Breast Reconstruction

If you are considering breast reconstruction, Dr. Jeremy Pyle looks forward to helping you make good choices for your long-term health and happiness. Techniques to reconstruct the breast after breast cancer surgery have advanced significantly in recent years, and even if you had a mastectomy years ago, it may be worth looking again at your reconstruction options. Women now have more options for natural-looking breasts following a cancer diagnosis, and thanks to Federal law, the cost of breast reconstruction is covered by all health insurance plans.

Dr. Pyle is a breast surgery specialist who remains on the leading edge of breast reconstruction techniques and technologies, performing both initial and delayed procedures for cosmetic improvement. The team at Davis & Pyle Plastic Surgery in Raleigh, NC looks forward to meeting with you and tailoring your reconstruction experience.

Please Request a Consultation to learn more about breast reconstruction. Dr. Pyle performs breast reconstruction procedures with a focus on achieving natural-looking results that fit your goals.

What to Expect

Breast reconstruction can be a daunting process. Dr. Pyle and the Davis & Pyle Plastic Surgery staff are here to help you throughout, to help you understand what to expect, and to put you at ease. The goal at the end of this process is to help you feel comfortable in your body. For much of the history of breast reconstruction, the goal has been to make a woman look relatively even in clothes, but today it is very reasonable for a woman to expect more from her results.

Breast cancer treatment may involve mastectomy, or removal of the breast. This oftentimes includes the nipple and some of the skin around the nipple. It is possible to preserve the nipple in some cases and we can talk about if that is possible for you. Ultimately, that decision is made between you and Dr. Pyle. A mastectomy results in a scar in the center of the breast. That one scar is oftentimes the only incision required for all of your breast surgery, including all of your reconstruction. This scar is changed and altered to fit your body and your specific situation and Dr. Pyle can talk about how to make it best for you.

Some women benefit from the addition of chemotherapy or radiation therapy as part of their breast cancer treatment. These can be incredibly important in preventing recurrence or spread of breast cancer. Radiation does make reconstruction more challenging, however, and we may want to change our plans should radiation be necessary. Chemotherapy, by itself, may change the timetable a little bit but does not change your options or significantly change the appearance of the breast reconstruction in most cases.

Reconstruction Options

There are three basic ways to reconstruct a breast: breast implants, your own tissue, or a combination of the two. You will have a great deal of input into which technique is used, but there are reasons that one or the other is usually selected and we will talk about them in detail during your consultation.

  1. Implant Reconstruction: This is the most common choice in America by a large margin. This technique involves two separate operations. The first occurs, in most cases, at the time of your mastectomy. While you are still asleep, and as soon as the breast surgeon is complete, a tissue expander is placed in the breast. The tissue expander will be gradually filled up over the course of a month or two with saline fluid. The process of expansion makes room for a more permanent implant. At a second operation, about 4 to 6 months after the first, the tissue expander is removed and replaced with a breast implant. At this time, liposuction, fat grafting, or the use of a tissue matrix such as Strattice™ or Alloderm® can help shape the chest for a more natural look. We have an array of implants to choose from, and you can choose how large and what shape implants you desire, for example. After the second operation we can be done if you so choose. Some women also want to have a reconstructed nipple. The nipple reconstruction can be performed using just local anesthesia or it can present an opportunity to go back to the OR to refine other aspects of the surgical result. Again, you are to a large degree in control of this decision.
  2. Your Own Tissue Reconstruction: This is also called autologous reconstruction. The most common autologous way to build a breast is using your own abdominal tissue. This operation, called a TRAM flap, is sometimes mistakenly considered a tummy tuck. There are two important distinctions between the two operations. First, a tummy tuck only removes skin and fat, while breast reconstruction using the abdominal tissue uses the skin, fat and six-pack muscle. Because this muscle is important, a woman who is going to have bilateral mastectomy is advised against this kind of reconstruction. Secondly, the other important difference is that the TRAM flap incision is a good bit higher on the abdomen than a tummy tuck incision.
  3. A Combination of the Above: A third way to reconstruct a breast is with the back tissue called a Latissimus flap. This uses skin, fat and a muscle from your back to reconstruct a breast. Because there is not usually enough tissue with this method to make an appropriately sized breast, the Latissimus flap is usually combined with a tissue expander. The expander is removed at a second operation and replaced with a breast implant as in the first type of reconstruction.

Each of these options has a place in reconstruction but not all are suitable for all people. The decision you make to undergo one of the above types of reconstruction is important. You can of course also choose not have reconstruction right after a mastectomy and instead re-evaluate whether or not you want reconstruction in the future.

After Your Procedure

Soon after surgery, you will be encouraged to walk around (with assistance) to ensure proper blood flow. Prescription pain medication is available to make your recovery as comfortable as possible. Our team will be in regular contact with you every day to check that your recovery is going smoothly. Sutures are typically removed after about a week and most post-surgical swelling should subside about 6 to 8 weeks after the procedure.

Your healing process will depend on which reconstruction technique is being performed and many other factors. We will be sure to give you the information you need to plan for your recovery and know exactly what you can expect.

The New You

After a breast cancer diagnosis and being told they will need a mastectomy, many women feel that breast reconstruction is a central component in them feeling “whole” again. Our goal with breast reconstruction is to provide you with a supportive environment where you can make good decisions about your breasts and your body.

Davis & Pyle Plastic Surgery in Raleigh welcomes local patients as well as those from all over North Carolina, including Durham, Chapel Hill, Wake Forest, Fayetteville, Cary, Apex and Wilson. For more information about your breast reconstruction options, please don’t hesitate to Request a Consultation, or call us today at 919-785-1220.

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