— Verve Patient
Mastectomy with Implant Based Reconstruction
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What Is Implant Based Breast Reconstruction?
Who Is a Good Candidate?
- You will discuss with your general surgeon as well as Dr. Gupta to determine what surgical plan is best for you. Depending on the stage of your cancer your General surgeon my recommend breast conserving therapy, such a lumpectomy or to remove the entire breast, such as a mastectomy.
- You should not smoke. Smoking increases the chances of wound healing complications such as skin death. If you currently smoke, it may be recommended to undergo delayed reconstruction in which you will have your mastectomy only, then 2-3 months later you will begin the reconstruction process.
- The most common causes for complications after your mastectomy include: obesity, smoking, history of prior radiation therapy & diabetes.
The Procedures
Undergoing a mastectomy is a very stressful experience for patients; we aim to make the process as streamline as possible. The flow chart below outlines the most common path that patients take. We will sit down with you and discuss each surgery in detail. This is a general idea of what to expect:
Image Transcript:
The image presents a detailed flowchart for breast reconstruction post-mastectomy. It begins at the top with “Mastectomy” and branches into two paths depending on whether there is good blood flow. If blood flow is sufficient, the process moves on to determine the quality of blood flow and then diverges into two potential treatments: “Implant” for perfect conditions or “Tissue Expander” for okay conditions. The tissue expander pathway includes a period of expansions over two months, followed by an exchange for a permanent implant and surgery on the opposite breast, if necessary. Both paths eventually lead to “Revisions, fat grafting & surgery to the opposite breast,” and finally, to “Nipple Reconstruction.” In contrast, if there is inadequate blood flow, there is no reconstruction at that time, and the patient is advised to wait 2-3 months before returning for surgery. The layout is systematic, using different colors and shapes for decision points and action steps, illustrating a medical treatment plan with clear timelines.
Mastectomy & Reconstruction
- Your mastectomy will be scheduled with your General Surgeon and Dr. Gupta.
- A special camera will be used at the time of surgery after your mastectomy to assess the blood supply to the remaining breast skin, depending on those results a decision will be made to either:
- Place an implant
- Place a tissue expander
- No reconstruction is performed at this time
- If an implant or tissue expander is placed, it will be placed OVER the pectoralis muscle.
- The tissue expander is like a deflated implant. It has a special port which will allow fluid to be gradually inflated during office visits.
- You will spend 1 night in the hospital – one of your doctors will see you prior to sending you home.
- Down time 3-4 weeks.
Tissue Expansion
- Begins 2-3 weeks after your mastectomy.
- You will come in for weekly visits to see our Medical Assistants (MA) for tissue expansion.
- There is a port inside tissue expander. The port will be located using a special magnet. The area of skin will be cleaned and using a small needle the appropriate volume will be injected.
- Many patients do not feel any pain during this procedure. After the mastectomy is performed the skin over the breast is usually numb.
- Once the desired size is achieved, you will be scheduled for a consultation with Dr. Gupta or PA-C to discuss the next phase of reconstruction.
- The next surgery will be scheduled in 6-8 weeks from the last expansion and at least 3-4 months after your mastectomy.
- Chemotherapy (if indicated by your oncologist)
- Expansion can occur at the same time as chemotherapy.
- Radiation therapy (if indicated by your oncologist)
- It is preferred to have achieved full expansion prior to radiation therapy because radiation causes damage to the skin making it very difficult to stretch later on.
Implant Exchange
- This is an outpatient surgery; you will go home the same day.
- The most common type of implants for reconstruction are silicone textured “teardrop” or anatomical shaped implants. They tend to look and feel the most natural. We also have the option to use silicone smooth round implants. We will discuss which implant type is best for you.
- The implants well settle into their final position over the next 3-4 months.
- ** Other options are available to reconstruct the breast using your own tissue, instead of implants. These are more invasive procedures and typically reserved for special circumstances. Typical procedures involved in that category include TRAM flap, Latissimus flap, DIEP flap and SGAP flap
Fat grafting & Revisions
- Fat grafting
- Since all the breast tissue is removed during mastectomy, patients often experience rippling at the top of their implants or a noticeable “drop off” between the chest wall and the implant.
- Fat can be harvested from other areas of the body using liposuction. The fat is cleaned and processed and then the fat can be injected in the areas lacking volume.
- This is an outpatient surgery.
- Revisions
- At the time of fat grafting if there is noticeable asymmetry in the breasts surgical revisions can be made.
- Remember that Dr. Gupta will do his very best to achieve symmetry at the time of implant exchange it is not uncommon for revision to be desired.
Nipple reconstruction
- This is an in-office procedure, typically takes 30 minutes (per side)
- Marks are made on the skin in the desired position of the nipple. Small incisions are made allowing for the skin to be lifted and the nipple to be constructed. Dissolvable sutures will be used.
- Areola tattoo can be scheduled ~2 months after nipple reconstruction.
Procedure Video
Title screen for Procedure – Breast Reconstruction
Dr. Gupta speaking to the camera like an interview
Breast reconstructions are designed to correct any type of deformity
Images of women who want to correct deformity due to lumpectomy or mastectomy procedures
that has occurred due to lumpectomy or mastectomy procedures. It provides their breast contour back and it helps women regain the part that was missing due to cancer.
One good thing about breast reconstruction that patients should know is that breast reconstruction can be done at the same time as their mastectomy or lumpectomy procedures.
Dr. Gupta in a consultation appointment with patient
Some patients do not qualify for one stage breast reconstruction and today we have special technology that enables us to see who will be the right candidate for one step breast reconstruction and we use that technology on every single patient.
Before and after photos of breast reconstruction patients
Dr. Gupta in a consultation appointment with patient
Breast reconstruction serves a lot of different purposes. It gives women their self-confidence back, but more importantly,
Dr. Gupta speaking to the camera like an interview
they are able to move on from the traumatic experience of breast cancer and mastectomy.
Patient admiring results in mirror post procedure
A complete picture on the body helps the brain to forget the past traumatic event, whereas an
Female patient with a breast cancer pin on her shirt
ongoing absence of a part of the body can be a constant reminder for the patients what they went through.
Closing title screen with Verve Plastic Surgery logo
On-screen text: Call today (760) 436-7600
The Recovery
- Depends on exactly what procedure is being performed, the mastectomy tends to have the longest recover of 4-6 weeks, while subsequent surgeries have quicker recoveries ranging from 2-4 weeks.
- Before each surgery we will discuss with you at length what you can expect before, during and after your procedure.
FAQs
Request an Appointment
Call (760) 436-7600 or fill out the form to schedule an appointment to discuss your needs in detail