For most patients, a diagnosis of breast cancer often comes with significant concern over the possible loss or deformity of the breast. However, many patients are unaware of the advances that have been made in the field of breast reconstruction. In most cases, our surgeons can reconstruct a woman’s breast following mastectomy or lumpectomy with outstanding, natural results. We understand that improving your self-image and sense of wholeness are equally important and an integral part of your treatment and recovery from breast cancer. In short, your recovery from breast cancer treatment no longer means living without your breasts. Learn more about the Spy Elite® System
Breast Reconstruction Options
Breast reconstruction is a staged process in which the breast mound is reconstructed either immediately following mastectomy or at a later date depending on a patient’s individual situation. Our doctors will often use an adjustable implant or a tissue expander that is placed at the time of mastectomy under a patient’s skin and pectorals muscle. This following several (2-5) painless in-office expansions over 2-3 months, a second operation is required to then exchange the temporary expander with a soft permanent implant. The nipple and areola are reconstructed using small in-office procedures and medical tattooing.
“Dr. Gawley is confident, optimistic and easy to talk to. My bilateral mastectomy surgery went very well and he was able to go straight to implants. When I visit the radiologist and oncologist, they’ve all complimented his work.
– Charlotte S.”
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Tissue expander and implant reconstruction offers excellent results with less downtime and risk to patients. For this reason, our surgeons perform this type of reconstruction more often. Some patients, however, may need a more aggressive type of reconstruction depending on their specific situation and type of cancer treatment.
In some cases, your surgeon may recommend the use of a your own tissue for reconstruction. Commonly, this “autologous” reconstruction uses either a patient’s abdominal skin or muscle—TRAM flap, or back skin and muscle—latissimus flap, for reconstructing the breast mound. Patients with a history of or future need for radiation treatment may benefit from this type of reconstruction; however, many patients with radiation may still be a candidate for implant reconstruction. It really depends on how a patient recovered from the radiation treatment and the quality of the chest skin.
Mastectomy and Reconstruction
Patients who undergo mastectomy and reconstruction on one breast commonly undergo a symmetry procedure on the opposite breast to match. This may be an augmentation, reduction or lift, depending on each situation. If you have already had a mastectomy, even if it was years ago, Gawley Plastic Surgery and the Arizona Breast Center can still begin the reconstructive process and create beautiful, symmetrical breasts.
It is very common that over the years following breast reconstruction, changes may occur in a patient’s breasts—asymmetry, implant hardening, and recurrent deformity. Our surgeons can often offer revisional surgery to improve size, shape, and symmetry years after your cancer treatment and reconstruction.
Most importantly, both initial and revisional breast reconstruction surgeries are usually covered by your insurance.
Each patient is unique and has unique needs. At your will go over your options and help you decide which method is best for you.
Breast Reconstruction Safety
Breast reconstruction will not cause your cancer to come back and does not interfere with treatments such as radiation or chemotherapy. Cancer patients who have a positive outlook typically have a much better treatment outcome. For many women, breast reconstruction is an important part of recovery, minimizing the emotional impact and sense of loss and helping them maintain hope, self-esteem, and a positive outlook.
Gawley Plastic Surgery and the Arizona Breast Center can reconstruct your breasts if you suffer from congenital defects and breast abnormalities such as missing nipples or lack of chest muscle (Poland’s Syndrome).
Corrective Breast Surgery
Gawley plastic surgeons are some of the few cosmetic surgeons who are willing to perform corrective breast surgery for patients who have undergone prior breast surgery with poor results. If you have had breast augmentation, breast reduction, or a breast lift and are unhappy with the results, Gawley Plastic Surgery can restore the beauty of your breasts.
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We want you to get the most out of your consultation. If at all possible, it is best to make arrangements for small children to stay home rather than having them join us for your appointments.
Breast Reconstruction Frequently Asked Questions
What is the difference between a TRAM flap and DIEP flap?
Until a few years ago, the TRAM flap technique was the gold standard in breast reconstruction surgery after mastectomy, but it has been replaced by the cutting edge DIEP flap technique today. The TRAM surgery has three different forms that can be used – the Pedicled TRAM flap, the Free TRAM flap, and the Muscle-sparing Free TRAM flap. All these procedures use abdominal tissue to recreate the breast except that in the Pedicled TRAM, the skin, fat, and muscle from the abdomen is tunneled under the upper skin of the abdomen to create the new breast. In the Free TRAM technique, the tissue flap is disconnected and reconnected at the chest area with microsurgery. The Muscle – sparing TRAM is the most beneficial since during it, the majority of the abdominal muscle is spared and it leads to lesser complications.
The DIEP flap is the most advanced form of breast reconstruction and like the muscle-sparing TRAM, it also uses your own abdominal skin and fat to recreate a soft breast. However, unlike the TRAM, all your abdominal muscles are preserved. It is like a tummy tuck wherein you experience less pain, maintain the strength of your abdomen and recover faster.
How long does it take to recover from a DIEP flap surgery?
During your DIEP flap surgery, the incision is made along your bikini line to remove the excess skin and fat which are then moved from your abdomen to the chest to create a new breast. No muscles are moved or cut during the procedure. An extra artery and vein from the abdomen are reconnected to an artery and vein in the chest using microsurgery (and sutures finer than human hair). For both breasts, it takes between 6 to 8 hours for completion. You will get detailed aftercare instructions before surgery. The most important aspect after surgery is to rest and refrain from vigorous physical activity. You will be up and walking the same day and ready to leave hospital after a day or two. With the Enhanced Recovery after surgery (ERAS) protocols, most patients need only Tylenol and ibuprofen to manage their discomfort. However, you must avoid any strenuous activities, heavy lifting, and sexual activity for about 6 weeks after your DIEP flap surgery. There will be incisions and drainage tubes in the abdominal donor area as well as your reconstructed breasts for a week or two. Overall, most women are pleasantly surprised how well they recover from this surgery when they follow the instructions.
Insurance and Breast Reconstruction
In most cases, breast reconstruction is covered by health insurance because it is not an elective procedure. Gawley Plastic Surgery accepts insurance for reconstructive breast surgery. Unfortunately, we cannot accept insurance for corrective breast surgery.
Learn more about breast reconstruction surgery by checking out these Questions about Breast Reconstruction or visiting our Arizona Center for Reconstructive Breast Surgery website.
If you are anticipating mastectomy, Gawley Plastic Surgery can coordinate with your surgeon for a streamlined mastectomy/reconstruction procedure. Please call or email us right away so we can schedule your initial consultation and get you on your way to recovery.
The Gawley Blog
October is Breast Cancer Awareness Month, so we have put together a mini guide regarding available breast reconstruction options. Breast reconstruction is an option for men or women who have undergone a mastectomy or for those who have tested positive […]