What Is Breast Reconstruction?
Recent surgical advances have expanded the surgical options available to women facing breast reconstruction. Englewood plastic surgeon Dr. Richard A. D’Amico & Dr. Julie Ferrauiola specialize in breast reconstruction for women. Whether you’ve undergone a mastectomy or are facing one, navigating reconstruction choices in the midst of an emotional time isn’t easy. Dr. D’Amico & Dr. Ferrauiola and his staff provide a caring, professional environment and all the information you need.
Who Is a Good Candidate for Breast Reconstruction?
Any woman who has undergone or plans to undergo a partial or full mastectomy and wants to restore her body image may be a candidate for breast reconstruction. As long as she is physically well enough to undergo the surgeries and her cancer treatment protocol does not preclude it, a woman should be eligible for breast reconstruction.
The Breast Reconstruction Procedure
Dr. D’Amico & Dr. Ferrauiola is proud to offer his service as a breast surgeon in New Jersey. He is skilled at performing advanced breast reconstruction techniques that help to restore your positive body image. He works with general surgeons in the region to coordinate the mastectomy with the reconstruction for the optimal outcome. Breast reconstruction is divided into 2 general categories: immediate and delayed.
Immediate Reconstruction during Mastectomy
Most breast reconstruction begins at the time the mastectomy is performed. For certain women, it is the only surgery necessary. The choices for immediate reconstruction include:
If you are undergoing a preventive mastectomy, or are in the early stages of cancer, you may be a good candidate to have breast implants inserted immediately after your general surgeon completes your mastectomy. This is often called single-stage reconstruction. Candidates for a direct-to-implant procedure must have enough healthy, elastic skin remaining after the mastectomy to accommodate a breast implant. However, the use of an acellular dermal matrix has made direct-to-implant reconstruction an option for women who, in the past, were not candidates.
Women with insufficient tissue can opt to have inflatable expanders inserted at the time of the mastectomy. The expanders are gradually filled with a saline solution at follow-up appointments. As the expanders are filled, breast tissue and skin grows to accommodate them. It usually takes 8 to 12 weeks to create a pocket large enough to replace the expanders with implants. Again, the use of an acellular dermal matrix has improved this process, allowing the expander to be filled more quickly and safely. View photos of Dr. D’Amico & Dr. Ferrauiola’s patients who have undergone tissue expander breast reconstruction*.
Autologous Tissue Reconstruction
Advances in microsurgery have resulted in several reconstruction techniques that involve using a patient’s own tissue to rebuild a breast mound. Also called flap surgery, the use of a patient’s tissue, muscle, fat, and blood vessels for breast reconstruction is often used because the result looks and feels more like a natural breast. However, these are lengthy, complex surgeries, and the recovery from flap procedures is generally much longer than reconstruction with implants. View photos of the results Dr. D’Amico & Dr. Ferrauiola’s have achieved through flap reconstruction*.
Delayed Reconstruction After Mastectomy
Women who are still undergoing radiation therapy are not always able to have immediate reconstruction. Some patients are more comfortable making the decision about reconstruction after recovering from the mastectomy. Others may change their minds after initially deciding against breast reconstruction. Each of these situations involves delayed reconstruction. The same reconstruction techniques are available, even if you wait to have your reconstruction surgery.
DIEP Flap Breast Reconstruction
We offer the DIEP Flap Breast Reconstruction technique which is similar to a muscle-sparing free TRAM flap. This technique uses skin from the lower belly to rebuild the chest and does not involve cutting or removal of muscle.
Breast Implant Options
If you are having breast reconstruction with an implant, you will need to decide on the type of implant. There are 2 general types:
Saline breast implants are filled with a saline solution after insertion.
Silicone implants are prefilled with a gel and come in a variety of shapes and sizes. A new generation of silicone implants, called cohesive gel implants, is becoming popular because the gel retains its shape and doesn’t leak, even when ruptured. Dr. D’Amico & Dr. Ferrauiola use 2 types of cohesive gel implants: Allergan Natrelle® 410 and Sientra® Silimed. The silicone used in these implants is stronger than in previous implants, ensuring that they retain their shape, even in the unlikely event of a rupture.
Natrelle 410 implants are shaped, which means they have a tapered, teardrop appearance instead of a traditional rounded appearance. The tapered shape mimics the natural shape of most women’s breasts, and many patients are pleased with their discreet results. Silimed implants come in both round and shaped versions.
Dr. D’Amico & Dr. Ferrauiola can help guide your selection of an implant that is right for you. The decision will be influenced by your body’s individual characteristics. Learn more about your breast implant options.
If you are having a mastectomy for only one breast, it’s likely your other breast will need some modification to create symmetry. That may involve a breast lift or breast reduction. Federal law requires health insurance companies to cover all reconstructive procedures related to mastectomies, even on the breast that is not removed. Many women opt for a double mastectomy, both to improve their chances of a cure, and to ensure the best reconstructive outcome.
Breast Surgery Recovery
Recovery from breast reconstruction surgery will depend on the type of procedure done. The length of recovery ranges from several weeks for a staged reconstruction using tissue expanders and implants to several months if you undergo a more complicated flap procedure that involves multiple surgical sites*.
It’s important to have your plastic surgeon and breast surgeon collaborate as early as possible to discuss potential treatment options. If you have already been diagnosed with cancer, or are electing to undergo a preventive double mastectomy, please request a consultation with Dr. D’Amico & Dr. Ferrauiola to learn more about your breast reconstruction options. Women from the New York metro area, may also call the office for more information.
* = Results may vary