NJ Breast Reconstruction | New Jersey Plastic Surgery
Modern surgical technology makes it possible to construct a natural-looking breast after mastectomy (breast removal) for cancer or other diseases. The New Jersey breast reconstruction procedure is commonly begun and sometimes completed immediately following mastectomy, so that the patient wakes with a new breast mound instead of no breast at all. Alternatively, breast reconstruction may begin years after mastectomy. Many insurance companies cover breast reconstruction following breast cancer surgery, and legislation was passed several years ago which makes insurance coverage of breast reconstruction mandatory.
Women whose cancer seems to have been eradicated with mastectomy are the best candidates for breast reconstruction. Those with health problems such as obesity and high blood pressure and those who smoke are advised to wait. The NJ breast reconstruction itself consists of multiple operations, the first of which involves creation of the breast mound and is performed during or after mastectomy in a hospital under general anesthesia. Later surgeries, if necessary, may be done in the hospital or an outpatient facility, with either general or local anesthesia.
What is Reconstructive Breast Surgery?
Breast reconstruction offers hope for a woman losing her breast to cancer. The NJ plastic surgery can often be performed at the same time as the mastectomy, beginning the process of restoration and healing. Depending on health conditions, however, a mastectomy patient may have to wait before undergoing breast reconstruction surgery. Whether Breast Reconstruction is done immediately or on a delayed basis, this surgery holds much promise that the post-operative breast can match the natural breast again.
The Breast Reconstruction Surgery Procedure
When reconstructive surgery is performed simultaneously with the mastectomy, Dr. Rosenberg will discuss your surgical options, as well as the risks and alternatives to each option. This may include the two-stage approach, inserting a tissue expander at the first operation, followed months later by replacement of the expander with a silicone breast implant, or the use of your own tissues to reconstruct the breast mound in one stage. Dr. Rosenberg will work with your oncologist and general surgeon to ensure the best possible conditions for reconstruction.
New Jersey Breast Reconstruction usually involves more than one operation, and secondary follow up procedures may be performed on an outpatient basis. Follow-up procedures may only require local anesthesia, and often involve reconstruction to recreate the nipple and areola, or scar revisions. Sometimes surgery is performed on the natural breast to match the reconstructed breast; such procedures include Mastopexy (breast lift), Breast Reduction, or Breast Augmentation.
Soft Tissue Expander with Breast Implant
This is the simplest of breast reconstructions, with the shortest recovery period. This is the favored procedure for persons who have heath problems or contradictions to surgery that is more extensive. Breast reconstruction using tissue expanders is performed in two stages. In the first stage, a tissue expander is placed under the skin and muscles of the chest wall at the same operation as the mastectomy procedure (immediate reconstruction). In other circumstances, the expander is placed many months or years after the mastectomy procedure (delayed reconstruction). After healing of the incisions, saline is added on a weekly basis to the expander. As the expander inflates, the skin envelope is gradually stretched and enlarged.
When the skin has been sufficiently stretched, the tissue expander is removed, and is replaced by a breast implant in the second stage procedure. Nipple reconstruction, if desired, is performed as a separate procedure.
Advantages: Simplest surgery and shortest recovery from surgery.
Disadvantages: Multiple trips to the office over several weeks or months to undergo expansion. Possibility of capsule formation surrounding the prosthesis.
Latissimus Dorsi Myocutaneous Flap
This New Jersey plastic surgery involves moving the latissimus dorsi muscle and overlying skin from the back, tunneling it to the chest to create a new breast mound. The incision is usually made along the bra line so the scar will be concealed.
Blood transfusions are not usually required. A breast implant is often placed under the flap if necessary to balance a difference in size. Nipple reconstruction is done later.
Advantages: This is a very reliable procedure, which provides good tissue coverage for an implant. The chances of capsule formation around the implant are reduced.
Disadvantages: Scar across the back. There may be decreased strength in the back due to muscle loss (usually minimal). Capsule formation may occur and result in the need for additional surgery.
Rectus Abdominus Myocutaneous Flap
This is the most complicated type of breast reconstructive procedure, involving about 4 - 5 hours of surgery. The procedure can be done either as a â€œpedicleâ€ flap, or as a flap. In the pedicle flap operation, one of the rectus abdominus muscles along with itsâ€™ blood supply is tunneled along with the overlying skin up to the chest. In the free or microsurgical procedure, a portion of the rectus abdominus muscle with its overlying skin is removed from the lower abdomen. The artery and vein are then surgically re-attached under the operating microscope to an artery and vein on the chest wall near the mastectomy site. In both procedures, the breast mound is then created to match the opposite site. A blood transfusion may be required. You may donate your own blood before surgery to be re-infused during the surgery.
Breast implants are not usually required. 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 procedure must stop smoking six weeks prior, and six weeks following surgery. Failure to comply may result in death of the flap. A synthetic mesh is placed over the area of the abdominal wall where the muscle is removed. This strengthens the abdominal wall and minimizes the chance of hernia formation. Nipple reconstruction is done as a second procedure. Some contouring of the new breast mound may be necessary at the same time.
Advantages: This provides the most natural looking breast reconstruction with the added benefit of a Tummy Tuck. No implant is needed so capsule formation is not a risk. The scar is easily hidden with clothing.
Disadvantages: There is a risk of herniation of the bowel resulting from moving the rectus abdominus muscle. Abdominal strength is diminished. This is the longest procedure and has the greatest risk for complications, and may require a blood transfusion.
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 goal of the New Jersey plastic surgery is to create a nipple that has the appearance of the nipple of the opposite breast. To reconstruct the nipple, a local flap of skin is usually taken from the breast flap. To reconstruct the areola, skin may be taken from the inner part of the upper thigh or from behind the ear. These areas tend to have a darker pigment, which will provide a better contrast to the breast tissue. As a second procedure, the healed nipple can be tattooed to improve the color match of the opposite breast.Contact our New Jersey Plastic Surgery center today to schedule a breast reconstruction consultation!
While many women are happy with their NJ breast augmentation performed by other surgeons, some patients come to us seeking revision surgery after unsatisfactory results from their initial procedure. These feelings of unhappiness may be caused by the shape, size or placement of the implant, or by complications that occurred after the procedure. Other patients also come to us because of safety concerns caused by their initial procedure. Even patients who are happy with the results of their initial procedure require additional procedures to replace their implants after a certain amount of time.
Revision NJ Breast Augmentation is often performed through a procedure very similar to the initial augmentation surgery, with slight modifications made depending on the reason for revision. After these procedures, patients are able to fully enjoy the breast size, shape and position they desire.
*Disclaimer: Surgical results are not guaranteed and vary greatly from patient to patient.