If you have undergone a mastectomy or experienced damage to the breasts from other causes, a breast reconstruction can help restore your sense of wholeness and femininity. At Newport Plastic Surgery, we are proud to offer breast reconstruction procedures through Dr. Go, a highly trained plastic surgeon in Newport Beach, Costa Mesa, Irvine, and the surrounding areas of CA.
What is Breast Reconstruction?
Breast reconstruction surgery is performed to reconstruct a breast that has been lost to mastectomy or, in other cases, to correct a congenital abnormality or a deformity in the chest. Other times, if an accident or injury has left one or both breasts damaged or deformed, the breast can be reconstructed to restore a more natural appearance or to restore balance to the breasts. Whatever the cause, a breast restoration is vital to maintaining a woman’s self-esteem and to help reinforce a positive body image.
How Much Does a Breast Reconstruction Cost?
The cost of a breast reconstruction procedure can vary depending on the extent of treatment necessary to deliver optimal results. In some cases, your health insurance provider may cover a portion of the cost of treatment. When you schedule a consultation with Dr. Go of Newport Plastic Surgery, his staff will review your insurance coverage in order to determine the situation. However, please note that Dr. Go is out-of-network for all insurance carriers and that there are no guarantees that your insurance will cover the cost of the treatment, which you will be responsible for. We do offer competitive out-of-pocket rates for reconstructive procedures and offer financing through CareCredit® to make this and other treatments more affordable.
What is Involved in a Breast Reconstruction?
There are several approaches to breast reconstruction, and the use of each depends on the type of mastectomy that you and your surgeon decide upon. If you elect to have a nipple-preserving mastectomy, or if you choose not to have nipple reconstruction, the reconstruction process can be completed in a single procedure, often immediately after a mastectomy. In other cases, as with delayed breast reconstruction, breast reconstruction is a multi-stage process.
- Stage 1: The new breast mound is formed either by using tissue expanders and implants or with autologous (your own) tissues.
- Stage 2: A new nipple is created, along with any cosmetic revisions to the new breast.
- Stage 3: The nipple and areola are tattooed (optional).
What is the Initial Breast Reconstruction Procedure Like?
Dr. Go utilizes a variety of techniques to reconstruct breast tissue with the intent of creating a natural appearance and feel. Each of these techniques has benefits and drawbacks, and Dr. Go will help you evaluate which will be the most beneficial for your situation.
Tissue Expander with Implants
Breast reconstruction using a tissue expander with implants is the most common method of breast reconstruction and is typically a two-stage procedure that begins with the insertion of a temporary tissue expander (an empty saline breast implant). The expander is filled with saline solution, which stretches the chest muscle and skin, creating a pocket that will accommodate a permanent breast implant. Over the next six to eight weeks, saline solution is gradually added to the expander to increase its volume and the size of the pocket. Once the desired volume has been reached, the new breast is allowed to rest for several weeks before the expander is removed and a permanent implant is inserted.
Autologous Tissue Breast Reconstruction
Autologous tissue breast reconstruction uses donor tissue that is taken from another part of the body to reconstruct the breasts. This method is often combined with the use of tissue expanders to create a pocket for the donor tissues. There are two main techniques used in the autologous tissue transfer method, and each has its advantages and disadvantages:
- TRAM Flap technique
- Latissimus Dorsi Flap technique
TRAM Flap Technique
One of the more commonly used methods for autologous breast reconstruction is the Transverse Rectus Abdominus Myocutaneous (TRAM) flap technique. In the TRAM flap procedure, Dr. Go will use skin and fat along with portions of the rectus abdominus, the muscle that extends along the center of the abdomen on either side of the navel and stretches from the pubic area to the central ribs and sternum. During the procedure, the lower section of the muscle is divided and loosened from its original location, creating a muscle flap. The lower, loosened section is folded and moved upward into the breast area by tunneling underneath the skin. The upper portion of the flap, called the pedicle, remains partially attached to its original location to preserve the attachment of the blood vessels, allowing blood flow to the reconstructive tissues in the breast.
A similar procedure, called a free TRAM flap procedure, may also be used for women who have larger breasts. In a free TRAM flap procedure, donor sections of the TRAM muscle are removed and the vessels are detached and reattached to vessels at the breast site.
Latissimus Dorsi Flap
The other commonly used autologous breast reconstruction method is the Latissimus Dorsi Flap procedure which been an accepted method for breast reconstruction for decades. The procedure often includes the use of tissue expanders to create a pocket for an implant, allowing for expansion and a larger appearance of the reconstructed breast. For women with smaller breasts, this procedure can be utilized without an implant, using only natural flap tissue to reconstruct the breast mound.
During the procedure, Dr. Go will dissect and relocate the latissimus dorsi flap, which is a flat, broad, triangular-shaped muscle on the back that connects to the bones of the spine, shoulder and arms. This muscle is gently detached from its natural location on the back and transplanted on the front of the chest wall. The main vessels are left intact to ensure proper blood supply to the flap. This flap provides enough native soft tissue to allow for complete coverage of an implant if one is to be used.
What is Recovery Like After the Breast Reconstruction Procedure?
Breast reconstruction is performed under general anesthesia and may require a one to three day post-operative stay in the hospital depending on the method used. The initial recovery time is also variable depending on which breast reconstruction technique is utilized, but can range from two to six weeks, and any secondary procedures follow in about three months. Overall, there should be no major long-term physical limitations and normal light activities can be resumed as recovery permits.
What Kind of Secondary Procedures Are Necessary?
About three months after the initial procedure, it may be necessary to perform one or more secondary procedures to:
- Switch out tissue expanders for implants
- Improve breast symmetry and/or revise any irregularities
- Reconstruct the nipple
- Tattoo the nipple-areolar complex
Secondary procedures are usually performed as outpatient surgeries and the recovery period is much shorter. If you are undergoing chemotherapy or radiation therapy, any secondary procedures must wait until these are completed. Many women opt to have the color of the skin around the nipple and areola tattooed to help create the appearance of a normal breast. Patients who wish to have this third and final stage completed at a later date are encouraged to do so.
Breast reconstruction is a highly personal and varying procedure. To schedule a consultation with triple board-certified plastic surgeon Dr. Go, contact us today. Newport Plastic Surgery is proud to be led by Dr. Go, a highly skilled plastic surgeon in Costa Mesa, Huntington Beach, Irvine, Newport Beach, and the nearby areas of California.