Breast Reconstruction

Background

Breast reconstruction after breast cancer surgery has changed dramatically over the past several years. More options are now available to women to give them the natural looking breasts they desire and deserve. Dr. Sayah has performed extensive research in the field of breast reconstruction as evident by his curriculum vitae on this website. Thanks to effective legislature, breast reconstruction after cancer is a right and not a privilege. In this manner, all insurance companies must cover breast reconstruction.

Options for breast reconstruction naturally depend on the type of deformity that is present after breast cancer surgery. In those who have had a small portion of their breast removed and no radiation therapy, a breast implant can be an excellent option. If the opposite normal breast is too large, another option is to make the larger breast smaller to match the affected breast. Radiation therapy makes matters a bit more complicated: breast implants have a much higher chance of becoming hard if you have had radiation. Better options in such cases would be a breast lift on the opposite breast, or if the deformity on the affected breast is large, Dr. Sayah can reconstruct your breast with your own tissue. There are several options when it comes to using your own tissue for breast reconstruction. These include your latissimus dorsi muscle (on your back) or your tummy tissue which would be obtained from a tummy-tuck (TRAM flap). In the second case, Dr. Sayah would peform a tummy-tuck on you, and then use the excess skin and fat that was removed to reconstruct your own breast. This type of surgery under the microscope is the most cutting-edge approach to breast reconstruction.

In those who have had the entire breast removed for cancer, reconstructive options would include breast implants or using their own tissue as described above. Dr. Sayah will spend as much time as it takes to describe the options to you in detail until you have made your choice of techniques. There is far too much information to discuss on this important topic, and you are encouraged to schedule a consultation with Dr. Sayah so your particular case and preferences can be discussed in detail.

Procedure

During your consultation and the pre-surgical visits, Dr. Sayah will help you decide which is your best surgical option. If you are having breast implants, they are typically inserted through the already existing scar from your prior surgery. If necessary, breast lifts on the opposite normal breast are typically performed with a short scar technique. This will accomplish symmetry between the affected breast and its opposite normal breast.

Your own tissue can be derived from your back, tummy, thighs, or buttocks. Each “donor site” has its own benefits and disadvantages which would have to be discussed. The most common by far are tissue from your back or your tummy. When using tissue form the back (latissimus dorsi muscle) the muscle and its overlying skin and fat are carefully separated from the back and rotated to the chest to reconstruct the affected breast. When using tissue from your tummy (TRAM flap), a tummy-tuck is essentially performed and the excess skin and fat is rotated to the chest to reconstruct the breast.

After the Procedure

You can enjoy regular food after your surgery, but start slow. You should be pain-free until the day after your surgery. If you experience some discomfort, prescription pain medication will be available to you. You should walk around the house with some assistance. Dr. Sayah will see you in the office the day following your surgery. You are asked to take your prophylactic antibiotics and other medications as necessary. We expect that you walk around the house every day, slowly increasing your level of activity daily. Our staff will be in regular contact with you every day to assure that your recovery is a smooth and comfortable one. Your sutures will be removed in 5-7 days. The swelling will decrease every week, such that by 6-8 weeks, about 80% of the swelling will have dissipated. It will take 6 months for your breasts to mature from the surgery and for the final results to be evident. Other reconstructive options at this point would include nipple and areola reconstruction, nipple and areola tattoo, and fine tuning of the breasts to make them look as natural and symmetrical as possible.