Breast Reconstruction

Reconstruction of a breast that has been removed due to cancer or other disease is one of the most rewarding surgical procedures available today. New medical techniques and devices have made it possible for surgeons to create a breast that can come close in form and appearance to matching a natural breast. Frequently, reconstruction is possible immediately following breast removal (mastectomy), so the patient wakes up with a breast mound already in place, having been spared the experience of seeing herself with no breast at all.

But bear in mind, post-mastectomy breast reconstruction is not a simple procedure. There are often many options to consider as you and your doctor explore what's best for you.

This information will give you a basic understanding of the procedure -- when it's appropriate, how it's done, and what results you can expect. It can't answer all of your questions, since a lot depends on your individual circumstances. Please be sure to ask your surgeon if there is anything you don't understand about the procedure.

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Revision of reconstruction with Alloderm and shaped implants

This patient underwent bilateral skin-sparing mastectomies several years earlier, with reconstruction using saline implants. Despite previous attempts at revision, she now presents with capsular contracture and breast deformity. I removed the scar capsules, reconstructed a new space for the implants using Alloderm to form a living internal bra, and replaced the implants with 370 cc Sientra high-profile anatomic cohesive gel implants.

Bilateral skin-sparing mastectomy and immediate reconstruction

This patient presented with a request for a breast lift, but on screening mammography was found to have breast cancer. She underwent a skin-sparing mastectomy and immediate reconstruction with a breast lift, Alloderm internal bra, and implants. Nipple reconstruction was done later and she is considering tattooing to make the areola.

Tram Flap Breast Reconstruction

This patient was referred to plan reconstruction of her right breast after mastectomy for cancer. Note the biopsy scar on the upper outer part of the breast. The mastectomy removed all of the breast tissue including the nipple and areola. The reconstruction was done immediately following the mastectomy, with a Transverse Rectus Abdominis Musculocutaneous flap. This operation uses skin and fat tissue from the lower abdomen, similar to a "tummy tuck," except that the tissue remains attached to the rectus muscle which carries the blood supple to keep the flap alive. The flap is delivered into the breast area through a tunnel under the skin and shaped to match the opposite breast. The nipple and areola were reconstructed later. The results are shown at 5 months post-op.