Breast reconstruction surgery makes it possible for women to restore natural-looking breasts after a mastectomy. There are several types of reconstructive surgery available, and the reconstruction process sometimes means more than one operation. You may have a choice between having breast reconstruction at the same time as the mastectomy (immediate reconstruction) or at a later time (delayed reconstruction).

At NYBG plastic surgery, most patients receive immediate reconstruction. Immediate breast reconstruction is done, or at least started, at the same time as the mastectomy. The benefit of this approach is that the breast skin is often preserved, which can produce better-looking results, and provide an initial shape of the breast. Of note, some women will require several stages to restore natural-looking breasts after a mastectomy.

All women are usually a candidate for breast reconstruction; however, the type of breast reconstruction surgery depends upon several factors:

  • Your overall health (including issues that might affect your healing, such as smoking, diabetes, circulation problems, or certain health conditions)
  • The size and location of your breast cancer
  • Your breast size and shape
  • The extent of your breast cancer surgery
  • Whether you will need treatments (chemotherapy or radiation) for your cancer
  • The availability of natural tissue that can be harvested to use in flap reconstruction
  • Whether you want reconstructive surgery on one or both breasts

It is sometimes not possible for a woman to have immediate reconstruction; a discussion with your plastic surgeon, who will work together with your cancer surgeon, will reveal which breast reconstruction surgery technique will be the best option for you.

Before & After

Types Of Breast Reconstruction

There are several different techniques employed in surgical breast reconstruction. At NYBG Plastic Surgery, we perform two main techniques for reconstructing breasts:

Autologous Reconstruction

This technique uses your own natural tissue from the abdomen or back to rebuild the breast shape. In flap reconstruction, specific body tissues, including skin, fat, blood vessels, and muscle are removed from the tummy or back area and then used to rebuild the breast.

Autologous reconstruction typically requires a longer operation and longer recovery because of two surgical sites.

Implant Reconstruction

This technique requires a single-stage or two-stage reconstruction that involves inserting an implant filled with salt water (saline), silicone gel, or a combination. We supplement implant reconstruction with an acellular dermal matrix: a durable, natural mesh created from the collagen in human skin to provide structure and support for your new breast. Implant reconstruction is less complex, with less downtime, and involves the placement of implants to restore the breast tissue lost in the mastectomy.

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Ancillary Procedures

Nipple and Areola Reconstruction

Nipple and areola reconstruction are usually the final phase of breast reconstruction. This is a separate surgery done to make the reconstructed breast look more like the original breast. It can be done as an outpatient procedure. It’s usually done after the new breast has had time to heal (about 3 to 4 months after surgery). 

Fat Grafting

Fat grafting for breast reconstruction involves liposuction of various sites and transferring that tissue to the reconstructed breast. Fat grafting may supplement implant reconstruction or autologous reconstruction to restore the natural contour of the breast. It can be done as an outpatient procedure. It’s usually done after the new breast has had time to heal (about 3 to 4 months after surgery).

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FAQ

It is important to us that our patients understand what the surgery entails and what to expect. We have answered some of the common questions we are asked by our patients:

How Long Is The Recovery After Breast Reconstruction Surgery?

Am I A Candidate For Breast Reconstruction Surgery?

Will I Feel Sensation In My Reconstructed Breast?

How Long Is The Recovery After Breast Reconstruction Surgery?

In general, patients who have breast reconstruction will have a recovery time of six to eight weeks. Patients who have flap reconstruction may have a longer recovery time. Recovery from surgery and the body’s healing time also varies person to person.

Am I A Candidate For Breast Reconstruction Surgery?

All women who have had a mastectomy can usually have breast reconstruction at some point. The timing of your surgery depends upon your overall health and the cancer treatments you may need after the mastectomy. Since breast reconstruction is surgery, it is vital that the patient is in good general health prior to the procedure. Conditions such as diabetes and autoimmune diseases can increase the risk of certain infections during the healing process, and any health risk must be evaluated when determining eligibility.

Will I Feel Sensation In My Reconstructed Breast?

While you will not have sensation in the nipple-areola area, it is possible to regain some level of skin sensation in the reconstructed breast. The sensation will be less than what you experienced with your natural breasts and varies from person to person.

Alliance In Reconstructive Surgery Foundation

Dr. Small of NYBG Plastic Surgery is on the national board of the AiRS Foundation, which raises money for breast reconstruction. For more information about breast reconstruction, visit AiRS Foundation website.

Visit AiRS Foundations Website

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Get Your Questions Answered – One On One

At NYBG Plastic Surgery, we understand the many decisions you need to make, and the concerns and questions you may have about breast reconstruction. We want to provide you with as much information as you need to move forward and restore your breasts.

If you are scheduled for a mastectomy or have already had the procedure, and you are considering breast reconstruction, we encourage you to connect with one of our breast reconstruction surgeons to discuss your options.

We are here to help women move forward after a mastectomy, restoring their feminine curves in a manner that looks and feels natural to the touch.

Kevin Small Md Publications (Breast Reconstruction)

Is Unilateral Implant or Autologous Breast Reconstruction Better in Obtaining Breast Symmetry?

Unilateral breast reconstruction poses a special set of challenges to the reconstructive breast surgeon compared to bilateral reconstructions.

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A Novel Technique of Preserving Internal Mammary Artery Perforators in Nipple Sparing Breast Reconstruction

As nipple-sparing mastectomy with implant-based reconstruction has increased, attention must be paid to the viability of the nipple-areolar complex. This article describes the use of preoperative Doppler ultrasound to identify the internal mammary artery perforators.

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Transition from Round to Shaped Implants in Immediate Breast Reconstruction

Smooth, round, silicone implants predominate device-based breast reconstruction in the USA; despite their prevalence, complications can include bottoming out, superior contour deformity, rippling, and/or lateral malposition.

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Is There an Ideal Donor Site of Fat for Secondary Breast Reconstruction?

Loss of volume after autologous fat transfer to the breast is well documented, and various methods to improve long-term survival of fat grafts have been investigated (including both distant and neighboring harvest sites), but no optimal technique has been identified.

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Nipple-Sparing Mastectomy via an Inframammary Fold Incision with ImplantBased Reconstruction in Patients with Prior Cosmetic Breast Surgery

Nipple-sparing mastectomy through an inframammary fold incision (NSM-IMF) with implant-based reconstruction (IBR) is a cosmetically preferable approach to breast cancer treatment in appropriate candidates. However, patients who have undergone prior cosmetic breast surgery (CBS) may be at increased risk for postoperative complications secondary to existing surgical scars.

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