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Daniel Y. Maman, MD FACS

Breast Cancer Reconstruction

Women battling with breast cancer often find breast reconstruction to be an empowering and fulfilling part of their journey. When cancer survivors undergo mastectomies or double mastectomies, the implications are not just physical. Because breasts can be synonymous with femininity, losing them can affect self-confidence and impact overall mental health. Breast reconstruction is a form of New York plastic surgery that rebuilds and restores the natural look of the breast, as well as self-confidence.

What is Breast Reconstruction?

Women who have had various stages of breast cancer, resulting in the removal of one or both breasts, often seek breast reconstruction. Some cancer treatments do not remove the entire breast, but, instead, eliminate much of the tissue, leaving the breast(s) misshapen. Others have suffered from accidents that leave their breasts damaged. Breast reconstruction helps to restore the look, shape, and sensation of the chest, reassuring and helping patients feel their best.

Breast Cancer Reconstruction Gallery

 

The Procedure

Consultations often begin as early as immediately following a breast cancer diagnosis. Dr. Maman will discuss your goals, questions, and procedure in great detail during your consultation and preoperative appointments. He will conduct a physical examination during your initial visit and will address your medical and surgical history to have a comprehensive understanding of your needs and ensure an optimal experience with New York plastic surgery. Dr. Maman will discuss with you your treatment plan, thoroughly exploring all your options, and help you identify realistic and reasonable goals.

Each patient is different, and, therefore, will discuss their unique situation with Dr. Maman who will help customize the treatment. For those who have had entire breasts removed, breast reconstruction may require multiple steps or specific techniques to rebuild the breasts as adequately as possible; after a total mastectomy, many patients receive nipple reconstruction after their breast reconstruction surgery.

People who received a nipple-sparing mastectomy will be likely able to preserve their own breast skin and nipple-areola complex. Patients can have their breast reconstruction performed at the time of their mastectomy (immediate) or in a later operation (delayed). There are a few options in regards to procedure types: implants, fat transfer, or autologous reconstruction.

Implants

Breast implants are a very direct way to recreate the natural mound of the breast. Some treatments require the use of a tissue expander, which stretches the skin and muscle to accommodate the desired breast size. This technique might be necessary if you lost a significant amount of skin, muscle, or tissue during cancer treatment.

Patients can receive either silicone or saline-filled shells that Dr. Maman will insert into the breast pocket, most commonly underneath the pectoralis muscle. Both incorporate the surgical implantation of silicone shells that contain a saline solution of sterile water (saline implants) or a synthetic gel (silicone implants). There are small risks associated with silicone-based implants, as they would need to be quickly removed or replaced if any leakage occurs.

Patients tend to prefer silicone as they result in fewer surface variations and smoother outcomes. Saline-based implants, on the other hand, come in a wider variety of custom sizing. Some patients prefer this flexibility and the peace of mind that comes with a natural filling. The type of implant you receive is entirely up to you. Dr. Maman will help you decide what is best for your body and particular situation.

Fat Transfer

Another option for breast reconstruction is fat transfer. Dr. Maman will remove fat from one area of the body and transfer it to the breast pocket. Fat is usually sourced from the stomach or hips using liposuction. To make room for the new fat, patients will need to use an expanding device for several weeks before the surgery. Fat transfers are an excellent option for those looking for a modest or localized improvement.

It is important to note that the expansion process before surgery does take time. You will need to use an expansion system, which consists of suction cups that sit on your breasts for three to five weeks, increasing in use frequency as you near the operation. The week before surgery, patients will wear these cups throughout the entire day, removing them only when showering. Patients must also use the system for up to three months after the procedure. The suction cups expand the tissue and also increase the body’s blood flow.

Autologous Reconstruction

Similar to a fat transfer, autologous reconstruction uses tissues from a different part of the body to create the breast. This method is particularly useful for those who have had extensive cancer treatment, leaving little tissue, skin, or fat to work with. Autologous reconstruction is commonly performed using tissue from the abdomen, allowing for aesthetic improvement of this area concurrently. Autologous reconstruction that uses tissue from the lower abdomen is referred to as a DIEP Flap. Abdominal tissue is transferred to the chest, and then microsurgery is used to connect the blood vessels from the repositioned tissue to surrounding tissue in order to ensure appropriate blood supply. The tissue is shaped to form the breasts and the abdomen is sewn in a now more sculpted and flattering fashion. Similar to fat transfers, this technique results in a very natural-looking reconstruction.

Results and Recovery

All three methods of breast reconstruction will show results immediately. Patients will experience some swelling after surgery, although Dr. Maman will help to ease it with compression garments, bandages, drainage, and prescribed medication. Scarring will naturally occur but will be hidden and likely diminish as time goes on. Any scars will be managed following Dr. Maman’s post-procedure protocol.

Dr. Maman will work with you to ensure a successful recovery period and an optimal experience with New York plastic surgery. You will be provided with all postoperative care instructions to promote healing. Most women will feel less pain and return to daily life within a week, with full recovery taking about one month. Monitoring the outcome of breast reconstruction will require close observation and regular post-operative visits with Dr. Maman.

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1165 Park Avenue, New York, NY 10128