Breast reconstruction is a surgical procedure to rebuild and reconstruct a woman’s breasts after mastectomy, trauma, illness, or congenital defects. Although many variables influence a woman’s decision to consider breast reconstruction, the most common motivating factor is the removal of one or both breasts during a mastectomy after breast cancer. At Gabbay Plastic Surgery, located in Beverly Hills, California, Dr. Joubin Gabbay M.D. has helped many women who have faced the anguish of losing one or both breasts by reconstructing natural-looking and feeling breasts.
Beverly Hills breast reconstruction techniques have improved dramatically over the past decade, and breast cancer advocacy and awareness have led to the coverage of breast reconstruction procedures by the majority of health insurance companies. The Federal Women’s Health and Cancer Rights Act of 1998 mandates that health insurance also covers all stages of breast reconstruction after mastectomy. Research has shown that reconstructive breast surgery can have a positive emotional and psychological impact on breast cancer survivors, and can provide a sense of closure to the traumatic experience of battling breast cancer.
As a result of advances in reconstructive surgical technology and techniques, there are many options available for breast reconstruction procedures; however, the three primary reconstructive methods involve using artificial breast implants, the patient’s own body tissue (autologous tissue), or a combination of the two techniques. During your complimentary initial consultation, Dr. Gabbay will conduct a thorough medical evaluation and listen carefully to your reconstructive surgery goals before creating a customized treatment plan for your breast reconstruction surgery.
Breast cancer is the most common cancer among women in the United States (other than skin cancer), and the chance of a woman having invasive breast cancer at some point in her life is about 1 in 8. Breast reconstruction can begin at the same time as a mastectomy (immediate reconstruction), or at a later date (delayed reconstruction). If you are facing a mastectomy due to breast cancer, it is very important that you talk to your physician about post-mastectomy breast reconstruction options. By doing so, your surgeon can utilize specific mastectomy techniques in order to provide a better foundation for your future reconstructive surgery. Breast reconstruction can be performed for partial mastectomies as well as complete mastectomies. If you would like additional information about breast reconstruction surgery, please contact Gabbay Plastic Surgery today.
Some of the most common reasons patients elect to undergo breast reconstruction include:
If you are interested in learning more about breast reconstruction surgery, please call Gabbay Plastic Surgery and let us schedule your personal consultation with Dr. Gabbay. During your meeting, Dr. Gabbay will discuss your overall expectations and aesthetic goals, in order to determine whether breast reconstruction surgery is a suitable option for you.
You should come to your consultation prepared to discuss your medical history (including any past surgeries), present medical conditions, allergies, and medications. It is imperative that you are honest and provide complete information, as numerous medical conditions can potentially increase the risks and complications associated with surgery. If Dr. Gabbay feels that you are a good candidate for breast reconstruction surgery, he will explain the different techniques, costs and potential side effects before scheduling your procedure. When choosing Dr. Gabbay, you can be assured that you are in the hands of a surgeon who has undergone extensive training and is highly esteemed by his colleagues and patients alike.
The implants used in breast reconstructive surgery are made out of silicone gel or saline (or a combination of both) and are placed underneath the chest muscle. Compared to natural tissue flap procedures, implant surgery is shorter and results in fewer scars; however, the entire reconstructive process can take longer to complete unless the patient undergoes a nipple-sparing mastectomy combined with direct-to-implant reconstruction.
Depending upon how tight the patient’s skin is after mastectomy, it may be necessary to place a tissue expander under the skin and muscle to create a pocket (envelope) for the new breast implant. After the tissue expander is in place, saline (salt water) solution is injected through a tiny valve and filled over a period of a few weeks to gradually expand the skin to make room for the permanent implant insertion. The final stage of implant-based breast reconstruction is to construct a nipple and then tattoo the areola and nipple area to create a more authentic breast appearance. If additional support is needed to keep the implant in place, an acellular dermal matrix (comprised of human skin cells) may be utilized. Depending on the patient’s needs, Dr. Gabbay may recommend a fat transfer (fat will be harvested from the abdomen, thighs, buttocks, or hips) to graft onto the edges of the reconstructed breast, thereby creating a more natural silhouette.
Also called “one step” reconstruction, the direct-to-implant procedure involves using an acellular dermal matrix (donated human tissue from which the cells have been removed or Strattice™ derived from porcine dermis) to complete the reconstructive process. By alternatively stitching patches of acellular dermal matrix to the sides of the muscle or along the inframammary fold, an instant pocket for the implant is created. Direct-to-implant reconstruction does not require any tissue expansion, and when this procedure is combined with a skin-sparing and nipple-sparing mastectomy, patients can complete their entire reconstruction in a single operation.
Tissue flap breast reconstruction involves the transfer of skin, fat, or muscle to form a tissue flap that helps to recreate the breast. During tissue flap reconstruction, a breast mound is created using tissue taken from other parts of the body (i.e. the abdomen, back, thighs, or buttocks), which is then transplanted to the chest by reconnecting the blood vessels. Flap procedures are more complex than implant reconstruction procedures, and recovery can take more time (although the overall reconstruction timeline is shorter) because flap reconstruction involves surgery at the chest and the donor site. Unlike traditional implant reconstruction with expanders, flap procedures form full-size breasts that look and move naturally because they are made from human tissue. Breasts created from flaps need a healthy blood supply to survive, and there are a number of options in terms of harvesting the blood vessels for the procedure.
Tissue flap reconstructive options include:
Breast reconstruction surgery is performed under general anesthesia, and usually takes 3-8 hours, depending on the type of surgery you are having, the complexity of the procedure, and if one or both of your breasts are being reconstructed.
The timing of the surgery can be customized to meet your specific needs:
Other surgical options for breast reconstruction include:
Lastly, it is important to consider the opposite breast when planning your breast reconstruction. Although some women choose to leave the healthy breast untouched, many want to achieve symmetry with the newly reconstructed breast and may elect to undergo a unilateral breast reduction, breast lift, or breast augmentation to create a symmetrical and balanced appearance.
You can expect some discomfort and/or pain following your breast reconstruction surgery, which can be controlled with pain medication. Your incisions will be wrapped in gauze and bandages and you will be given a surgical bra to facilitate the healing process. You will be advised to limit your physical activity for at least six weeks and will return to the office for follow-up appointments so that Dr. Gabbay can monitor your progress. Depending upon the type of breast reconstruction you had performed, the recovery process can take a few weeks to a few months.
To learn more about our Beverly Hills breast reconstruction surgeries, call Gabbay Plastic Surgery today at (310) 928-2558. Our team is dedicated to providing you with the world class service you deserve.