There are several occasions where patients come to our practice and they have previously undergone a mastectomy reconstruction, but would like to improve the appearance of their reconstruction. Common reasons for wanting to improve the appearance of their reconstruction is thin skin, with waviness and rippling of the implant, asymmetry of the reconstructed breast volume or position, and capsular contracture.…
Tissue expander and implant reconstruction can be accomplished at a later stage following mastectomy surgery. When the mastectomy reconstruction is performed at a later time, the term used is a “delayed reconstruction”. During a delayed reconstruction, the mastectomy defect is re-created and often a tissue expander is placed beneath the skin and or pectoralis major muscle. The skin is then…
When a patient undergoes a bilateral mastectomy, there can be several different options for breast reconstruction. One option is to reconstruct the breast with mammary prosthesis or breast implants. In patients who are not going to undergo radiation therapy implant reconstruction can be a viable option for breast reconstruction. In an implant reconstruction, often a tissue expander is placed first…
Breast reconstruction for bilateral mastectomy can be accomplished in several ways. One option for breast reconstruction is the placement of tissue expanders at the time of mastectomy and then removal of the tissue expanders and replacement with implants at a later date. The interval placement of tissue expanders allows the skin to heal prior to the direct placement of implants.…
In patients with ptotic breasts who have breast cancer, the nipple areola complex can not often be kept alive during the mastectomy because the remaining blood supply is not adequate enough to perfuse the nipple areola complex. In these patients, the nipple areola complex is removed at the time of mastectomy. These patients can then choose to undergo nipple areola…
There are often times when patients may undergo a lumpectomy with an oncoplastic reconstruction of the lumpectomy defect and then in the future undergo a mastectomy. This may happen in patients who have a genetic mutation that puts them at higher risk for breast cancer. In these patients, the nipple areola complex may be preserved as it is re-positioned to…
There are a subset of patients who have undergone implant reconstruction following mastectomy and who choose to have their implants removed and their breasts reconstructed with DIEP flaps. The deep inferior epigastric artery perforator flap uses the skin and/or fat from the lower abdomen to reconstruct the breast. This flap is helpful to reconstruct the upper pole of the breast…
Tissue Expanders are often inserted as a first stage of breast reconstruction during the mastectomy. The tissue expanders can be placed above the muscle or below the muscle and depending upon the type of reconstruction that is going to be undertaken. When the tissue expander is placed beneath the pectoralis major muscle it often assumed a higher position that expected…
