Reconstructive breast surgery should produce natural-looking, long-lasting results.
If breast cancer, trauma, or congenital conditions have resulted in atypical appearance of one or both breasts, reconstructive surgery can help.
What is breast reconstruction surgery?
Breast reconstruction is performed to restore the shape, size, and symmetry of one or both breasts after treatment for breast cancer, benign breast tumors, accidents, or a congenital breast deformity.
The complexity of a reconstruction will depend on the type of trauma sustained by the breast(s). The greater the trauma, the more involved the surgery.
Dr. Daniel Y. Maman is a nationally recognized expert in breast reconstruction surgery. He is pleased to offer the latest in cutting-edge surgical breast reconstruction techniques to patients at his NYC office. He has authored several book chapters in modern breast reconstruction textbooks, including Breast Reconstruction: Art, Science, and New Clinical Techniques. His research has also appeared in Plastic and Reconstructive Surgery.
Types of Breast Reconstruction
Breast mounds can be reconstructed using implants, fat transfers, and autologous reconstruction techniques. Each method has its own advantages and disadvantages, and a patient’s personal preferences can be as important as their clinical needs in determining which option is right for them.
Regardless of the reconstruction technique used, beginning the reconstructive process at the same time as a mastectomy tends to yield the most favorable results. While each patient’s reconstruction follows its own timeline, you can generally expect a reconstruction to follow the steps below:
- The patient will be given a medical device like a tissue expander or suction system.
- The tissue on the chest will be gradually expanded to make room for the new breast mound.
- Once the tissue is expanded to the desired breast size, Dr. Maman will reconstruct the breast using either implants, a fat transfer, or an autologous tissue transplant.
Breast implant reconstruction
Because it does not require harvesting tissue or fat from another part of the body, using implants to recreate the natural mound of the breast is the least invasive breast reconstruction technique. It is still more complicated than a simple breast augmentation, but you will not have multiple surgical sites healing at the same time.
Implant reconstruction is an excellent choice if you are not interested in using your own tissue or if your cancer treatment has left your skin, muscle, and breast tissue too damaged to be used successfully. Implant reconstruction usually looks like this:
- A tissue expander (a special type of empty breast implant) is placed on the chest wall, usually in a pocket under the pectoral muscle but sometimes between the muscle and skin, at the end of the mastectomy surgery.
- Over the next six to eight weeks, Dr. Maman will fill the tissue expander with either saline solution or air, adding more every few weeks to gently stretch the skin and tissue until the breast reaches the desired size.
- One to two months after you have finished the tissue expansion process and completed your chemo/radiation therapy, Dr. Maman will place either a permanent breast implant, a fat transfer, or an autologous tissue transplant.
You can choose between implants filled with a silicone gel or saline solution. While both are safe, most patients choose silicone implants because they deliver results that are closer to natural breasts in terms of look and feel. You can read more about the types of implants on our breast augmentation page.
Fat transfer reconstruction
Fat transfer can be a good reconstructive option for patients who are repairing damage from a lumpectomy or other partial breast trauma.
The first step in a fat transfer reconstruction is to expand the tissue on the chest to make room for the fat transfer. Unlike an implant reconstruction, a fat transfer reconstruction does not aim to create an empty cavity to fill later. Fat is living tissue, and for it to survive the transfer, it needs to be placed in well-vascularized tissue.
Instead of using a tissue expander to separate and thin tissue, a fat transfer reconstruction utilizes an external suction system that you will wear on your chest multiple hours a day for up to three months. The suction cups slowly expand the tissue, increasing the blood flow to the area.
After the tissue is adequately expanded, Dr. Maman will perform liposuction, usually on the stomach or hips, to harvest fat. Once the fat is processed to remove debris, dead cells, and extra fluid, it is injected into the prepared tissue on the chest.
Advantages of fat transfer reconstruction include:
- No risk of fat grafts being rejected
- Minimal scarring
- Shorter hospital stay and recovery time
- Unwanted fat is minimized
The disadvantage of a fat transfer is that it often takes multiple sessions to reach your desired cup size. There is also a risk that your body will resorb some of the fat transfer, leaving you with a lumpy reconstruction.
Autologous breast reconstruction
Similar to a fat transfer, autologous reconstruction, also called perforator flap reconstruction, uses tissue from different parts of the body to create a new breast.
Autologous reconstruction is highly complex and requires advanced microsurgery techniques to be successful, but it also delivers long-lasting results that look, feel, and move like natural breasts. This technique is also more successful for delayed breast reconstruction or a revision of the original reconstruction.
A DIEP flap is the most common type of autologous reconstruction. In a DIEP flap surgery, Dr. Maman will make a long incision along the pubic line and remove a section of skin, fat, and blood vessels from the abdomen. This piece of tissue is shaped to form the breasts and connected to blood vessels in the chest, then the abdomen is closed using tummy tuck techniques.
We make sure you have the information you need to feel informed about your decision, from your inquiry about our practice through the consultation and recovery.
The first step is a thorough, collaborative consultation. Before surgery, we provide:
- 60- to 90-minute in-depth initial consultations with a complete medical history review and physical assessment by Dr. Maman
- Multiple pre-op visits to answer all your questions
- Specialized surgery coordinators to help you navigate scheduling, financial, and insurance processes
Once you’ve decided to move forward with surgery, we emphasize convenience, comfort, and a smooth recovery. This includes:
- Convenient NYC operating facilities
- Luxury recovery room options at NYC hotels
- Complimentary, custom post-operative support garments and scar treatment regimens
- Attentive and routine aftercare visits
Personalized, Holistic Patient-Centered Approach
Understanding each patient’s personal and clinical needs is central to our practice. We customize treatment plans for each patient, and each patient receives Dr. Maman’s personal contact information along with direct round-the-clock access to our nurse and surgical coordinator.
“Dr. Maman knows his craft so well. He listens to my requests and provides information when I need it. His staff are thoughtful and make sure I feel guided. Grateful to have found him, I feel safe all throughout and the result is beautiful.”
Results & Recovery
Our priority is to provide the highest degree of comfort for our patients throughout their breast augmentation procedure and recovery.
We schedule multiple pre-op appointments to make sure that our patients are fully informed and know exactly what to expect from the procedure. We also stay in close contact during the pre-op period in order to ensure that each patient receives prompt and personalized care.
Once surgery is complete, local patients have the option to recover at home in NYC or in one of our luxury recovery rooms located in select hotels in the city. Recovery timelines vary depending on procedure, and our thorough aftercare options ensure optimized recovery and results.
For more information, read our FAQs below.
Visit our breast reconstruction gallery to see what a difference reconstruction can make.
Breast Cancer Reconstruction Gallery
Meet Dr. Daniel Maman
Dr. Daniel Maman is a Harvard fellowship-trained and board-certified plastic surgeon specialized in cosmetic and reconstructive surgery of the breast, body, and face.
Breast Reconstruction Surgery FAQs
How much do you charge for breast reconstruction surgery?
The price for breast reconstruction surgery depends on the type of procedure you need. By law, breast reconstruction is covered by all insurance carriers. If you have out-of-network benefits, our office will be able to work with your carrier to figure out your level of benefits and determine how much will be covered. After your initial consultation with Dr. Maman, our specialized surgical coordinators will provide you with an itemized price quote.
Will my insurance cover a breast reconstruction?
The Women’s Health and Cancer Rights Act, passed in 1998, is a federal law that requires almost all insurance companies to cover mastectomies (whether cancer-related or not), all stages of reconstruction for the affected breast or breasts, breast asymmetry correction on the untreated breast, and prostheses or implants.
Our surgical coordinators are experts in determining coverage and will work with your insurance provider on your behalf.
Am I a good candidate for breast reconstruction?
Although meeting with Dr. Maman is the best way to determine if you are a good candidate for a breast reconstruction, patients who are generally healthy, non-smokers, and have trauma to one or both breasts are good candidates.
One note: breast reconstruction is usually a multi-step process involving more than one surgery. Many of our patients also find the reconstructive experience an emotional journey. As such, it is important to maintain realistic expectations and open communication with both your support system and Dr. Maman.
Surgical Procedure FAQs
Where will my surgery be performed? How long does breast reconstruction surgery take?
Dr. Maman usually performs breast reconstruction surgeries at an in-office, AAAASF-certified facility or an outpatient ambulatory surgery center (ASC). He also has operating privileges at Mount Sinai Hospital, Lenox Hill Hospital, New York Eye & Ear Infirmary, and Englewood Hospital. We work with you to select the best facility for your needs.
Your surgery can last between one and eight hours, depending on the level of reconstruction you need and which phase of reconstruction you are in.
Will I need special clothes after my surgery?
We will provide you with custom surgical bras and compression bandaging after your surgery at no additional cost. These specialized undergarments will help reduce swelling and speed your healing. Most patients find that wearing loose-fitting clothes and button-down tops for the first week or two accommodates their surgical drains and provides the most comfort.
How long does breast reconstruction recovery take?
While it depends on what type of reconstruction you have, most patients return to normal life four to eight weeks after their surgery. Bruising, soreness, and swelling are all to be expected and may last for up to 12 weeks.
Many of the muscles in your upper arm and shoulder are anchored in your chest, so you may notice tightness, numbness, and weakness that makes it difficult to complete simple tasks at first, but Dr. Maman and his team will give you exercises to help restore functionality to these muscle groups.
When can I work out after a breast reconstruction?
You can go back to light, lower-body-only exercise like spinning or walking after two weeks. Workouts that involve your upper body, like yoga, weight lifting, and swimming, should be avoided for four to six weeks after your surgery.
It is important to remember that feeling recovered is not the same as actually being healed. Easing back into your fitness regimen will reduce the risk of complications and protect your results.
How do I treat scars after surgery?
Dr. Maman will provide you with detailed scar treatment protocols, medical-grade creams, and tapes to minimize your scarring.
Will the surgery require follow-up visits?
Monitoring the outcome of breast cancer reconstruction surgery requires close observation and regular post-operative visits with Dr. Maman. Because we value our patients’ health and satisfaction above everything else, we do not charge for post-operative visits, whether they are part of your detailed follow-up plan during the first year after surgery or the annual visits that we recommend to ensure your final results are maintained.
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