With Tissue Expander and Implant                        With Latissimus Flap
          

With Abdominal Flap


THE PREOPERATIVE FEATURES

• The absence or abnormality of the breast for whatever reason including cancer, infection, trauma, or congenital.
• The diagnosis of cancer and planning to remove the breast and desire for immediate reconstruction.
• The presence of a breast reconstruction with unevenness, pain, deformity, or hardness and desire for a more natural and matching breast.
• Enlarged, heavy, sagging breast or breasts often associated with breast pain, shoulder pain, back pain, nipple numbness, and shoulder grooves from heavy bra straps.
• Nipples that may be below the breast crease and desire for lifting into a more youthful position.
• Most of the breast volume is in the sagging lower portion of the breast.
• Large nipples and areolae.

THE PROCEDURE

• General anesthesia can be used and it takes anywhere from one to six hours.
• The procedure depends on if you want an implant reconstruction or natural (back or abdominal skin and fat) tissues.
• Implant reconstructions involve an implant placed at the time of mastectomy or later. It may be the only surgery required, or it may be done in several stages with insertion first of a tissue expander that is then inflated to stretch out the skin, and later replaced with the implant.
• Natural tissue reconstruction involves borrowing some skin and fat and muscle from the back or abdomen (TRAM flap) and transferring this into the breast area. A tummy tuck at the same time is an added bonus.
• Incisions depend on the size and contour of the breast and are slightly conspicuous. They can often be hidden around the areolae and in the lower breast crease or we can use previous incisions.
• The surgery for reconstruction may sometimes involve several stages. The nipple and areola may be reconstructed at a later date. It depends on your anatomy.
• A careful exam of the breast tissue is undertaken to make sure no abnormalities are present and full cancer screening and evaluation is done prior to surgery.
• Drains are used for the first two days, and these are removed painlessly in the office.

THE RECOVERY

• You can go home after several hours or stay overnight.
• You can shower on the second day after surgery.
• You will feel very groggy for the first two days and weak for about ten days.
• Swelling is mild to moderate for the first week after which it rapidly disappears.
• Usually only very mild or no bruising.
• Breasts are square shaped for the first three weeks then settle into a very normal rounded position.
• Resume many activities within the first week, and most by at least three weeks.

THE RESULT

• Elevated, full, and natural size and shape to the breasts.
• A result that just gets better in time.
• Much better proportion and fit into clothing.
• Able to return to exercise and engage in strenuous activities.
• Natural and presentable appearance right away that gets better over the next three to six months.