We consider breast reconstruction one of the most important things we do. The chance to meaningfully help someone at one of the most difficult times in their lives is the reason we went into medicine. The possibility of a mastectomy for cancer or other breast disease, or the deformity that has some after a lumpectomy, is daunting for most women. We feel we provide a highly supportive, caring, and warm environment for those facing this challenge.
After the detection of a lump, and the visits with your primary care physician and likely a general surgeon, it may be appropriate for you to see a plastic surgeon. They, and you, may have determined that mastectomy is right for you, or at least a possibility. We can then educate you about breast reconstruction and its possible role in your situation. We will also coordinate your care with the other providers, so that everyone understands the plan and the reasons for it. We will show pictures and drawings, examine you carefully for all the options available, and even put you in touch with our other patients if you wish.
This is a highly customized situation, depending on your tumor, your body, your preferences regarding the extent of the surgery, and many other factors. Your consultation will help you with these decisions.
The most common method of reconstruction in this country is the expander/implant method. At the time of the mastectomy, a shaped envelope is placed under the pectoral muscle of the chest. We also use a piece of bio engineered skin to cover this envelope, which is called a tissue expander. Over the next several weeks after surgery, the expander can be filled with saline through the skin, and gradually the skin and muscle are expanded so that a permanent implant, usually a silicone gel implant, can be placed at a second, outpatient surgery. The advantage to this method is that it involves no additional incisions beyond that of the mastectomy, it is relatively simple, and most patients are satisfied with it. The disadvantages are that the implants are not your own tissue, they may not feel as natural, and there may be visible rippling of the implant. They are also not desirable if you are going to have radiation, as they can get quite hard.
