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.…
When patients choose to undergo lumpectomy and when the cancer resides outside of the standard Wise mastopexy pattern, the pattern is sometimes adjusted to remove the skin above the tumor. This will help the oncologic surgeon remove the skin above the tumor and help to clear the anterior margin. When the incisions are sutured closed the final suture placed is…
Breast reconstruction is a common procedure in the United States and more specifically in Newport Beach, California. Often patients may have undergone a bilateral mastectomy with implant reconstruction. At the time of the mastectomy, the nipple areola complex may have been removed and the breast reconstructed with tissue expanders and then subsequently the placement of bilateral mammary prosthesis. When the…
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…
DIEP flaps are excellent options for breast reconstruction in patients who have undergone radiation therapy. Often the skin above the tumor needs to be resected during a mastectomy and an oncoplastic mastectomy is completed to facilitate clearing an anterior margin. When tissue expanders are placed and then radiated, the tissue expander can be affected by capsular contracture forces around the…
Patients who have breast cancer may be a candidate for lumpectomy and intra-operative radiation therapy. The intra-operative radiation therapy is completed at the time of the lumpectomy and the lumpectomy defect is closed. The aesthetic outcome following this type of oncologic resection and reconstruction can have a great outcome.
Bilateral mastectomy is often reconstructed with tissue expanders and breast implants. The tissue expander is inserted at the time of the mastectomy and the skin is allowed to heal and more oncologic information is gathered. Once the mastectomy skin has healed, saline is placed in the tissue expander to gradually expand the skin. The expanded skin is allowed to settle…
Capsular contracture can be a challenging problem for patients and surgeons. Often correcting a chronic capsular contracture may require a staged procedure to most effectively treat the problem. When a capsular contracture is recurrent, it is often best to remove the implants for approximately one year prior to placing the implants back into position. Removing the mammary prosthesis and changing…
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…
When tumors are close to the nipple areola complex the nipple is often removed at the time of the lumpectomy to clear the anterior margin. When mammary prosthesis are in place, often the mammary prosthesis can be removed at the time of the lumpectomy procedure. Patients often choose to have their implants removed at the time of lumpectomy as they…
