Breast Reconstruction

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Breast reconstruction following mastectomy is a deeply personal choice. Reconstruction options span from no reconstruction (going flat), to breast mound formation, to complete breast reconstruction with a pigmented nipple. Reconstruction can be immediate (at the time of breast removal) or delayed (after recovery from breast removal). The timing and type of reconstruction options available to the patient are based on a number of factors including tumor location and treatment protocol.

What are implant
reconstruction options?

Implant reconstruction uses an implant to replace breast tissue that has been removed. The implant is placed below the pectoralis muscle or below the skin.

Tissue Expander

If the breast skin and muscle cannot accommodate a patient’s desired implant size, the tissues can be expanded to create space for a larger implant. This is accomplished by initially placing a tissue expander in the breast pocket instead of an implant. The tissue expander has a port that can be accessed with a needle through the skin and can be filled with fluid slowly over time. Once the desired size is achieved, the tissue expander is removed, and an implant is placed in a second operation.

What are the tissue
reconstruction options?

Deep inferior epigastric artery perforator flap (DIEP flap) breast reconstruction is a type of autologous tissue breast reconstruction. Instead of using implants, Dr. Vial constructs breasts using tissues from your body.

During DIEP flap surgery, parts of the skin, fat, and blood vessels from the lower abdomen are moved up to the chest to create a breast mound. This has the dual benefit of sculpting the lower abdomen while creating a natural breast mound. The deep inferior epigastric blood vessels are detached from the abdomen, matched to the vessels in your chest, and reattached using microsurgery.

Candidates for breast reconstruction:

In general, candidates for breast reconstruction:

  • Do not have underlying medical conditions or illnesses that preclude surgery
  • Are non-smokers or are willing to stop smoking one month before and one month after the procedure
  • Do not use nicotine products, or are willing to stop using products one month before and one month after the procedure (gum, chews, patch, vape)
  • Are not exposed to second-hand smoke
  • Have realistic expectations from the surgery
  • Realize that visible scar lines will remain on the breast after the procedure
  • Realize that certain techniques, such as DIEP flap surgery, will leave scars on the abdomen

How is breast reconstruction performed?

Your breast reconstruction journey starts with a consultation with Dr. Vial. Dr. Vial discusses your goals and expectations to create the ideal breast reconstruction plan for you. He highlights all your breast reconstruction options, including reconstruction with tissue expanders, tissue based reconstruction, skin sparing mastectomy, and nipple sparing mastectomy.

After curating a personalized surgical plan, your breast reconstruction is performed as an inpatient procedure. The surgery is performed under general anesthesia. The specific techniques depend on the type of breast reconstruction, implant-based or autologous, and whether it’s immediate (at the time of breast removal) or delayed (after recovery from breast removal).

What is the recovery process after breast reconstruction?

How you recover in the three months after your surgery determines the outcome for years to come. Dr. Vial will provide a list of step-by-step recovery guidelines after your surgery. Recovery following breast reconstruction is difficult. There are many restrictions, and you will need significant support following surgery.

What are the risks of breast reconstruction?

Dr. Vial places the utmost importance on your safety. He only works with board-certified anesthesiologists and certified nurses to minimize the risk of side effects or complications. However, all surgeries carry inherent risks, including breast reconstruction. Dr. Vial will highlight the potential risks of your procedure during your consultation.

The complications unique to breast reconstruction that are reported nationally include, but are not limited to:

  • Mastectomy skin flap necrosis
  • Infection
  • Capsular contracture (implant scarring)
  • Implant malposition
  • Loss of flaps
  • Reoperation

Why choose Dr. Vial for breast reconstruction?

Dr. Vial is a board-certified plastic surgeon with extensive training and experience in breast augmentation. He has trained at the world’s best institutions where many of these procedures continue to be advanced. He makes safety a top priority and has developed a reputation for beautiful, natural results.