About Breast Reconstruction
Breast reconstructive surgery is important to help restore breast shape and size after a mastectomy or lumpectomy. It is also available to repair the chest if it has been damaged by trauma or a birth defect. New techniques in reconstructive surgery make it possible for breast cancer patients to feel fully healed and attain breasts that look natural even after they have been removed. This surgery generally involves several procedures and different stages that may either be done at the same time as your breast cancer treatment or delayed until the treatment is complete. The Woodlands, TX board-certified plastic surgeon Dr. Steven Gordon creates a unique surgical plan and uses compassion as we work with you and your cancer team to restore your appearance and confidence at Gordon Plastic Surgery.
Breast Reconstruction Reviews
"I was nervous at first because I was told my cancer came back. Dr. Gordon was awesome!! He explained everything thoroughly, and answered my questions so I could understand what was going on. I will what possibly could happen later on. I left his office relaxed and not so worried about what was happening. he takes his time with his patients which is important to me. All of his staff were excellent, friendly, and helpful. I would recommend Dr. Gordon to anyone that needed any kind of reconstructive surgery or surgeries that he might be able to do."- R.C. / Office Visit / Aug 19, 2018
"Steven Gordon is one of the Best plactic reconstruction surgeon I have ever dealt with so very kind and concern about my health .. And his office staff are so kind love this place"- M.T. / Office Visit / Jan 26, 2018
"I visit with Dr Steven Gordon for a Consulation in Jan 2020 with my Family referred by my Breast Onocology, Dr. Lisa Thalheimer a Team member of his to dicuss my Breast Reconstructive. Dr. Gordon took his time to make sure I was comfortable as he explained all Options after my Breast Surgery. He's very Honest, Knowledgeable, Professional about what to expect, never made you feel rushed if you have any questions or concerns and goes out of his way to Achieve the Best Results for You. Dr. Gordon and his Assistant Paula, have been so caring during my Mastectomy Recovery since April 2020 and a continuing Patient in his care of my recent Implant, July 2020. His STAFFS just AMAZING!! They go above to make sure you're taken Care Of. I am BLESS and Have so much to Be Thankful for. I Recommend anyone to Dr. Steven Gordon 10 and ABOVE☆☆☆☆☆☆☆☆☆☆"- L.D. / Google / Aug 31, 2020
Reconstruction of the breast(s) is a very customized surgery. Every patient will be required to have a thorough consultative appointment with Dr. Gordon to decide on their surgical plan based on their concerns, needs, and suitable techniques. These may include implant based reconstruction, flap based reconstruction or a combination of both. While Dr. Gordon strives to give you an attractive, natural appearance, your reconstructed breast(s) may not have the same look, feel, or sensation as your original breast(s). You should get approval from your oncology team to have reconstructive surgery and tell Dr. Gordon regarding any other medical conditions that could impact healing.
FLAP BASED OPTIONS
There is a variety of surgical techniques available for breast reconstruction. There are many factors that Dr. Gordon considers when determining the technique that will give you your best results. A few of these factors include your specific cancer diagnosis, when the reconstruction is performed, if radiation is needed, and if nipple reconstruction or nipple-sparing is a part of the process. In order to recreate the breast, there must be enough tissue to fully cover the breast mound. Flap procedures accomplish this by using your own skin, fat, and muscle to create, cover, and build the breast. The most frequent flap techniques are:
- TRAM Flap
This method takes skin, fat, and muscle from your abdominal area to build the breast. The tissue used to build the new breast may be removed from the stomach or it may remain connected to the donor location, keeping the original blood supply. This is an older technique that has since been modified to the DEIP flap
- DIEP Flap
Like a TRAM flap, a DIEP flap removes skin, fat, and blood vessels from the lower abdominal area; however, it does not use the muscle. The DIEP (deep inferior epigastric perforator) flap removes fat and skin from the abdomen to build the breast mound, then uses microsurgery to attach the transferred blood vessels to the chest.
- Latissimus Dorsi Flap
This method uses muscle, fat, and skin from your back. During this procedure, tissue is moved from the back to the mastectomy site through a surgically created path and remains attached to the donor location, which leaves the original blood supply in place.
- PAP Flap
Another flap is the profunda artery perforator (PAP). This method takes skin, fat, and muscle tissue from your inner thigh to build your breast(s)
- Composite Flap
Also called a composite stacked flap, this technique takes flaps from different areas on your body to reconstruct the breast
IMPLANT BASED RECONSTRUCTION
Breast implants are another option for breast reconstruction. Frequently, a tissue expander is placed at the time of mastectomy to maintain the breast pocket while the overlying skin recovers. Several in office inflation sessions may be needed to get you to the volume desired and then a subsequent procedure is performed to exchange the expander for a permanent implant. On occasion, a patient may be an ideal candidate for direct to implant placement at the same time of the mastectomy. This is determined by the breast size, degree of laxity or ptosis and viability of the mastectomy skin flaps.
Dr. Gordon will discuss all of these options during a comprehensive consultation and help guide you through the process to avoid being overwhelmed.
What to Expect
Breast reconstruction surgery is performed in various steps allowing time to heal between surgeries and address specific needs that may arise. Often fat grafting, or transferring fat from one area of your body to the breasts, is employed to help restore volume or contour specific areas.
With flap based reconstruction, patients typically remain in the hospital for about 5 days after the procedure to closely monitor and ensure that their flap is healing properly
For implant based reconstruction, most patients remain overnight after the tissue expander is placed and subsequent surgeries can often be done as an outpatient.
Frequently Asked Questions
Does insurance cover my surgery?
Enacted in 1998, the Women's Health and Cancer Rights Act (WHCRA) requires health insurance plans that cover mastectomies to cover reconstruction surgery as well. If you have insurance, a team member at Gordon Plastic Surgery will help you understand your coverage. We will also assist you in getting the needed information for your insurance.
Which technique should I choose?
With so many options, there is no single technique that works for every patient. The best technique for you will depend on your cancer treatment plan, concerns, wants, and body. During your consultation, Dr. Gordon will discuss your options, including both flaps and implants, so you understand the advantages and drawbacks before you decide. Whether you decide on implants or a flap, Dr. Gordon will do his best to make your results look natural.
What about nipple reconstruction?
Reconstruction of the nipple can be performed with local tissue flaps are cosmetic tattooing. Gordon Plastic Surgery is one of the only plastic surgery practices in Houston, TX that offers in office 3D nipple areolar tattooing. Through use of colors, shading and depth, the nipple and areola can be expertly reconstructed to match a native nipple or to create both new nipple areolar complexes in bilateral cases.
Should I have reconstruction with my mastectomy or wait?
When you choose to have breast reconstruction is dependent on many factors. Some patients choose to get their breast(s) reconstructed at the same time as their mastectomy while some patients decide to defer reconstructive surgery. Dr. Gordon recommends you make a consultation following a diagnosis of breast cancer so you can begin thinking about your choices and when you want to have reconstructive surgery. If you decide to have reconstruction at the same time as your breast cancer treatment, Dr. Gordon can collaborate with your oncologist to plan your surgery.
Reclaim Your Self-Confidence
Although the breast reconstruction process can be lengthy, it is probably one of the top worthwhile surgeries for our The Woodlands, TX patients at Gordon Plastic Surgery. Dr Gordon feels extremely fortunate to be able to get you past your breast cancer treatment and through reconstruction to boost your self-confidence and figure. If you have breast cancer, have had trauma to the chest, or were born with a defect that affects the look of your breasts, we invite you to contact our The Woodlands, TX office and schedule your consultation with Dr. Gordon.