Top Breast Reconstruction Annapolis Plastic Surgeon
Breast reconstruction is the surgical restoration of a breast following mastectomy. Regardless of if the breast was removed to treat cancer or to prevent cancer in a high-risk patient, it can be an emotionally overwhelming time. Whether you have immediate reconstruction at the time of your mastectomy or delayed reconstruction at some point in the future, the decision to pursue reconstruction is a very personal one.
What are the types of breast reconstruction?
There are many different options for restoring a breast (or breasts). The surgical plan will depend on your breast size and shape, the stage of your cancer and any additional treatments recommended (such as radiation), and your goals for your new breast size. During your consultation with board-certified plastic surgeon Dr. Claire Duggal, all the options can be discussed and any questions answered. The final plan will be something decided on by you, your surgical oncologist, and Dr. Duggal.
Immediate breast reconstruction refers to starting the reconstructive process during the same surgical procedure as the mastectomy. Under general anesthesia, your breast surgeon will first perform the mastectomy and then Dr. Duggal will perform the reconstruction.
Delayed breast reconstruction refers to waiting until your mastectomy has healed and you have completed any additional treatment you need before beginning breast reconstruction. Delayed reconstruction also refers to women who were not initially sure they wanted breast reconstruction and come to see a plastic surgeon after they have recovered from their mastectomy and treatment.
While there are many different types of breast reconstruction, they generally fall under two main categories:
- breast reconstruction with an implant
- breast reconstruction with your own tissue
Breast reconstruction with an implant
Most often, the first step to reconstruction with an implant is placement of a tissue expander, or temporary implant, which can be gradually filled with saline to stretch out your skin. This tissue expander would be changed to a permanent implant at a second surgery once you have reached the size breast you would like.
Depending on the size and shape of your natural breasts and the location of your cancer, Dr. Duggal may be able to place a permanent implant at the time of your mastectomy (called “direct to implant reconstruction”).
When using an implant to reconstruct your breast, you will likely also need a tissue substitute to help to add an additional layer of tissue between your skin and the implant.
Breast reconstruction with your own tissue
There are several options for reconstructing a breast with your own tissue, or autologous breast reconstruction. This means using skin, muscle, and fat from your back or tummy to shape into a breast. The tissue used to create a breast is referred to as a “flap”.
Sometimes a flap is done in addition to an implant to bring in softer, healthier skin for your new breast, especially if you required radiation therapy and your skin is scarred.
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Second Stage Breast Reconstruction
Regardless of if you choose implant based or autulogous breast reconstruction, it is common to elect to have additional surgeries after you have healed from your first reconstruction. Second stage reconstruction refers to procedures done to improve shape, symmetry, or size of your breasts. It could involve the exchange of an implant for a different size or type, or fat grafting to your breasts to create better shape after reconstruction. Dr. Duggal frequently sees patients who are not yet happy with the cosmetic outcome after breast reconstruction done in the past and who elect to have second stage reconstruction.
FAQS Breast Reconstruction
Breast reconstruction has a low risk of infection, bleeding, wound healing complications, and anesthesia risks. Other risks are specific to the different methods of reconstruction. Flap surgery has the risk of partial or total loss of the flap,and use of an implant has the risk of firmness (capsular contracture) around the implant. This risk is higher if you have undergone radiation therapy to the breast.
Some patients may choose not to pursue reconstruction and simply continue their lives after their mastectomy incisions have healed. One alternative to breast reconstruction for women who are worried about how they will look in clothes is to wear a breast prosthesis.
Depending on the site, size, and stage of the tumor, some women may be candidates for a nipple sparing mastectomy where the nipple and areola can be saved. If the nipple needs to be removed during the mastectomy, it can be recreated at a later surgery from your own breast skin. A secondary tattoo is then done to color the areola.
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The Sandel Duggal Center for Plastic Surgery is one of the top plastic surgery practices in Maryland and Dr. Claire Duggal has extensive experience in breast and body enhancement procedures. Schedule a consultation to learn whether breast reconstruction is right for you, and to find out why Dr. Duggal’s patients rate her so highly. Contact us online or call 410-266-7120.