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Breast Reconstruction

Breast reconstruction is a general term used to describe surgery to rebuild the breast. This can refer to rebuilding the breast after mastectomy, which is the most common cause, or building the breast due to birth defects or post-traumatic defects. Fortunately, the science of breast reconstruction has evolved over time. We offer a range of breast reconstruction options in the Houston area. The goal of each of our breast reconstructive surgeons is to allow our patients to make the best choices they can about their breast cancer, and do so with complete confidence that they will still look and feel like themselves.

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Why Undergo Breast Reconstruction?

Our surgeons recognize that breast cancer can take a large toll on our patients. Along their cancer journey, we understand that patients lose time, sleep, tears as well as their sense of security. Through breast reconstruction, patients can avoid losing their self-image, self-confidence, femininity and/or their sexuality.

Numerous studies show that breast reconstruction not only improves a patient’s self esteem and sexuality after surgery, but some patients even see their reconstruction as a silver lining to an otherwise dark cloud. Over many years, our surgeons have guided thousands of patients through the breast reconstruction process. Based on our extensive experience, our goal is simple: we hope that when you complete your breast cancer journey, you’ve not only beaten cancer, but when you look in the mirror you see a more complete version of yourself.1

Benefits of Breast Reconstruction

The procedure can provide:

  • Confidence after a mastectomy or trauma
  • Natural looking and feeling breasts
  • Restored femininity and sexuality

Before & After

          Results from DIEP Flap Breast Reconstruction

Breast Reconstruction Options

There are a number of techniques used for breast reconstruction, and our surgeons custom-tailor each treatment plan to suit a patient’s unique needs and desires.2

Deep Inferior Epigastric Perforator (DIEP) Flap Breast Reconstruction

In most cases, DIEP flap breast reconstruction is our breast reconstruction procedure of choice, as it allows our patients to enjoy restored confidence with reconstructed breasts that look and feel natural. With a DIEP flap procedure, breasts are reconstructed using skin and fat from the patient’s lower abdominal area without the need to cut or remove any muscle, which reduces recovery time and discomfort.

Stacked Deep Inferior Epigastric Perforator (DIEP) Flap Breast Reconstruction

In some cases, patients may not have adequate fat and skin in the lower abdominal area to be used in breast reconstruction. For these patients, we are able to achieve fantastic results by combining two separate flaps to reconstruct a single breast with what is known as Stacked DIEP flap breast reconstruction. These flaps may be from the inner thigh (PAP flap), from the abdomen (DIEP flap), or a combination of both.

Superficial Inferior Epigastric Artery (SIEA) Flap Breast Reconstruction

SIEA flap breast reconstruction is very similar to DIEP flap breast reconstruction in that it is also a muscle-sparing procedure during which skin, fat, and blood vessels are harvested from the abdomen. This type of breast reconstruction utilizes a different section of blood vessels from those used in DIEP flap reconstruction, which are smaller and more superficial. As a result, not all patients are ideal candidates for SIEA flap breast reconstruction.

Profunda Artery Perforator (PAP) Flap Breast Reconstruction

With PAP flap breast reconstruction, our Houston plastic surgeons harvest tissue and blood vessels from the inner posterior area of the patient’s thigh to build breasts that are soft, supple, and natural-looking. PAP flap breast reconstruction is an excellent option for patients who have undergone previous breast reconstruction procedures that yielded unsatisfactory results or for patients who delay breast reconstruction after mastectomy. This procedure can also be performed immediately after mastectomy.

Superior/Inferior Gluteal Artery (GAP) Flap Breast Reconstruction

GAP flap breast reconstruction uses fat, skin, and blood vessels harvested from the patient’s upper superior gluteal artery perforator (sGAP flap), lower buttock region (inferior gluteal artery perforator or iGAP flap), or both (bilateral GAP flap). Using advanced techniques, our surgeons are able to use this procedure to reconstruct one breast at a time with minimal scarring and no nerve or muscle damage to the buttocks.

Direct Implant

The above-noted breast reconstruction procedures use tissues harvested from the patient’s own body to rebuild the breasts (autologous breast reconstruction). Our Houston plastic surgeons are also highly experienced in using saline or silicone implants to reconstruct the breasts. A direct implant breast reconstruction may be the best option for patients who don’t have sufficient excess tissue to be harvested to rebuild the breasts, patients who are not good candidates for a more lengthy flap reconstruction procedure, or patients who wish to avoid incisions on other parts of their bodies. It is important to note, however, that this type of reconstruction may require multiple office visits or procedures and could yield results that look and feel less natural than an autologous breast reconstruction procedure.

Tissue Expanders

In patients whose breast reconstruction will be conducted in stages or those who have had significant skin removed during mastectomy, it may be necessary to employ tissue expanders. Tissue expanders are somewhat like balloons, and are used to create enough space to accommodate a breast implant. Over the course of a number of months, fluid will incrementally be added to tissue expanders so that the skin is gradually stretched to make room for the breast implant.

Our surgeons are skilled in all types of reconstruction, and can use either tissue and fat from the patient’s own body (abdomen, thigh, buttocks, etc.) or silicone/saline implants. The technique depends on the patient, but our doctors will discuss your options with you during an initial consultation.

Breast Reconstruction: Frequently Asked Questions

What are the risks of breast reconstruction?

When considering whether to undergo breast reconstruction, it’s important that our patients are aware of all potential risks so that they make an educated decision about the right treatment plan for them.

All surgical procedures carry the risk of infection, bleeding, anesthesia risks, and poor incisional healing. With flap breast reconstruction surgeries, additional risks may include a loss of sensation or muscle weakness in the donor site or flap failure (when harvested tissue does not receive adequate circulation after implantation). Risks associated with the use of an artificial implant to reconstruct breasts may include implant rupture or capsular contracture, which is a result of scar tissue contracting around the implant.3

What if I only need one breast reconstructed?

In cases where a patient has undergone a single mastectomy, an analogous breast reconstruction procedure like the DIEP flap or PAP flap often yields the most natural-looking and harmonious results. The use of a silicone or saline implant to reconstruct a single breast may create the appearance of a lack of symmetry to the chest, often requiring cosmetic surgery to the opposite (healthy) breast so that it matches the implant.

How does nipple reconstruction work?

Nipple reconstruction is an outpatient procedure that is performed under either general or local anesthesia, depending on the patient’s unique needs. In most cases, the tissues surrounding the placement location can be manipulated to mimic the look, feel, and elevation of a natural nipple. Sometimes our surgeons also inject a dermal matrix into the area to ensure the nipple maintains its shape after recovery. We always conduct nipple reconstruction 3-4 months following breast reconstruction to ensure proper recovery and optimal results. Then several months after nipple reconstruction patients typically undergo nipple/areola 3D tattooing in our office with a nipple tattoo specialist in order to mimic the natural color, tint and contours of the nipple areola.

Is breast reconstruction covered by health insurance?

Thanks to the Women’s Health and Cancer RIghts Act of 1998, breast reconstruction and other post-mastectomy treatments and benefits must be covered by all group health plans that cover mastectomy. Under the WHCRA, these benefits must include post-mastectomy reconstruction, reconstruction of the opposite breast to achieve a balanced look post-mastectomy, external breast prostheses, and treatment for any complications resulting from mastectomy such as lymphedema.4

Quality Reconstructive Breast Care in The Woodlands and Houston

The surgeons and staff at our Houston plastic surgery practice are dedicated to supporting our patients in every way possible throughout each step of their journey, from initial consultation through recovery. We understand that breast reconstruction is much more than a cosmetic surgery procedure: it’s an important and emotional step towards reclaiming your life. We’re proud to have helped thousands of patients achieve healing, and we would be honored to do the same for you.

Your MHS Breast Surgeons

Breast Reconstruction Blog Posts

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References
1 Tkachenko GA, Arslanov KhS, Iakovlev VA, Blokhin SN, Shestopalova IM, Portnoĭ SM, Poddubnaia IV. Long-term impact of breast reconstruction on quality of life among breast cancer patients. Vopr Onkol. 2008;54(6):724-8. PubMed PMID: 19241847.
2 BreastCancer.org. Types of Breast Reconstruction. Available: https://www.breastcancer.org/treatment/surgery/reconstruction/types. Accessed March 23, 2020.
3 American Society of Plastic Surgeons. Breast Reconstruction Risks. Available: https://www.plasticsurgery.org/reconstructive-procedures/breast-reconstruction/safety. Accessed March 23, 2020.
4 Centers for Medicare & Medicaid Services. Women’s Health and Cancer Rights Act (WHCRA). Available: https://www.cms.gov/CCIIO/Programs-and-Initiatives/Other-Insurance-Protections/whcra_factsheet. Accessed March 23, 2020.