Breast reconstruction surgery can be performed to restore one or both of the breasts to an attractive size, shape, and appearance following a lumpectomy or mastectomy. It's also used to repair the chest if it has been damaged by a birth defect or trauma. Advanced options in reconstructive surgery make it easier for breast cancer patients to feel whole again and have breasts that look natural after removal or damage. This surgery generally involves several procedures and different stages that may be done at the beginning of your breast cancer treatment or delayed until the treatment is complete. NY State & Federal law requires insurance to cover the procedure. Long Island plastic surgeons Drs. James Romanelli and John Layliev create personalized surgical plans with compassion as they help you and your cancer team restore your physical appearance and confidence.

Reconstruction of the breast(s) is an extremely individualized surgery. Each patient will be required to have an in-depth consultation appointment to determine their surgical plan from their concerns, needs, and available techniques. If you are considering reconstruction, it's important that you are emotionally prepared for reconstruction and understand realistic expectations for results. While we aim to give you an attractive, natural appearance, your reconstructed breast(s) may not have the same sensations, look, or feel as your original breast(s).

There are many surgical techniques available to reconstruct the breast. There are also multiple factors that we look at when deciding on the technique that will give you your best results. A few of these factors include your specific cancer diagnosis, when the reconstruction is performed, whether you will use implants or natural tissue, and if nipple reconstruction or nipple-sparing is a part of the treatment plan. To recreate the breast, you must have enough tissue to fully cover the breast mound. Flap techniques accomplish this by using your own fat, muscle, and skin to build and cover the breast. The most common techniques we use are:

• Implant based reconstruction

      Following your mastectomy, a tissue expander or an implant will be used to reconstruct your    breast. In cases of tissue expanders, your tissue expanders will be expanded in our office        incrementally until we achieve your goal in breast size. During a second stage operation, tissue expanders are exchanged for permanent breast implants and fat grafting may be used achieve symmetry.

• DIEP Flap
  During this technique, skin and fat are taken from the abdomen, along with the corresponding blood vessels, and this tissue is used to rebuild the breasts. This procedure is performed for women who have undergone a mastectomy and it keeps the muscle in place so that it may continue to function properly. A DIEP flap may be preferable as it can preserve abdominal strength and decrease the risk for a hernia and tissue damage. It can also have a quicker recovery period. 
• PAP Flap
  The profunda artery perforator (PAP) uses fat, skin, and muscle tissue from your posterior and inner thigh to reconstruct your breast(s).

• TRAM Flap
  This technique takes muscle, skin, and fat from your abdomen to rebuild the breast. The tissue selected to build the new breast may be removed from the stomach or the tissue may stay connected to the donor location, maintaining the original blood supply.
• Latissimus Dorsi Flap
  This technique uses muscle, fat, and skin from your back. During this technique, tissue is taken from the back to the breast(s) via a surgically created path so it stays attached to the donor location, which keeps the original blood supply in place.

Although flap procedures are a common and highly successful method for breast reconstruction surgery, you may want to reconstruct your breast(s) with the tissue expansion method. This technique places a tissue expander below the breast wall and then gradually fills it with a saline solution over 3-4 months to stretch the skin naturally.  After your reconstruction mammoplasty, you can further improve the look by having areola and nipple reconstruction. There are several procedures to restore the nipple and areola so that it appears natural.

Surgical breast reconstruction is done in several steps.  Some patients may need to stay overnight, but this is based on the actual treatment phase. When the last stage is completed for your breast reconstruction, you should wear a medical support bra and you may be prescribed medication to help control discomfort, bleeding, and swelling. In time, the reconstructed breast(s) should appear more normal so you can feel more comfortable. Regular checks with breast exams and mammograms are essential and highly recommended for your ongoing health.

Although the process of breast reconstruction can take time, it's considered to be one of the top beneficial surgeries for our patients at Romanelli Cosmetic Surgery. It may help improve the physical and emotional impact of breast cancer treatment while also allowing you to reclaim your figure and self-confidence. If you have breast cancer, have had an injury to the chest, or have a congenital defect that affects the appearance of your breasts, we encourage you to contact our Huntington, NY office and make an appointment.