Breast Reconstruction in Cancer Care is the dimension of plastic surgery devoted to repairing a breast following breast conservation therapy (partial mastectomy and radiation therapy) or creating a new one after mastectomy surgery. Also included are procedures that produce symmetry (breasts equal in shape and size).
Plastic surgeons perform breast reconstruction also to correct a congenital or acquired deformities or absence of the breast.
Drs. Pellegrino and Perrotta have extensive training and experience in breast reconstruction, and they receive great fulfillment in providing successful results which help their patients feel their best.
Drs. Perrotta and Pellegrino have developed a sensitive process for preparing you for breast reconstruction. They will devote as much time as necessary during your consultation to discuss what you can expect from breast reconstruction surgery and how you would like to look.
Dr. Pellegrino or Dr. Perrotta performs a focused physical examination to provide preliminary recommendations. Note that all procedures have risks. Minor complications do occur occasionally, but major complications are rare.
If you have recently discovered breast carcinoma, Dr. Pellegrino or Dr. Perrotta will work hard to expedite the process leading to your partial or complete mastectomy.
Much is covered during your pre-op visit. Your surgeon will explain the surgical techniques to you and thoroughly inform you as to what you can expect, including any potential complications. Dr. Perrotta or Dr. Pellegrino will then obtain a more complete medical history from you and perform a final pre-op physical examination. Your chest will be measured, and your vital functions will be checked to ensure that you are physically fit for surgery. Prior to releasing you from your pre-op visit, your doctor and our staff will give you detailed instructions for the time leading up to your surgery, as well as for the time immediately following it.
Drs. Perrotta and Pellegrino are experienced with multiple types of reconstruction, including implant, TRAM flap, latissimus dorsi flap, and state-of-the-art perforator flap reconstruction.
For implant reconstruction, the surgeon initially stretches the skin with a tissue expander. He inserts the tissue expander immediately following your mastectomy or weeks, months, or years after (depending on your preference). At least two weeks after the tissue expander has been inserted, the surgeon passes a fine needle through the skin and inflates the expander with some saline. This minor office procedure is repeated every 2-3 weeks, until the skin is adequately expanded, at which point the tissue expander should be slightly larger than the envisioned reconstructed breast. The process of tissue expansion usually takes a minimum of three months to complete.
Next, the surgeon brings the patient back to the operating room to replace the tissue expander with a permanent saline or silicone gel breast implant. In selected cases, the tissue expander can serve as the permanent implant, which spares the patient a surgery.
During TRAM flap reconstruction, a 5-7-hour procedure, the surgeon uses skin and fat from the lower belly to form a breast. This procedure leaves a long scar but also produces a flatter belly with tighter skin. Some patients feel they have undergone a simultaneous tummy tuck. Generally speaking, a TRAM flap-reconstructed breast appears and feels more natural than a breast reconstructed by either the implant or latissimus dorsi technique.
During Latissimus Dorsi Reconstruction, the surgeon elevates the latissimus dorsi muscle (on the back) with overlying skin and tunnel both to the chest. The muscle and skin is then draped over a saline or silicone gel breast implant. Since there is a thick layer of soft tissue covering the breast implant, the reconstructed breast drapes well and appears and feels more natural than a breast reconstructed with an implant alone. This approach does result in a large scar on the back, however.
The perforator flap enables the surgeon to recruit additional skin and volume for a breast without the sacrifice of a muscle or strength in any other part of the body.
There are other types of breast reconstruction available at the university setting that your surgeons will discuss with you if you are interested or if they are recommended in your case.
Following successful breast reconstruction, most patients opt for reconstruction of the nipple/areola complex as well.
The duration of the recovery period is dependent on the type of reconstruction. Following surgeries for implant reconstruction, most patients return back to work at home or the office within two weeks. Following latissimus dorsi or TRAM flap reconstruction, the recovery period takes at least 4-6 weeks.
Both doctors monitor all patients closely after reconstruction surgery. They offer complimentary annual check-ups, during which the breasts are assessed for capsular contracture or any migration of the breast implants.
Following mastectomy or lumpectomy, health insurance companies usually cover their share of the costs of reconstructive surgery. For the correction of congenital deformities or asymmetry, some insurance companies cover reconstructive surgery, and some do not.
Click here to see our Breast Reconstruction Before and After photo gallery.
We are grateful to our patients for granting us the privilege of posting their before and after photos on our website. While we greatly value their privacy, we also salute their eagerness to share their life-changing results with other individuals considering plastic surgery. Every patient on this website has enthusiastically provided his or her written consent for us to show the world his or her results.
Contact us today to discuss Breast Reconstruction Surgery.
Read the latest article by Dr. Vincent Perrotta, M.D. “Total Breast Cancer Care: Part 1 of a Series.” (The County Woman Newspaper – Winter 2013)