If you have had a mastectomy or have been told that you will need one, breast reconstruction may be an option for you. Breast reconstruction is a series of operations designed to recreate your breast in its original shape. For breast cancer survivors, breast reconstruction can help to heal the emotional trauma and complete the sense of recovery following their cancer journey.
Plastic surgeon Dr. Eric Mariotti has been trained extensively in the latest reconstructive surgery techniques and consistently provides excellent breast reconstruction results that look natural for women visiting his Concord plastic surgery practice. Dr. Mariotti believes that warmth and compassion is important for all patients, especially for those women who have been through the trauma of cancer.
or call our Concord office at 925-685-4533 to request a consultation.
Breast Reconstruction at a Glance
Candidates for Surgery
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For many years, mastectomies were performed without any chance of reconstruction at all, but today you have a choice. Some women don’t feel breast reconstruction is necessary and would rather opt out of additional surgeries. Many women, however, have a sense of loss from their mastectomy that can be remedied through reconstructive breast surgery.
If you decide that you would like to pursue breast reconstruction, there are two choices: immediate or delayed reconstruction.
- Immediate reconstruction can begin at the time of your mastectomy. In fact, the first step is during the mastectomy procedure. This approach to reconstruction helps avoid additional operations and reduces repeated exposure to general anesthesia. Other advantages include the absence of scar tissue (which could build up from an older mastectomy) and the fact that the breast skin still retains its size and shape from your original breast. In some instances, however, breast cancer or other medical conditions may make immediate reconstruction unfeasible.
- Delayed reconstruction is performed some period of time after the mastectomy, often after all necessary chemotherapy or radiation treatments have been completed. One advantage to this approach is that you can benefit from a quicker recovery time than with immediate reconstruction.
It has been noted that women who go through less time without a breast seem to be less affected psychologically than those who wait longer to schedule breast reconstruction.
TRAM (Abdominal Flap) Reconstruction
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During TRAM flap reconstruction, Dr. Mariotti uses the skin, fat and muscle from your abdomen to reconstruct the breast. Advantages include the ability to avoid breast implants and the reconstructed breast has a very similar feel to the original breast. Additionally, a tummy tuck is performed in order to gather the tissue needed for the new breast. Disadvantages include 4 additional hours in surgery after mastectomy, plus a 4- to 5-day hospital stay. Recovery is between 4 and 6 weeks.
What to Expect
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Just as there are choices about when to elect for reconstruction, we will work with you to decide upon the type of reconstruction to perform. There are multiple factors to be considered when choosing which approach to pursue. Dr. Mariotti will take all the time you need to help you fully understand your options before moving forward.
There are three main categories for breast reconstruction surgery: implant reconstruction, latissimus flap (back flap) reconstruction and the TRAM (abdominal) flap reconstruction.
Implant Reconstruction
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Still the most common type of reconstruction, breast implant reconstruction recovery is the shortest. Implant-based reconstruction does require 2 separate surgeries, but the second procedure is relatively short.
First, Dr. Mariotti will place an expander under your skin and muscle and, over several weeks, will gradually inflate the device by adding saline through a valve in the implant. Once the skin has expanded enough to match your other breast, the expander is removed and Dr. Mariotti places a saline or silicone gel implant, just how a cosmetic breast augmentation is performed.
Flap Reconstruction
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For flap-based breast reconstruction, Dr. Mariotti uses the skin and muscle from your back to reconstruct the breast. In order to match original breast size, an implant may also be used for volume. The advantage here is that this surgery is completed in one step and you will wake up with a full-sized breast. The disadvantage is that this is a longer surgery and necessitates a 2- or 3-day hospital stay.
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After Your Breast Reconstruction
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Each woman’s recovery experience after breast reconstruction surgery will vary depending on the technique used. Implant-based reconstruction has a relatively minimal recovery period, while TRAM flap reconstruction requires a longer hospital stay as well as a longer recovery period.
Some soreness is expected after surgery, including in the area where donor tissue was collected for flap-based reconstruction. Dr. Mariotti will give you specific recovery guidelines to follow and over-the-pain medication can help control any discomfort as you heal.
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These before and after photos contain nudity. Please click/tap to view the images.
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These before and after photos contain nudity. Please click/tap to view the images.
Sensitive Content
These before and after photos contain nudity. Please click/tap to view the images.
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These before and after photos contain nudity. Please click/tap to view the images.
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Breast Reconstruction FAQs
The discussion of when to plan your breast reconstruction after your mastectomy depends on the recommendations of Dr. Mariotti and your oncologist as well as your personal preference. Reconstruction can begin at the same time as your mastectomy, or several weeks (or even months) after your mastectomy.
Once the breast mound has been reconstructed, the nipple can be created. To do this, Dr. Mariotti will harvest tissue during the reconstructive surgery. The areola, which is the pigmented circle around the nipple, can be colored to match your skin tone by matching and adding pigment via tattoo. This completes the reconstructive process and provides a very natural look. Nipple reconstruction is generally done approximately 2 to 3 months after breast reconstruction and is an outpatient procedure.
The good news is that insurance companies are required by law to cover the cost of breast reconstruction at any time after a mastectomy. This includes surgery to your other breast for symmetry, if needed. This may include a breast lift or breast reduction on the opposite breast, or in some cases breast enlargement.
The cost of breast reconstruction can vary widely depending on what is required to achieve an improved appearance and which techniques are used. Thankfully, breast reconstruction following mastectomy or lumpectomy is in most cases covered by insurance, so instead of worrying about pricing, you can focus on choosing the best plastic surgeon for the procedure.
In most cases, all of the breast tissue is removed during a mastectomy, so it is unlikely that the tissue will be able to regrow afterward. However, there are a number of breast reconstruction techniques that can restore the look and feel of natural breast tissue following a mastectomy.
Breast reconstruction requires a specific skill set, acute attention to detail, intricate anatomical knowledge and an artistic eye. For this reason, you will want to choose a plastic surgeon like Dr. Mariotti who has experience performing this procedure. Look at before and after photos on his or her website, read client reviews and ask for referrals from friends and family members near you to begin your search. To narrow your search, schedule a consultation or two with your top picks based on your preliminary research.
There are a variety of breast reconstruction techniques, each with their own benefits. The best surgical technique for you will depend on your specific situation, needs and goals. Dr. Mariotti will discuss your breast reconstruction options in detail during your consultation and help you decide which could be the best method for you.
You shouldn’t feel any pain or discomfort during your breast reconstruction surgery, as it is performed under general anesthesia. For the first few days after your procedure, you can expect to feel some tenderness, discomfort or a tingling or numb sensation. These side effects should gradually improve over the coming weeks and are usually easily managed with over-the-counter or prescription pain medication. Dr. Mariotti will provide you with detailed recovery guidelines to help make your breast reconstruction recovery as smooth and comfortable as possible.
The length of your breast reconstruction recovery period will depend on the surgical technique used. Implant-based reconstruction, for example, typically requires a shorter recovery period than a TRAM flap reconstruction. Generally speaking, expect to be able to return to normal exercise and activities within 6 to 8 weeks after your procedure.
While you should be able to notice immediate changes following your breast reconstruction surgery, it can take up to 3 months for bruising and swelling to diminish, giving you a sneak peek of what your final results will look like. Over the next several months, you should continue to see improvements in the appearance of your new breasts, with final results developing around 6 months to a year after surgery, depending on the technique used.
*Information for education only, not meant as a guarantee of results. Your results may vary. Unless otherwise noted, images on this site are of models.
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