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.

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

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.

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.

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.