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 may be performed either immediately following breast removal or at a later date. Immediate breast reconstruction is often the best option as it allows the patient to awaken from surgery with a breast mound already in place, sparing her the experience of seeing herself without a breast. Our plastic surgeon offers several options for breast reconstruction, including implant reconstruction or reconstruction with your own tissues (usually from the abdomen or back). 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 receive a mastectomy are referred to Dr. Joshua Hyman prior to their breast cancer procedure. At that time, he will review your medical history, perform an examination of the breast and body, and make a recommendation based upon these factors. Your questions and concerns regarding breast reconstruction will be addressed fully and all options will be discussed.
Implant Breast Reconstruction
The most common type of breast reconstruction is implant reconstruction. Following the mastectomy, there is a relative skin deficit. Because of this deficiency, implant reconstruction requires a period of time to stretch or expand the remaining skin. 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
Recovery varies depending upon the procedure and the individual patient. Implant reconstruction patients are generally able to return to their normal activities more quickly than TRAM flap breast reconstruction patients. Additional surgery may be required to make minor revisions to the reconstructed breast. Because the goal of reconstructive breast surgery is to match your opposite breast, Dr. Joshua Hyman may suggest an additional operation to enlarge, reduce, or lift the unaffected breast.
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.