to attach the transferred blood vessels to the chest.
- Latissimus Dorsi Flap
This method uses muscle, skin, and fat from your back. During this procedure, tissue is moved from the back to the mastectomy site through a surgically created tunnel and remains attached to the donor location, which leaves the original blood supply intact.
- PAP Flap
Another flap alternative is the PAP (profunda artery perforator). This technique takes fat, skin, and muscle tissue from your inner thigh to reconstruct your breast(s).
- LTP Flap
While the TRAM flap tends to be one of the more common methods used during reconstruction, sometimes there is not enough muscle, skin, and fat that can be taken from the abdominal area. In these situations, the LTP flap may be used, which takes tissue from the lateral thigh area.
- Composite Flap
Also known as a composite stacked flap, this method combines flaps from various areas on your body to reconstruct the breast.
What to Expect
Breast reconstruction surgery is performed in various stages. During certain phases (such as creating a flap, inserting an expander, or placing implants), general anesthesia may be used. Some patients will require an overnight stay — this is dependent on the actual phase of treatment. Once the final step has been completed in the breast reconstruction process, you will wear a medical support bra and you will be given medication by Dr. Plamondon to help control bleeding, swelling, and discomfort. Over time, the breast(s) will look normal so you can feel more confident. Ongoing monitoring with mammograms and breast exams are essential and recommended for your ongoing health.
Frequently Asked Questions
How much does breast reconstruction surgery cost?
Breast reconstruction is a complex surgery so to get your best results, you should concentrate on finding a plastic surgeon with years of training, like Dr. Plamondon, over the lowest price. At your consultation, Dr. Plamondon will listen to your needs and goals before developing your unique treatment plan. Then, she can go over cost estimates and payment methods.
Does insurance cover my surgery?
The Women's Health and Cancer Rights Act (WHCRA) of 1998 requires insurance plans that cover mastectomies to also cover breast reconstruction surgery. If you have health insurance, someone from Caroline J. Plamondon, M.D. Cosmetic and Reconstructive Plastic Surgery will help you understand your policy and benefits. We will also help you submit any needed information to your insurance.
Which technique should I choose?
There is no single technique that is right for everyone. The best technique for you will depend on your needs, goals, and body. During your consultation, Dr. Plamondon can explain your options, including both implants and flaps so you can understand the advantages and drawbacks of each before deciding which is best for you. Whether you decide on implants or a flap for reconstruction, Dr. Plamondon will do her best to make your results look natural.
What about nipple reconstruction?
Nipple and areola reconstruction are usually performed with 3D cosmetic tattooing. If you are interested in this, you should talk to Dr. Plamondon during your consultation. She will explain your options so you can decide if you want nipple and areola reconstruction to be a part of your treatment plan.
Should I have reconstruction with my mastectomy or wait?
When you choose to have breast reconstruction is a personal decision. Some patients choose to have their reconstruction performed at the same time as their mastectomy, while others prefer to wait. Dr. Plamondon recommends you schedule a consultation after your cancer diagnosis so you can begin thinking about your options and when you may want reconstruction surgery. If you decide to have reconstruction at the same time as your mastectomy, Dr. Plamondon can work with your oncologist to plan your surgery.
Plan Your Procedure
Reclaim Your Self-Confidence
While the breast reconstruction process can be lengthy, it is considered one of the most worthwhile surgeries for our Dartmouth, MA patients at Caroline J. Plamondon, M.D. Cosmetic and Reconstructive Plastic Surgery. It can help decrease the emotional and physical impact of a mastectomy while also allowing you to reclaim your self-confidence and figure. If you have been diagnosed with breast cancer, have had trauma to the chest, or were born with a defect that affects the appearance of your breasts, we invite you to call our Dartmouth, MA office and schedule your consultation with Dr. Plamondon.