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Breast reconstruction surgery is performed to restore a breast that has been removed due to cancer or other diseases. A new breast is formed using tissue from the abdomen and/or back muscles or by using a tissue expander and inserting an implant. The reconstruction creates a breast that can be close in form and appearance to match the natural one. Surgery can also be performed on the other breast to improve the symmetry such as a reduction, a breast lift or insertion of an implant.
Dr. Rohrich is a *board-certified, nationally renowned, plastic surgeon with over 15 years experience in breast reconstruction. He believes that breast reconstruction surgery should enhance your cosmetic result while assuring your safety and speed of recovery during this challenging time in your life.
If you're considering breast reconstruction, the information provided will give you a basic understanding of the procedure but it can't answer all of your questions, since a lot depends on your individual circumstances. For more information, click on the "Frequently Asked Questions" to read about the surgical procedure.
* American Board of Plastic Surgery
Am I a good candidate for the surgery?
Your visit with Dr. Rohrich will determine if you are a good candidate. If you are in good physical and mental health and your breast surgeon has approved the timing for your breast to be reconstructed then more than likely you will be an appropriate candidate.
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What should I expect from my consultation?
During your consultation, Dr. Rohrich will evaluate your general health. You will learn about the surgery, its limitations and risks, and discuss your needs and concerns. He will explain which surgical techniques are the most appropriate, based on your desires, your body limitations and the condition of your breast(s). He will describe alternatives, risks and the limitations of each procedure. He will examine your body and will consider such factors as the quality of your skin tone and the contour of your abdomen, back and breast(s). After your consultation, Dr. Rohrich's photographer will take photographs for your medical record and you will meet with his patient coordinator to discuss the surgery fees and available dates.
You should come to the consultation prepared to discuss your medical history. This will include information about any medical conditions, drug allergies, medical treatments you have received, previous surgeries including breast biopsies, and medications that you currently take. It is important for you to provide complete information.
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How is skin expansion performed?
Skin expansion is the most common breast reconstruction performed. It combines skin expansion and the subsequent insertion of a breast implant.
Following your mastectomy, Dr. Rohrich will insert an expander beneath your skin and chest wall muscle. Through a tiny valve that is part of the expander, injections of saline (saltwater) will gradually fill the expander over a period of weeks or months. This stretches the skin allowing room for a more permanent implant, either saline or silicone depending on your choice and Dr. Rohrich's recommendation, to be inserted during the second procedure. Not all patients require a tissue expander before the insertion of an implant. In these cases the implant is inserted following your mastectomy.
A nipple reconstruction is performed on an outpatient basis as the third procedure. Many patients come back to have their areola and nipple tattooed in the clinic after their nipple reconstruction.
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How are flap reconstructions performed?
The TRAM flap breast reconstruction involves the creation of a skin and muscle flap using tissue from your back or abdomen. There are two kinds of flap reconstructions, the latissimus and the TRAM flap.
The latissimus flap uses the muscle and skin from your upper back that is still attached to its blood supply but is repositioned to create a breast. This procedure may require an implant or expansion with an implant as well.
The TRAM flap uses tissue from the abdomen either leaving it attached to its blood vessels or reattaching it to blood vessels in the chest area.
These procedures are more complex than tissue expansion. Scars will be left at both the donor site and on your newly constructed breast. Even though the healing phase takes longer, your results are more natural and in the case of the TRAM flap, you have the added benefit of an improved abdominal contour.
You will have some discomfort and/or pain following surgery. While you are in the hospital your pain is controlled intravenously for the first 24 hours. When you are discharged, you will be given prescriptions for pain medication and antibiotics as well.
The surgical bra will be removed after 2 to 3 days and you will be permitted to shower after removal of your drains. Your sutures will come out in 7 to 10 days. Steri-strips should be worn to decrease the appearance of scars. You may have drains that will require you to measure and record the fluid that your body expresses. You will be given instructions on how and when to report it during your recovery.
Plan on having limited physical activity for at least six weeks. No lifting over ten pounds for 4 to 6 weeks and no workouts or activities that increase your heart rate above 100 beats per minute or stretching exercises for at least 3 weeks.
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What should I know about my results?
Whenever surgery is performed on the body a scar will result. Your incision will be around your nipple and down the center of your breast. These scars will become pale-pink to white in color, depending on your skin color, in 6 to 12 months.
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Some medical insurance companies may pay for this type of surgery if your internist or Primary Care Physician determines it is "medically necessary." Dr. Rohrich's secretary will assist in coordinating insurance approval by sending photographs and preparing information for predetermination. You will be responsible for paying any co-payment or services not covered by your insurance company.
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