Breast Reconstruction.

Breast Reconstruction

For some women, breast reconstruction can be a critical component of healing and regaining your femininity. We recommend a team approach where the oncologist, surgical oncologist, and plastic surgeon work together to achieve an R0 or complete resection and achieve long-term remission or cure.

Breast reconstruction is a surgical procedure that helps restore and reshape the breasts after having a mastectomy or lumpectomy. While most breast reconstruction procedures are performed at the same time as your cancer surgery, we know from experience that many patients feel self-conscious over the loss of their breasts and nipples. 

Every woman needs something slightly different from their breasts, but most women desire the ability to get out of the shower, get dressed, and not have to think of an incredibly challenging time in life. Breast reconstruction can provide that emotional healing.

The two methods for breast reconstruction are implant-based or autologous tissue reconstruction. Suppose your breast surgeon has recommended a lumpectomy. In that case, an oncoplastic reduction may be an excellent option to minimize scarring and potential complications that can distort the breast shape in the years to come. If you are considering a mastectomy, then Dr. Rankin can use both implant and autologous tissue methods at the time of mastectomy or months after your original procedure.

Implant-Based Reconstruction

Dr. Rankin performs most implant-based reconstructions in steps. During the first operation, after the surgical oncologist removes the breast tissue, he places a tissue expander – a tougher, fillable implant – to shape and preserve an ideal pocket for the final implant. 

Like breast augmentation, tissue expanders can be placed in front or behind the chest muscle, also known as the pectoralis major. You have the option of prepectoral, where Dr. Rankin places the implant on top of the chest muscle or submuscular, behind the chest muscle. 

Dr. Rankin prefers to place the implant in front of the chest muscle, minimizing post-operative pain and shortening the period between the first and second stage reconstruction. Prepectoral implant reconstruction can also reduce the number of visits after surgery needed to fill your tissue expander to the desired volume. Once you have achieved the desired volume, the breasts need to heal for the next three months. 

The second stage operation will be easier than the first stage and is an outpatient procedure. Dr. Rankin removes the tissue expanders, makes small modifications to the implant pocket, and then places the final breast implant. He can perform this procedure with or without fat grafting, but fat grafting will typically improve the outcome. 

In light of advances in medical tattooing, many women choose not to proceed with surgical reconstruction of the nipple. However, Dr. Rankin can perform nipple reconstruction during a third operation.

Autologous Breast Reconstruction

If implant reconstruction is not an attractive option to you, skin and fat from other parts of your body can be used to reconstruct the breast during an autologous breast reconstruction. Most of these procedures require microsurgery to transplant your tissue and make a new breast. Microsurgery entails Dr. Rankin detaching an area of tissue still attached to an artery and vein, then reconnecting that artery and vein in its new location. These blood vessels are typically two to three millimeters in diameter. 

He can use the Deep Inferior Epigastric Perforator (DIEP) flap from the lower abdomen. This procedure has become the most popular form of completely autologous breast reconstruction since it usually produces enough tissue to make an appropriately sized breast. The scar in the donor area (abdomen) is similar to an abdominoplasty (tummy tuck). 

Other donor options include the upper buttocks, lower buttocks, and inner thigh.

Recovery after breast reconstruction surgery can depend on whether you choose implant-based or autologous breast reconstruction. 

For implant-based surgeries, you will need to recover for at least three months following the first step of the procedure before you can move on to the next step in the process. For the first couple of weeks after your reconstruction, we recommend having a close family member or friend help take care of you. 

For autologous breast reconstruction, it can take up to eight weeks to recover from surgery. Similarly, you should have help from someone to do basic household chores for a couple of weeks. 

We also recommend avoiding strenuous activities until eight weeks after your recovery.

A good candidate for implant-based breast reconstruction will have enough breast skin and tissue to cover the implants and reconstruct the breasts. With autologous breast reconstruction, good candidates must also have enough breast tissue, as well as tissue from another part of the body to donate to breast reconstruction. 

Ultimately, your candidacy for breast reconstruction will be determined after consulting with you and your team of doctors, including your oncologist and surgical oncologist.

How much breast reconstruction costs will depend on which procedure you choose, how much insurance covers, and your doctor’s experience. The average cost for breast reconstruction is $15,000 to $17,000. We will determine your final cost, and how much insurance can cover during your consultation.

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Want to learn more about how Breast Reconstruction can help you gain more confidence in your appearance? Schedule your consultation with a NorCal Plastic Surgery provider by calling (925) 856-4800 or filling out the consultation request form below. We look forward to helping you achieve your aesthetic goals.

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