Virginia Breast Reconstruction

What is breast reconstruction?

Breast reconstruction is surgery to help restore a normal shape and size to the breast. This may be needed because of loss of the breast due to cancer or trauma, or because of differences in size with development. The goal is to achieve as much balance and normalcy as possible.

What techniques are used in breast reconstruction?

There are two main categories of reconstruction, one using the patient’s own tissue and the other using implants to build the breast volume.

How do I know what is best for me?

Dr. Wray will evaluate you and review your options with you, which will depend on your medical history and physical exam. Dr. Wray performs the tissue expander/implant type of reconstruction, frequently using an acellular dermal graft to help with the reconstruction, and also will sometimes use a muscle from the back to help with the reconstruction. She no longer does the major breast reconstruction using the abdominal tissue to form the breast mound.

When is the best time to have breast reconstruction?

The answer is simply “when you are ready”. Patients who have just been diagnosed with breast cancer should have the opportunity to talk with a plastic surgeon about reconstruction. Some patients elect to start reconstruction at the time they are having their mastectomies, whereas others elect to wait. This decision involves a lot of different factors, such as how the patient is able to handle more choices on top of those associated with her cancer care, whether she wants to proceed with something that may require multiple surgeries, the extent of her cancer, or other health problems. There are situations when it is best to postpone reconstruction until after the cancer has been treated.

Are there advantages to having reconstruction start at the time of the mastectomy?

A patient actually combines the first step of reconstruction with the mastectomy surgery, eliminating a separate surgery. The scar tissue has not formed yet, so there is usually more supple skin available, and the general surgeon can leave more skin which will be used in the reconstruction.

What are the advantages in delaying the reconstructive surgery?

When the surgery is performed after the cancer treatment is completed, we have the advantage of knowing what treatment was needed for the cancer that was present. Specifically, we will know if the patient needed radiation following the mastectomy, which will affect the ability of the skin to stretch for reconstruction. We may choose a different reconstruction based on the physical exam once radiation is complete. Also, if any complications arise from the reconstruction, they will not interfere with the cancer treatment.

What is involved with a tissue expander type of reconstruction?

This type of surgery is usually done in two steps. At the first surgery, a tissue expander is placed under the pectoralis muscle, which is the large muscle that is under the breast. Frequently an acellular dermal graft is also used to help cover the expander below the muscle. An acellular dermal graft is a piece of skin that has had all living cells removed, so there is just a framework of the skin left. The patient is usually in the hospital overnight after the surgery. A tissue expander is much like a water balloon, so after the skin is healed, it can be blown up slowly allowing the skin to stretch over it. Saline is added to the expander during brief visits to the office, and the expander is usually filled over a period of 1-2 months. Once it is stretched to the appropriate shape, the 2nd surgery is planned about 3 months later. This is an outpatient surgery to remove the expander and replace it with an implant and to do any touch up that may be needed for balance or appearance.

Can a nipple be reconstructed?

Yes, the nipple/areola complex (the nipple and the dark skin around it) can be reconstructed. This is done in the office after everything has healed after the implant is placed. First the bump to make a nipple is recreated, then the color is tattooed once the new nipple has healed.

Does anything need to be done to the breast without cancer?

In order to achieve better balance and appearance, sometimes a procedure is done on the non-cancerous breast. Depending on what is needed, a lift, a reduction, or even sometimes an augmentation is done to give better shape and symmetry with the reconstruction breast.

Is reconstruction covered by insurance?

Most insurance policies will cover reconstruction if it is done because of loss of a breast due to cancer. Private insurance also covers the procedure on the other breast needed to achieve symmetry. You will need to check with your particular insurance to know exactly what coverage you have.

For more information about Breast Reconstruction in Virginia...

The professionals at The Center for Plastic Surgery and MediSpa are always available to answer any questions regarding our Breast Reconstruction procedures. Please give us a call at 1-540-444-4343 to schedule a consultation. You can also schedule a consultation online by clicking here: Schedule a Consultation Online for a Breast Reconstruction

 

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