Breast Reconstruction Beverly Hills
Breast reconstruction surgery offers much hope for a woman losing her breast to cancer. Breast reconstruction surgery can often be performed immediately after the mastectomy, so the woman does not have to live with one breast or it is sometimes performed after the mastectomy has healed.
Breast Reconstruction Surgery
When breast reconstructive surgery is performed immediately following mastectomy, a breast mound is created in place of the breast that has been removed. This is done in the hospital or outpatient surgery center under general anesthesia. Dr. Begovic will work with your oncologist to ensure the best possible conditions for reconstruction.
Breast reconstruction surgery usually involves more than one operation, and follow up procedures may be performed on an outpatient basis. Follow-up procedures may only require local anesthesia, and often involve a skin expander with a breast implant, and reconstruction of the nipple and areola. Sometimes surgery is performed on the natural breast to match the reconstructed breast; however, this creates additional scars.
Types of Breast Reconstruction Surgery
Skin Expander with Breast Implant
In this procedure, a tissue expander is placed under the skin. Once sutures are removed, saline is added weekly to the expander. This stretches the skin as it expands. When the skin has been sufficiently stretched, the tissue expander is removed and replaced by a permanent breast implant in a two-stage procedure. Nipple reconstruction, if desired, is a separate procedure.
Latissimus Dorsi Myocutaneous Flap
This breast reconstructive surgery involves moving the latissimus dorsi muscle and overlying skin from the back to the chest to create a new breast mound. The incision is usually made along the bra line so most of the scar will be concealed. Blood transfusions are not usually required. A breast implant can be placed under the flap if necessary to balance a difference in size. Nipple reconstruction is done later.
Rectus Abdominus Myocutaneous Flap
This procedure takes about 4-5 hours of surgery. One of the rectus abdominus muscles is tunneled along with the overlying skin up to the chest. The breast mound is created to match the opposite site. The tissue is generally adequate to match the size of the opposing breast. If the opposite breast is large or pendulous it can be decreased in size by a simultaneous breast reduction. Patients wishing to have this breast reconstruction surgery must stop smoking six weeks prior to and six weeks following surgery. A synthetic mesh is placed over the area where the muscle is moved. This strengthens the abdominal wall and minimizes the chance of forming a hernia. Nipple reconstruction is done as a second procedure. Some contouring of the new breast mound may be necessary at the same time.
This provides a natural looking breast reconstruction with the added benefit of a “tummy tuck”, however abdominal strength is diminished and hernias can sometimes form.
The reconstruction of a nipple adds a very pleasing final touch to the breast. This is a simple outpatient procedure that may be done with local anesthesia. The average time for this is about 1-2 hours. The goal of the surgery is to create a nipple that has the appearance of the nipple of the opposite breast. As a second procedure the healed nipple and areola can be tattooed to improve the color match of the opposite breast.
Breast Reconstruction Surgery Final Thoughts
Surviving breast cancer is challenging and heroic. I feel extremely privileged to be part of a women’s recovery process. Many women describe their breast reconstruction surgery as a feeling of once again being whole. I am so thankful to be able to participate in such a rewarding procedure.