Dr. Stephen Small has the privilege to care for patients in some of their most trying times. At Ocean Plastic Surgery, P.A. we offer comprehensive reconstructive options and work with your breast surgeon to give you the best possible result. Depending upon your treatment, reconstruction can be done at the time of your mastectomy (immediate reconstruction) or later (delayed reconstruction).
We also perform many revision reconstructions and procedures to correct changes in your breast shape if you had a lumpectomy and radiation therapy.
Oftentimes, patients are referred to us by their breast surgeons but if you have breast cancer or have been treated you can come in for a consultation to discuss your options.
Breast Reconstruction Procedures
There are many approaches to breast reconstruction but the two main options are using a tissue expander and subsequently a breast implant or autologous reconstruction which is using skin and muscle from one area of your body to make a new breast.
Either procedure can be performed at the time of your mastectomy or after your mastectomy. Additionally, all breast reconstructions take into account the size and shape of your other breast, and sometimes a procedure is necessary on the opposite breast to give you the best symmetry.
Expander-breast implant reconstruction is a process where a temporary implant (expander) is initially placed. This surgery usually takes about an hour and is often a same-day surgery. If this procedure is done with the mastectomy most patients stay in the hospital overnight. Once the expander is placed your new breast is created by placing sterile saline solution into the expander. This is essentially a painless procedure done in the office which takes about 15 minutes. After your breast shape is created with the expander, usually 3-5 months, you are ready for the second procedure which is to place a permanent implant. This procedure is done in the hospital as same-day surgery and usually takes about an hour. At this point, your breast reconstruction is almost complete. The last part of breast reconstruction is recreating a nipple and the areola (the pigmented area around the nipple). There are many ways to make a new nipple and areola and Dr. Small will discuss these with you.
Autologous breast reconstruction is often the option necessary for patients who are anticipating needing radiation treatment with their care or for women who have very large and droopy breasts (called breast ptosis). The areas commonly used for this type of reconstruction are the abdomen (TRAM reconstruction) or the back (Latissimus reconstruction). This type of reconstruction is performed in the hospital and takes about 4-6 hours. Most patients stay in the hospital 2-3 days. Sometimes even with this type of reconstruction a tissue expander or implant might be necessary.
Recovery from either procedure is about 2 weeks. Full recovery where you are starting to resume normal activities is about 4-8 weeks depending upon the procedure. An expander-implant reconstruction takes about 1 year for all three stages to be complete. The autologous reconstruction usually is complete after the first procedure or around 6 months if there is a second procedure scheduled. Throughout your reconstruction, Dr. Small keeps in close contact with your breast surgeon, medical oncologist, and radiation oncologist to ensure your care is coordinated to give you the best possible outcome.
If you are considering breast reconstruction contact us so we can give you the best options which are right for you.