Breast Reconstruction New York City
For patients who have had mastectomy for breast cancer or congenital defects, Dr. Joshua Hyman may recommend breast reconstruction in New York, New York. Surgery for congenitally small or absent breasts is usually performed around the age of 18, after breast development has completed. Reconstruction for mastectomy can be performed immediately after the mastectomy (during the same procedure) or delayed for a later date. Dr. Hyman prefers to do an immediate breast reconstruction with implants whenever possible as it is ideal when the patient can wake up from her mastectomy and already be well on her way to a beautiful reconstruction. There are several options for breast reconstructions and the best option for you depends on the type and location and size of the breast cancer. For example, if radiation is planned after the mastectomy then Dr. Hyman will likely delay the reconstruction and try to avoid an implant based reconstruction. There are many reconstructions of the breast that can utilize your abdominal or back or leg tissue and are done whenever necessary. Thus, the appropriate technique for breast reconstruction is different for each patient, depending upon their body type, preference, and any additional therapy required for breast cancer treatment.
Initial Consultation for Breast Reconstruction Procedure
Patients who need a mastectomy are referred to Dr. Joshua Hyman prior to their breast cancer procedure. At that time, he will review your medical history and the treatment plan. Dr. Hyman will discuss all of your options which always include not to have any sort of reconstruction. However, Dr. Hyman feels it is necessary for you to hear about al your options so that one can make an informed consent. All your questions will be answered at that time as well as the morning of any planned procedure.
Implant Breast Reconstruction
The most common type of breast reconstruction done in our country and in Dr. Hyman’s practice is the immediate implant based reconstruction. Dr. Joshua Hyman will place a tissue expander beneath the skin and pectoralis muscle. Through a small valve in the expander, sterile saline will be periodically injected to gradually fill the expander over several months. After a three-month waiting period, the skin will be accustomed to its new size and the expander will be replaced at a second operation with a permanent saline or silicone implant. Reconstruction of the nipple-areola complex is generally performed during a third minor procedure several months later. Our plastic surgeon may recommend additional surgery of the contra-lateral breast in order to create a symmetrical appearance which usually consists of a breast lift or reduction in some cases.
TRAM Flap Breast Reconstruction
The TRAM (transverse rectus abdominus myocutaneous) flap uses skin, fat, and muscle from the patient’s lower abdomen to create a new breast. This type of surgery is more complex than typical skin expansion and implant placement and it will create scars on both the abdomen and the breast. However, the TRAM flap will also produce a more natural feel and appearance of the breast. In addition, your abdomen will appear slimmer and flatter because of the tissue removal. After the initial surgery, your nipple-areola complex will be reconstructed in a second procedure several months later.
Post-Breast Reconstruction Surgery
After your breast reconstruction you will likely spend the night in the hospital and be discharged the next day. The Breast Surgeon usually places a small drain in the chest wall which is removed about one week later. You will be able to walk and will be able to rest comfortably at your home. Any pain is controlled with oral medicine. Dr. Hyman will see you one week after the discharge from the hospital and then every 2 weeks to expand the implant/expander. The second stage of the process is to exchange the tissue expander for a permanent silicone implant and that is usually done about 3-4 months after the initial surgery. The second stage of the implant based reconstructions is a 1 hour, outpatient procedure. The recovery is much less involved.
How Do I Get Started?
Our plastic surgeon and his staff will be happy to discuss this procedure with you. Please feel free to call for a private consultation with Dr. Joshua Hyman, or you can request an appointment online.