About Breast Reconstruction
Surgical breast reconstruction can be performed to restore the chest to an attractive appearance in shape and size following a lumpectomy or mastectomy. It is also an option to restore the chest if it has been damaged by a birth defect or trauma. Advanced options in reconstructive surgery make it easier for breast cancer patients to feel complete and have breasts that look natural after removal or damage. This surgery can include a few procedures and different stages that may be done at the same time as your breast cancer treatment or delayed until the treatment is complete. Ashburn, VA board-certified plastic surgeon Dr. Michael J. Brown creates an individualized surgical plan with compassion as we help you and your cancer team to restore your appearance and confidence at The Loudoun Center for Plastic Surgery.
Reconstruction of the breast(s) is an extremely personalized surgery. Each patient will be required to have an in-depth consultation appointment with Dr. Brown to create their surgical plan from their concerns, needs, and appropriate techniques. If you are planning to have breast reconstruction surgery, it is vital that you understand realistic expectations for results. While Dr. Brown aims to give you an attractive, natural appearance, your reconstructed breast(s) may not have the same sensations, look, or feel as with your original breast(s). You should get approval from your oncology team to undergo reconstruction surgery, and talk to Dr. Brown regarding other factors that may impact your recovery.
There are a variety of surgical techniques available to reconstruct the breast. There are also multiple factors that Dr. Brown looks at when deciding on the technique that will give you your best results. A few of these factors include your specific cancer diagnosis, when the reconstruction is performed, whether you will use implants or natural tissue, and if nipple reconstruction or nipple-sparing is a part of the treatment plan. To recreate the breast, you must have enough tissue to fully cover the breast mound. Flap procedures accomplish this by using your own fat, muscle, and skin to build and cover the breast. The most frequent flap techniques are:
- TRAM Flap
This technique takes skin, fat, and muscle from your stomach to create the breast. The tissue selected to build the new breast may be removed from the stomach or the tissue may stay connected to the donor location, maintaining the original blood supply.
- DIEP Flap
Similar to a TRAM flap, the DIEP flap removes skin, fat, and blood vessels from the lower abdominal area; however, it does not use the muscle. The DIEP (deep inferior epigastric perforator) flap removes skin and fat from the belly to form the new breast, then uses microsurgery to reattach the blood vessels to the chest wall.
- Latissimus Dorsi Flap
This technique uses muscle, fat, and skin from your back. During this technique, tissue is taken from the back to the breast(s) via a surgically created path so it stays attached to the donor location, which keeps the original blood supply in place.
- PAP Flap
Another flap is the profunda artery perforator (PAP). This method uses skin, fat, and muscle tissue from your inner thigh to create your breast(s).
- LTP Flap
Although the TRAM flap is one of the most common techniques used for breast reconstruction, sometimes there is not enough muscle, fat, and skin that can be taken from the abdominal area. In this case, the LTP flap technique may be performed, which uses tissue from the outer thigh.
- Composite Flap
Also called a composite stacked flap, this technique takes flaps from different sections of your body for breast reconstruction.
Although flap procedures are a common and highly successful method for breast reconstruction surgery, you may want to rebuild your breast(s) with the tissue expansion method. This technique places a tissue expander below the breast wall and then gradually fills it with a saline solution over 4 – 6 months to stretch the skin naturally. After you choose the flap method or tissue expansion, you may then decide whether you would prefer to use breast implants or a fat transfer to create the shape and volume of the breast(s). After your reconstruction mammoplasty, you can further improve the look by having areola and nipple reconstruction. There are several procedures to restore the nipple-areola complex so that it appears more attractive.
What to Expect
Surgical breast reconstruction is done in several steps. In some phases (like the flap creation, tissue expansion, or implant placement), general anesthesia is often used. Some patients may need to stay overnight, but this is based on the current treatment phase. When the last stage is completed for your breast reconstruction, you should wear a compression bra for the chest, and you may be prescribed medication by Dr. Brown to control discomfort, bleeding, and swelling. In time, the reconstructed breast(s) should appear more normal so you can feel more comfortable. Regular checks with breast exams and mammograms are important and highly recommended for long-term health.
Frequently Asked Questions
How much does breast reconstruction surgery cost?
Breast reconstruction surgery can be complicated so to get great results, you should focus on choosing a doctor who has years of training and experience, like Dr. Brown, over the cheapest price. During your initial consultation, Dr. Brown will take time to understand your concerns and cosmetic goals before crafting your custom reconstruction plan. Once this is done, he will talk to you about costs, options for payment, and low-interest financing.
Does insurance cover my surgery?
The WHCRA (Women's Health and Cancer Rights Act) of 1998 requires health insurance policies that cover breast cancer surgery (mastectomy) to cover reconstruction surgery as well. If you have insurance, a team member at The Loudoun Center for Plastic Surgery will help explain your policy and coverage. We can also assist you with getting the needed information and paperwork to your insurance carrier.
Which technique should I choose?
With so many options, there is no single reconstruction technique that works for every patient. The recommended method for you will be based on your concerns, wants, and physique. In your initial consultation, Dr. Brown will go over your choices, including both flaps and implants, so you understand the benefits and challenges before you decide on your treatment plan. Whether you choose a flap or implants, Dr. Brown will do his best to give you natural-looking results.
What about nipple reconstruction?
Reconstruction of the nipple-areola complex is typically done using cosmetic tattooing. If you are interested in having your nipple-areola complex tattooed onto your reconstructed breast(s), you should tell Dr. Brown in your initial consultation. He will go over your options to help you decide whether you would like 3D tattooing of the nipple and areola to be included in your surgical plan.
Should I have reconstruction with my mastectomy or wait?
The timing of your breast reconstruction is based on several things. Some patients decide to get their breast(s) reconstructed along with their mastectomy while some patients decide to defer reconstruction surgery. Dr. Brown suggests you make an appointment for a consultation following a diagnosis of breast cancer so you can start learning about your choices, including when you want to have breast reconstruction surgery. If you want to get reconstruction with your breast cancer treatment, Dr. Brown will collaborate with your oncology team to plan your care.
Plan Your Procedure
- Average Cost
- $7,000 - $20,000
- Return to Work
- 1 - 2 Weeks
- Surgery Time
- 2 - 3 Hours
- Follow Ups
- 5 Days, 1 Month, 1 Year
Reclaim Your Self-Confidence
Although the process of breast reconstruction can take time, it is probably one of the top beneficial cosmetic surgeries for our Ashburn, VA patients at The Loudoun Center for Plastic Surgery. It may help improve the physical and emotional impact of breast cancer treatment while also allowing you to boost your figure and self-confidence. If you have breast cancer, have had an injury to the chest, or have a congenital defect that affects the shape of your breasts, we encourage you to contact our Ashburn, VA office and make an appointment with Dr. Michael J. Brown.