About Breast Reconstruction
Breast reconstruction surgery is performed to restore one or both of the breasts to a normal size, shape, and appearance after a mastectomy or lumpectomy. It is also used to repair a breast damaged by trauma or a birth defect. Advanced options in breast reconstruction surgery make it possible for you to feel whole again and attain natural-looking breasts, even after they have been removed. This surgery generally involves several procedures that can either be performed at the beginning of your cancer treatment or delayed until a later date. Portland, OR plastic surgeon Dr. Richard Bensimon creates a personalized treatment plan and uses a compassionate approach as he works with you to restore your physical appearance and confidence at The Bensimon Center.
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"Fillers and facial treatments - I have been getting treatments at Dr. Bensimon's office for years, fillers, botox, microderm abrasion and skin tightening treatments for my face. I cannot speak highly enough about how amazing my experience has been each and every time. My skin looks amazing, I look younger and feel great! My results are very natural (which was very important to me). Andrea, Dr. Bensimon, Christopher and..."- B.Z. / RealSelf / Nov 24, 2018
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Breast reconstruction is a very individualized procedure. Every patient will have a thorough consultation with Dr. Bensimon to determine their treatment plan based on their needs, concerns, and available options. If you are considering reconstruction, it is important that you have realistic expectations. While Dr. Bensimon strives to create a natural appearance, your newly reconstructed breast(s) will not have the same sensations, look, or feel as your original breast(s). You should be cleared by your oncology doctor to have surgery and tell Dr. Bensimon about any other medical conditions that could impair healing.
There are many techniques available today for breast reconstruction. There are also many factors that Dr. Bensimon considers when determining the technique that will produce your best results. Some of these factors include cancer diagnosis, reconstruction timing, whether you will use natural tissue or implants, and if nipple-sparing or nipple reconstruction is a part of the process. In order to rebuild the breast, there must be enough tissue to adequately cover the breast mound. Flap techniques accomplish this by using your own fat, muscle, and skin to create, cover, and build the mound. The most common flap techniques are:
- TRAM Flap
This method uses muscle, skin, and fat from your abdomen to rebuild the breast. The tissue used to create the new breast can be detached from the abdomen or it may remain attached to the donor location, keeping the original blood supply.
- DIEP Flap
Like a TRAM Flap, a DIEP Flap uses fat, skin, and blood vessels from the lower stomach, but it doesn't take the muscle. The DIEP (deep inferior epigastric perforator) flap moves fat and skin from the stomach to build the breast mound, then uses microsurgery to attach the transferred blood vessels to the chest.
- Latissimus Dorsi Flap
This method uses muscle, skin, and fat from your back. During this procedure, tissue is moved from the back to the mastectomy site through a surgically created tunnel and remains attached to the donor location, which leaves the original blood supply intact.
- PAP Flap
Another flap alternative is the PAP (profunda artery perforator). This technique takes fat, skin, and muscle tissue from your inner thigh to reconstruct your breast(s).
- LTP Flap
While the TRAM flap tends to be one of the more common methods used during reconstruction, sometimes there is not enough muscle, skin, and fat that can be taken from the abdominal area. In these situations, the LTP flap may be used, which takes tissue from the lateral thigh area.
- Composite Flap
Also known as a composite stacked flap, this method combines flaps from various areas on your body to reconstruct the breast(s).
While flap procedures are usually successful and a common method used in breast reconstruction, you may be able to reconstruct your breast(s) with tissue expansion. This involves placing a tissue expander under the breast wall and then slowly filling it with saline over the course of 4 – 6 months until the skin is properly stretched. After a flap has been created or the skin is stretched through an expander, you can then decide whether you want to use a natural fat transfer or breast implants to create the volume and shape of the breast(s). After your breast reconstruction surgery, you may want to improve the appearance with nipple and areola reconstruction. There are numerous procedures to restore the nipple and areola so it looks natural.
What to Expect
Breast reconstruction surgery is performed in various stages. During certain phases (such as creating a flap, inserting an expander, or placing implants), general anesthesia may be used. Some patients will require an overnight stay — this is dependent on the actual phase of treatment. Once the final step has been completed in the breast reconstruction process, you will wear a medical support bra and you will be given medication by Dr. Bensimon to help control discomfort, bleeding, and swelling. Over time, the breast(s) will look normal so you can feel more confident. Ongoing monitoring with mammograms and breast exams are essential and recommended for your ongoing health.
Frequently Asked Questions
How much does breast reconstruction surgery cost?
Breast reconstruction is a complex surgery so to get your best results, you should concentrate on finding a plastic surgeon with years of training and experience, like Dr. Bensimon, over the lowest price. At your consultation, Dr. Bensimon will listen to your needs and goals before developing your unique treatment plan. Then, he can go over cost estimates, payment methods, and where to find low-interest medical financing.
Does insurance cover my surgery?
The Women's Health and Cancer Rights Act (WHCRA) of 1998 requires insurance plans that cover mastectomies to also cover breast reconstruction surgery. If you have health insurance, someone from The Bensimon Center will help you understand your policy and benefits. We will also help you submit any needed information to your insurance.
Which technique should I choose?
There is no single technique that is right for everyone. The best technique for you will depend on your needs, goals, and body. During your consultation, Dr. Bensimon can explain your options, including both implants and flaps, so you can understand the advantages and drawbacks of each before deciding which is best for you. Whether you decide on implants or a flap for reconstruction, Dr. Bensimon will do his best to make your results look natural.
What about nipple reconstruction?
Nipple and areola reconstruction is usually performed with 3D cosmetic tattooing. If you are interested in this, you should talk to Dr. Bensimon during your consultation. He will explain your options so you can decide if you want nipple and areola reconstruction to be a part of your treatment plan.
Should I have reconstruction with my mastectomy or wait?
When to choose to have your breast reconstruction is up to you. Some patients choose to have their reconstruction performed at the same time as their mastectomy while others prefer to wait. Dr. Bensimon recommends you schedule a consultation after your cancer diagnosis so you can begin thinking about your options and when you may want reconstruction surgery. If you decide to have reconstruction at the same time as your mastectomy, Dr. Bensimon can work with your oncologist to plan your surgery.
Reclaim Your Self-Confidence
While the breast reconstruction process can be lengthy, it is considered one of the most worthwhile surgeries for our Portland, OR patients at The Bensimon Center. It can help decrease the emotional and physical impact of a mastectomy while also allowing you to reclaim your self-confidence and figure. If you have been diagnosed with breast cancer, have had trauma to the chest, or were born with a defect that affects the appearance of your breasts, we invite you to call our Portland, OR office and schedule your consultation with Dr. Richard Bensimon.