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Breast Reconstruction

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If you’ve had a lumpectomy or mastectomy after a breast cancer diagnosis, Dr. Wilson can help you regain your femininity with breast reconstruction surgery. At AW Plastic Surgery, we offer a number of options, including implants and fat grafting, to help you feel more like yourself again.

  • What is Breast Reconstruction?

    Breast reconstruction is a breast surgery used to restore one or both breasts to near-normal shape, appearance, symmetry, and size following a mastectomy, lumpectomy, or congenital deformities.

    The reconstructive surgery is often done at the time of the mastectomy or other breast cancer surgery, or it can be done at a later date.

    Breast reconstruction generally falls into two categories: implant-based reconstruction or flap reconstruction. Implant reconstruction relies on breast implants to help form a new breast mound, while flap reconstruction uses your own tissue from a donor site on your own body to form the new breast.

    When choosing which type of reconstruction is right for you, you’ll want to consider the type of mastectomy you’ve had, the cancer treatments you’ve had, and your body type.

  • Who is a Good Candidate for Breast Reconstruction?

    You may be a good candidate for breast reconstruction if you meet one or more of the following qualifications:

      • You do not have additional medical conditions that may impair healing

      • You have realistic expectations

      • Non-smoker

      • Who is a good candidate for breast reconstruction?

      • You’ve been able to cope well with your diagnosis and treatment

  • The Breast Reconstruction Procedure

    Breast reconstruction can be performed at the time of your mastectomy or lumpectomy (immediate reconstruction), or it can be performed at a later time after your breast cancer treatment/surgery. Typically, Dr. Wilson works with our dedicated breast team to perform simultaneous implant-based reconstruction.

    At the time of the mastectomy, a tissue expander is placed under or above your chest muscle. Over the following two to three months, the expander is filled with saline until a desired size is met. This expander is then removed and replaced with a permanent implant.

    Patients can elect to add fat grafting to their reconstruction as well. Fat grafting is typically done at a later time once the implant reconstruction has had time to heal. Fat is used to enhance natural contour and soften the appearance of the implants. Approximately three months after your final implant procedure,  a nipple and nipple areolar tattooing is performed to complete the reconstruction process.

    You can expect a one-night admission to the hospital for this procedure.

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BOARD-CERTIFIED PLASTIC SURGEON

Dr. Anthony Wilson

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When you are seeking a qualified and talented plastic surgeon, look no further than board-certified Dr. Anthony Wilson with AW Plastic Surgery. Dr. Wilson has a passion for both aesthetic and reconstructive surgery of the face and the body. He takes deep satisfaction in giving his patients the tools they need to feel confident, whole, and beautiful, no matter where they are in their aesthetic journey.

Dr. Wilson is recognized as an expert in cosmetic facial enhancement through both surgical and non-surgical measures. He is a national trainer for Revance and attends industry training to stay on top of the latest techniques. He conducts a multi-layered approach to aging and aesthetics, combining skincare and surgery to achieve a customized, natural result. Part of AW Plastic Surgery’s positive patient results stem from a stellar supporting group of aesthetic professionals. Dr. Wilson is backed by a strong team of injectors, nurses, and aestheticians at AW Plastic Surgery who ensure a high level of service.

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From my first call to book my appointment and scheduling post op visits and calls in between, with Taylor, who could not have been more accommodating and kind, to my consult, with Dr. Wilson, who is so sweet, and honest, to my actual procedure, with Rossli and Monica, who were the best! This entire staff was nothing but helpful, friendly, knowledgeable and kind. I had the CO2 laser procedure and was so nervous, these ladies put me at ease and made the experience more than tolerable, LOL! I highly recommend AW Plastic surgery!!

– Cheryl J.

  • Types of Breast Reconstruction Used at AW Plastic Surgery

    Breast Implant Reconstruction

    Dr. Wilson works with Sientra’s reconstructive breast implants and tissue expanders. While tissue expanders are uniformly filled with saline, permanent implants are filled either with saline or with silicone gel. The vast majority of patients elect for silicone breast implants given their more natural appearance and feel.

    DIEP FLAP Reconstruction Surgery

    Dr. Wilson, along with our colleague Dr. Fares Samra, performed the first neurotized DIEP (deep inferior epigastric perforator) flap on the East Coast. This procedure provides breast cancer patients the option for complete reconstruction without the use of implants.

    This is a vascularized transfer of tissue from the stomach to the breast. This procedure is performed after a one-sided or bilateral mastectomy. Blood vessels are carefully dissected from the underlying muscle in the abdomen and separated out; then, they are reattached to the vessels in the chest. Because abdominal tissue is soft and pliant,  this type of reconstruction most closely resembles a natural breast and breast tissue. In addition to hooking up the vessels, we also reattach the nerves to help provide sensation to the breast. This procedure is the best for patients with a history of prior radiation or failed implant reconstruction.

  • Recovery

    Following your breast reconstruction surgery, gauze or bandages may be applied to your incisions. Additionally, an elastic bandage or support bra will need to be worn to minimize swelling and support the reconstructed breast. A small, thin tube may be temporarily placed under the breast skin to drain any excess blood or fluid.

    You will also be given specific instructions on how to take care of your incisions, medications to take to help with healing and reduce the risk of infection, and when to follow up with Dr. Wilson.

    You will likely see initial results immediately, but due to the swelling and bruising that comes after surgery, it can take eight weeks or more to see the final results.

    If you are having a single breast reconstructed, eventually, the opposite breast may need breast augmentation or breast reduction surgery to address any asymmetry.

  • Frequently Asked Questions About Breast Reconstruction


    Does breast reconstruction look natural?

    A breast reconstruction can look natural with the most natural reconstruction being the DIEP flaps.

    How long does a mastectomy scar take to heal?

    A mastectomy scar can take 3-6 months to heal after the final surgery and their are typically multiple surgeries.

    How long does it take to recover from reconstructive breast surgery?

    The average recovery time for breast reconstruction surgery is between 2-4 weeks.

    Should you wear a bra to bed?

    Yes, you should wear a post-surgical bta to bed following breast reconstruction.

    What is a DIEP flap breast reconstruction?

    A DIEP flap breast reconstruction is when the patients own tissue from their belly is used to reconstruct their breasts in a microsurgical fashion.

    Do I need to wear a bra after breast reconstruction?

    Yes, we recommend wearing a bra depending on the size and procedure. We do not recommend wearing an underwire bra.

    How difficult is the recovery from DIEP flap surgery?

    The recovery time from a DEIP flap is approximately 6 weeks as this procedure incorporates an abdominoplasty as well as breast reconstruction.

    How long does DIEP flap surgery take?

    The average surgery time for a DIEP flap is around 10 hours.

    How long is hospital stay after breast reconstruction?

    The hospital stay following breast reconstruction is usually one overnight while a DIEP is two days. The hospital stays can vary depending on the procedure, provider and hospital guidelines.

    How soon after mastectomy can I wear a bra?

    Following a mastectomy, patients are put into a post-surgical bra by their provider.

    Is breast reconstruction surgery inpatient or outpatient?

    Breast reconstruction surgery can be both inpatient or outpatient depending on the procedure and provider/hospital preference.

    What can I do after breast reconstruction surgery?

    Following breast reconstruction surgery you are going to be limied to activity and your energy level may be minimal for about 2 weeks. Most patients gain more energy after the two week mark and can slowly start to resme normal daily activities between the 4-6 week mark.

    When can I sleep on side after breast lift?

    Typicall wait to 2-4 weeks dependigon healing

    Can I sleep on my side after breast reconstruction?

    Following breast reconstruction, we recommend people sleep on their backs so they do not displace the surgical work.

    How long after breast reconstruction can I exercise?

    After breast reconstruction, it is recommended no exercise for the first two weeks then light exercise may resume from 2-6 weeks. If you are having a DIEP no exercise is recommended for the first 4-6 weeks.

    How long is surgery for double mastectomy and reconstruction?

    The average surgery time for double mastectomy with reconstruction is around 3-4 hours.

    Can you have reconstruction after breast radiation?

    Yes you can, however, the risk of complications are much higher. The risk includes wound healing and scar exuberance such as capsular contraction.

    How do you massage your breasts after breast augmentation?

    After breast augmentation, we recommend massaging the breasts downward and towards each other, never out to the side. Patients should do this with guidance from their providers.

    Is a mastectomy considered major surgery?

    A mastectomy is considered a major surgery as it typically includes multiple stages/procedures and can have dealing times from 2-6 weeks.

    Is there an alternative to breast implants?

    The alternative to breast implants is fat grafting to your breasts.

    What is the difference between Diep and TRAM flap?

    The difference between a DIEP and Tram flap is a DIEP is microsurgical, meaning much less muscle injury and damage to the abdominoal wall where a TRAM flap is not microsurgical. A TRAM flap is not often practiced today.

    When can I stop wearing surgical bra?

    After breast reconstruction patients can usually stop wearing the post-surgical bra at two weeks. A patient should follow their providers guidelines as to what bras should be worn after this.

    What breast reconstruction options are available for mastectomy patients in Portsmouth, NH?

    At AW Plastic Surgery in Portsmouth, we offer comprehensive breast reconstruction options for mastectomy patients throughout New Hampshire and southern Maine. Your reconstruction choices include implant-based techniques, which use tissue expanders followed by permanent implants to rebuild the breast mound, and autologous (flap) procedures that use your own tissue. One advanced option available locally is the DIEP flap reconstruction, which uses abdominal skin and fat without sacrificing muscle to create a natural-looking breast. For appropriate candidates, we also provide direct-to-implant reconstruction, which places the final implant during the mastectomy procedure, eliminating the expansion phase. During your consultation, our Portsmouth reconstruction specialists will thoroughly evaluate your unique circumstances, considering factors like body type, cancer treatment needs, and personal preferences to recommend the most appropriate reconstruction pathway.

    What is DIEP flap breast reconstruction and who is a good candidate in the Portsmouth area?

    DIEP (Deep Inferior Epigastric Perforator) flap reconstruction is an advanced breast reconstruction technique available to Portsmouth and southern Maine patients that uses skin and fat from the lower abdomen to create a natural-looking breast. Unlike older techniques that sacrifice muscle, the DIEP flap preserves your abdominal muscles, resulting in less post-operative pain and faster recovery. During this microsurgical procedure, tissue is carefully transferred to the chest and blood vessels are reconnected using specialized techniques. Ideal candidates for DIEP flap reconstruction at our Portsmouth facility are women who have sufficient abdominal tissue, are in good overall health, don't smoke, and desire the most natural-looking and feeling reconstruction option. The procedure is especially beneficial for women who want to avoid implant-related complications or who have had radiation therapy, which can compromise implant-based reconstruction results.

    Is breast reconstruction covered by insurance for New Hampshire patients?

    Yes, breast reconstruction is covered by insurance for patients in Portsmouth and throughout New Hampshire. Under the Women's Health and Cancer Rights Act (WHCRA), all health insurance companies are required to cover reconstruction of the breast following mastectomy. This federal mandate ensures that Portsmouth women can access the reconstruction option that best suits their needs. Insurance coverage includes not only the initial reconstruction procedure but also surgery to achieve symmetry with the opposite breast and replacement of existing implants with a different reconstruction method if desired. At AW Plastic Surgery in Portsmouth, our team works closely with insurance providers to maximize your benefits for breast reconstruction. We have extensive experience navigating insurance requirements and can guide you through the process of obtaining authorization for your New Hampshire breast reconstruction procedure.

    What is the recovery time for breast reconstruction surgery in Portsmouth?

    Recovery following breast reconstruction at AW Plastic Surgery in Portsmouth varies depending on the specific technique used. For implant-based reconstruction, most Portsmouth patients spend 1-2 days in the hospital, with a return to light activities within 2-3 weeks. For DIEP flap reconstruction, which is more complex, the hospital stay is typically 2-3 days, with driving and desk work possible within about 4 weeks. Complete recovery from flap procedures generally takes about 8 weeks, during which time you'll need to avoid strenuous activities and heavy lifting. Throughout your recovery, our Portsmouth reconstruction team provides comprehensive follow-up care, monitoring your healing progress and addressing any concerns. While the initial recovery requires patience, most New Hampshire breast reconstruction patients find that the long-term benefits of restored breast appearance significantly improve their quality of life and psychological well-being after mastectomy.

    How natural will my reconstructed breast look and feel after surgery in New Hampshire?

    The natural appearance and feel of your reconstructed breast depend significantly on the reconstruction method chosen at AW Plastic Surgery in Portsmouth. DIEP flap reconstruction, which uses your own abdominal tissue, typically provides the mostrnnatural look and feel because it uses soft, living tissue that moves and ages with your body. Implant-based reconstruction can also achieve excellent aesthetic results, though the implant may feel firmer than natural breast tissue. Modern techniques used by our Portsmouth surgeons, including fat grafting to refine contours and nipple reconstruction or 3D tattooing, contribute to creating a more natural final appearance. Most New Hampshire patients report high satisfaction with their reconstructed breasts, particularly after the initial healing phase when swelling subsides and tissues soften. During your consultation, we can show you before-and-after photos of previous Portsmouth reconstruction patients to give you realistic expectations for your particular situation.


Schedule A Consultation

Whatever your reason for needing breast reconstruction, our team at AW Plastic Surgery can help you feel at home in your body again. Take the first step and call our Portsmouth, NH office today at  603-691-2725 or use our online contact form.

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