Effect
Breast reconstruction offers a pathway that others have followed toward richer emotional and physical recoveries following injury or removal of a breast from trauma, the effects of disease or treatments for disease. Advancements in breast implants and surgical techniques have improved what is possible in constructing a breast with a natural-looking shape and appearance. Even with these advances, reconstruction surgery should be approached with an understanding that the new breast will not look or feel exactly like a natural breast.

Process
Each patient’s medical situation, surgery goals and breast size/shape influence the unique approach taken by the plastic surgeon in the course of breast reconstruction. Often reconstruction involves two or more procedures over time. The Tissue Expander/Implant Reconstruction involves two procedures, where the plastic surgeon places a balloon-like tissue expander under the chest tissue that creates an implant pocket over 4 to 6 months. In the second stage, an implant takes the place of the expander. In the TRAM Flap Reconstruction, a segment of tissue from the abdomen is removed and used to create a breast. This tissue can either remain attached to the underlying muscle (rotation flap) or can be detached and reconnected up on the chest (free flap). Implants are rarely involved. The Latissimus Flap Reconstruction is similar, but the segment of tissue comes from the back. Because this skin is thinner, an implant is often placed under the flap to provide more volume and shape to the breast. Nipple/areola reconstruction is usually performed as a separate procedure.

Immediate or Delayed Reconstruction Following Mastectomy
Breast reconstruction can be performed at the time of a mastectomy—the surgical removal of a breast—or later, meaning weeks, months or years. Careful discussions with the surgeon for the mastectomy and the plastic surgeon should come before a final decision on reconstruction timing.

In immediate reconstruction, the plastic surgeon is in the operating room and begins as soon as the surgeon performing the mastectomy finishes. It is sometimes possible that the incision locations and method of mastectomy—skin-sparing mastectomy, for example—can be made favorable to reconstruction, but these chioces vary with the circumstances present in each patient’s case. Usually, immediate reconstruction produces superior results with fewer surgical procedures, and carries the benefit of some relief for the emotions associated with a changed body image. An elevated complication risk and lengthened recovery from the surgeries should be weighed in deciding on this option.

Delayed reconstruction allows more time following mastectomy for considering the surgical approach to reconstruction. In cases involving radiation or chemotherapy, the time interval allows for these treatments.

Often Asked
Q. Where will my surgery be performed?
A. If the reconstruction procedure immediately follows the mastectomy, it will likely be performed in a hospital. If performed later, the procedure could be performed in the private surgery suite at Calobrace Cosmetic Breast Center. Our fully equipped, state-of-the-art operating rooms were designed and built especially for plastic surgery procedures, and for use only by Calobrace plastic surgeons and our highly experienced surgical team.

Q. What will my recovery period be?
A. Because of the unique circumstances presented by each patient and because of the number of options involved, it is difficult to generalize about recovery time periods and instructions following breast reconstruction. Please feel that you can contact us and discuss your situation and, with that information, we can provide an overview of what can be done and what to expect.

Q. How will reconstruction surgery affect my prognosis?
A. Information published by the American Society of Plastic Surgeons says that reconstruction procedures have “no known effect on the recurrence of disease in the breast, nor does it generally interfere with chemotherapy or radiation treatment, should cancer recur.” The ASPS suggests continuation of periodic mammograms on both the reconstruction and the natural breast. If the reconstructed breast involves an implant, be certain to verify that the personnel/facility has the experience and equipment to reliably accomplish the mammogram.

Q. Will health insurance pay for breast reconstruction surgery?
A. In many cases this procedure may be covered by insurance. Although Dr. Calobrace does not participate directly with any insurance company, Dr. Mizuguchi participates with Anthem and Humana providers. If you are covered by one of these companies, you will be responsible for your co-pay for the consultation visit, for any deductible you have with your insurance coverage, and for the percentage of your procedure that your insurance does not cover. If you are covered by any other insurance provider, we will be happy to file documents with your insurance company to help aid in reimbursement should you qualify, but you will be responsible for the full fees of your procedure. Please contact us for more information regarding insurance and your procedure at Cosmetic Breast Center.