Table of content

PLASTIC SURGERY

BREAST RECONSTRUCTION

Breast reconstruction is a surgical procedure that aims to restore the shape, size, and appearance of a woman’s breast following a mastectomy or lumpectomy. It is an important option for women who have undergone breast cancer treatment or have congenital breast abnormalities.

Breast reconstruction can help improve body image, self-confidence, and quality of life for women who have lost one or both breasts.

Types of Breast Reconstruction Procedures:

1. Implant-Based Reconstruction:
    • Involves the use of breast implants to create a new breast mound.
    • Saline or silicone implants are inserted either below the chest muscle (submuscular) or above it (subglandular).
    • It may require tissue expanders to gradually stretch the skin and muscle before placing the permanent implant.
2. Autologous (Flap) Reconstruction:
    • Uses the patient’s own tissue, usually taken from the abdomen, back, or buttocks, to reconstruct the breast.
    • Common autologous reconstruction techniques include:
      • TRAM Flap: Transverse Rectus Abdominis Musculocutaneous flap uses tissue from the lower abdomen.
      • DIEP Flap: Deep Inferior Epigastric Perforator flap uses only the skin and fat from the lower abdomen, sparing the abdominal muscle.
      • Latissimus Dorsi Flap: Utilizes muscle, skin, and fat from the back, often combined with an implant.

Techniques:

1. Coronal Brow Lift (Traditional):
    • Incision made behind the hairline.
    • Forehead skin lifted and underlying tissues repositioned.
    • Excess skin trimmed and incision closed with sutures or staples.
2. Endoscopic Brow Lift:
    • Small incisions made in the scalp.
    • Endoscope inserted to visualize the internal structures.
    • Brow tissues lifted, repositioned, and secured with sutures or dissolvable devices.
    • Incisions closed with sutures or surgical tape.
3. Direct Brow Lift:
    • Incision made directly above the eyebrows.
    • Strip of skin removed.
    • Brows lifted to the desired position and incision closed with sutures or staples.

Procedure:

1. Implant-Based Reconstruction: a. Incision Placement:
    • Inframammary: Incision is made in the breast fold.
    • Periareolar: Incision is made around the areola.
    • Transaxillary: Incision is made in the armpit. b. Tissue Expansion (if required):
    • A tissue expander is placed beneath the chest muscle or skin.
    • Over several weeks, the expander is gradually filled with saline to stretch the tissue and create space for the implant. c. Implant Placement:
    • Once the desired size is achieved, the tissue expander is replaced with a permanent implant.
    • The implant is positioned either submuscularly or subglandularly. d. Additional Procedures:
    • Nipple and areola reconstruction can be performed at a later stage, if desired.
2. Endoscopic Brow Lift:
  1. Tissue Harvesting:
    • Tissue is harvested from the donor site (abdomen, back, or buttocks) with blood vessels intact.
    • The chosen flap is carefully dissected and transferred to the chest.
  1. Blood Vessel Connection:
  • Microsurgical techniques are used to reconnect the blood vessels of the flap to recipient vessels in the chest.
    1. Flap Shaping:
  • The transferred tissue is sculpted and shaped to recreate a natural-looking breast.
    1. Nipple and Areola Reconstruction:
  • Once the flap has healed, the nipple and areola can be reconstructed using local tissue or tattooing.

RISKS AND COMPLICATIONS

It’s important to note that while risks exist, the majority of breast reconstruction procedures are successful with minimal complications. However, it is crucial to be aware of the following possibilities:

1. General Surgical Risks:
    • Adverse reactions to anesthesia
    • Infection at the surgical site
    • Excessive bleeding or hematoma formation
    • Poor wound healing or wound breakdown
    • Formation of blood clots (deep vein thrombosis or pulmonary embolism)
    • Scarring
2. Implant-Based Reconstruction Risks:
    • Capsular contracture: Scar tissue formation around the implant, leading to firmness or distortion of the breast shape.
    • Implant rupture or leakage: Implants may rupture or leak, requiring implant removal or replacement.
    • Implant displacement: Shifting or movement of the implant from its intended position.
    • Implant malposition: Implants may sit too high, too low, or appear asymmetrical.
    • Inadequate tissue coverage: Insufficient soft tissue coverage over the implant may result in visible or palpable rippling or implant visibility.
3. Autologous (Flap) Reconstruction Risks:
    • Flap loss: Partial or complete loss of the transferred tissue due to inadequate blood supply, requiring additional surgeries.
    • Fat necrosis: Death of fatty tissue within the reconstructed breast, leading to firmness or lumps.
    • Seroma: Collection of fluid within the surgical site, requiring drainage.
    • Delayed wound healing: Prolonged healing time due to compromised blood supply or infection.
    • Donor site complications: Potential issues at the site from which tissue was harvested, such as abdominal weakness, bulging, or scarring (in autologous procedures).
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4. Other Risks and Considerations:
    • Changes in breast or nipple sensation: Temporary or permanent loss of sensation in the breast or nipple area.
    • Breast asymmetry: Differences in size, shape, or position between the reconstructed breast and the natural breast.
    • Need for revision surgery: Some patients may require additional procedures to optimize the results or address complications.
    • Psychological impact: Emotional adjustment to the changes in breast appearance and the reconstruction process.

It is essential to discuss these potential risks and complications with your plastic surgeon during the consultation phase to make an informed decision about breast reconstruction. Your surgeon will provide personalized guidance, manage any potential complications, and take appropriate measures to minimize risks.

PRE-OPERATION PREPARATION

  • Comprehensive medical evaluation and discussion of expectations and goals.
  • Review of medical history, including previous surgeries, allergies, and current medications.
  • Physical examination to assess the patient's overall health, breast size, and tissue quality.
  • Detailed discussion of available reconstruction options, risks, benefits, and expected outcomes.
  • Collaboration with the surgical team, including the oncologist, to plan the optimal timing of breast reconstruction.
  • Preoperative instructions regarding fasting, medication adjustments, and cessation of smoking, if applicable.
  • Emotional support and counseling to address any concerns or anxieties.

POST-OPERATIVE CARE

  • Close monitoring by the surgical team to ensure proper healing and manage any complications.
  • Pain management with prescribed medications and techniques such as ice packs.
  • Wound care instructions, including keeping the incision site clean and dry.
  • Wearing a supportive surgical bra or compression garment for the recommended duration.
  • Gradual return to normal activities, following the surgeon's guidelines.
  • Regular follow-up visits for evaluation of progress and potential adjustments.
  • Emotional support and counseling to address body image concerns or psychological effects.

EXPECTED RESULTS AND RECOVERY TIMELINE

Recovery Process:

1. Immediately Post-Surgery:
    • Close monitoring in a recovery area.
    • Dressings or bandages over incisions.
    • Possible drainage tubes.
    • Prescribed pain medications.
    • Surgical bra or compression garment for support.
2. Early Recovery Period (First 1-2 Weeks):
  • Follow wound care instructions.
  • Limit physical activities and avoid heavy lifting.
  • Attend scheduled follow-up appointments.
3. Drains and Dressings:
  • Manage and care for drainage tubes as instructed.
  • Regularly change dressings as directed.
4. Return to Daily Activities:
    • Resume daily activities based on surgeon’s guidance.
    • Gradually increase activity levels, avoiding strain on the chest area.
5. Long-Term Recovery (Several Weeks to Months):
  • Swelling, bruising, and discomfort will diminish.
  • Final shape of the breasts may take months to settle.
  • Follow post-operative care instructions and scar care treatments.
  • Attend follow-up appointments for monitoring.
6. Emotional Support and Body Image Adjustment:
  • Seek support from loved ones, support groups, or professional counselors specializing in breast cancer and reconstruction.

Potential Results:

  • Restored breast shape, size, and symmetry.
  • Enhanced self-confidence and improved body image.
  • Reduction in physical and emotional discomfort associated with breast loss.
  • Long-lasting results that evolve over time as the body heals and scars fade.
  • Possibility of minor complications, such as infection, bleeding, implant issues, or flap loss, which can be managed by the surgical team.

APPOINTMENTS AND CONSULTATION

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FREQUENTLY ASKED QUESTIONS

Breast reconstruction is a surgical procedure that aims to rebuild a natural-looking breast following a mastectomy or lumpectomy. It can help restore breast shape, size, and symmetry.

Breast reconstruction is an option for women who have undergone breast cancer treatment or have congenital breast abnormalities. It can be performed at the same time as the mastectomy or delayed until after cancer treatment is complete.

There are two primary types of breast reconstruction: implant-based reconstruction and autologous (flap) reconstruction. Implant-based reconstruction uses breast implants, while autologous reconstruction utilizes a patient’s own tissue to rebuild the breast.

The duration of breast reconstruction surgery varies depending on the technique used and the individual patient’s circumstances. It can range from a few hours to several hours.

Breast reconstruction aims to create natural-looking breasts that closely resemble the patient’s original breast shape. The surgeon will work closely with you to achieve the best possible outcome based on your unique circumstances.

As with any surgical procedure, breast reconstruction carries some risks and potential complications. These may include infection, bleeding, poor wound healing, implant-related issues, or flap complications. Your surgeon will discuss these risks with you during the consultation process.

The recovery period varies depending on the type of breast reconstruction performed and individual healing capabilities. Generally, it may take a few weeks to several months for complete recovery. Your surgeon will provide specific post-operative care instructions to promote a smooth recovery.

Breast reconstruction should not interfere with breast cancer detection in the future. However, it’s essential to continue regular breast cancer screenings, such as mammograms and clinical examinations, as recommended by your healthcare provider.

While it is possible to regain some nipple sensation after breast reconstruction, it is not guaranteed for all patients. Sensation recovery varies from person to person and depends on the chosen reconstruction technique.

In many cases, health insurance plans cover breast reconstruction following mastectomy as it is considered a part of the cancer treatment process. However, coverage policies vary, so it’s important to consult with your insurance provider to understand your specific coverage.

MEET THE TEAM

The medical team in the plastic surgery department deserves high praise for their exceptional dedication, expertise, and commitment to providing outstanding care, creating an environment of excellence and support.

  • Highly Skilled Surgeons: Experts in plastic surgery with extensive training, experience, and up-to-date knowledge in advanced techniques for precise and optimal procedures.
  • Compassionate Nurses: Crucial in patient care and recovery, providing comfort, expertise in wound care, monitoring, and patient education.
  • Supportive Administrative Staff: Efficiently manage appointments, provide clear communication and guidance, ensuring a seamless experience.
  • Collaborative Teamwork: Cohesive collaboration between surgeons, nurses, anesthesiologists, and support staff, ensuring a comprehensive approach and optimal outcomes.
  • Patient-Centered Care: Prioritize well-being and satisfaction, tailor treatment plans, and create a positive, supportive environment. In conclusion, the medical team in the plastic surgery department deserves high praise for their exceptional skills, compassion, and dedication. Their unwavering commitment to providing top-quality care and ensuring optimal patient outcomes sets them apart. Patients can trust in the expertise and professionalism of this remarkable team, knowing that they are in capable hands throughout their plastic surgery journey.

PRICING AND PAYMENT PLANS

While specific pricing can only be determined during a consultation, here is a general overview of the factors that contribute to the pricing and different fees associated with breast reconstruction:

  • Surgeon's Fees: This covers the expertise and skill of our board-certified plastic surgeon who will perform the procedure.
  • Anesthesia Fees: Anesthesia is administered by qualified professionals to ensure your comfort and safety during surgery.
  • Hospital or Surgical Facility Fees: These fees include the use of our advanced surgical facility, operating room, and necessary equipment.
  • Implant Costs (if applicable): The cost of breast implants, whether saline or silicone, will be considered if you choose implant-based reconstruction.
  • Additional Procedures or Treatments: Fees may apply for additional procedures like nipple and areola reconstruction or scar revisions.
  • Preoperative and Postoperative Care: Comprehensive care, including consultations, evaluations, and follow-up visits, is included in the overall cost.
  • Insurance Coverage and Financing Options: We can assist you in understanding your insurance coverage and offer financing options to make the procedure more affordable.

Please schedule a consultation with us to receive personalized pricing information based on your specific needs and goals. We are committed to providing transparent pricing and helping you achieve your desired outcome within your budget.

MEDICAL LITERATURE AND RESEARCH

In our clinic, our plastic surgeons stay up-to-date with the latest research and advancements in breast reconstruction. They actively engage in continuous learning and professional development to provide the best care. Their expertise allows for tailored treatment plans based on each patient’s needs. Our surgeons prioritize patient well-being and satisfaction. They utilize innovative techniques and technologies in breast reconstruction. Our clinic offers the highest level of expertise in the field. We are dedicated to achieving natural-looking, aesthetically pleasing results. Trust our skilled professionals for exceptional care in breast reconstruction. We stay current with the evolving landscape of breast reconstruction. Choose our clinic for the latest advancements and optimal outcomes.

SUPPORT AND COUNSELING

After the breast reconstruction procedure, we prioritize the well-being and comfort of our patients. Our clinic provides comprehensive support and counseling to ensure a smooth and comfortable recovery. Our team is dedicated to assisting you throughout the healing process, addressing any concerns or questions you may have. We understand the emotional aspect of breast reconstruction and offer personalized support to help you adjust to the changes and regain confidence. You can trust that our compassionate professionals will be there for you every step of the way, providing the necessary support and guidance for a comfortable and successful recovery.

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PLASTIC SURGERY – BREAST RECONSTRUCTION