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Breast Reconstruction Surgery

Mastectomies are life-saving surgeries designed to remove breast cancer. While effective, these surgeries often leave women feeling incomplete. Houston plastic surgeon Dr. Leo Lapuerta is a breast reconstruction specialist who works with cancer patients in the greater Houston, Pearland, and Katy, Texas, areas to help them regain their self-confidence following a mastectomy.

His goal is to surgically rebuild the breasts to restore their original appearance by creating a natural shape and contour, while at the same time ensuring they are symmetrical. Dr. Lapuerta will work with the cancer surgeon toward a mutual goal to achieve the best surgical outcome.

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Fat Grafting Breast Reconstruction

One technique for breast reconstruction is fat grafting. The surgeon takes fat tissue from the abdominal area and recreates the breast by inserting it under the skin in the chest area. This type of surgery is often done in place of using breast implants for a more natural feel and look. Fat is chosen from the abdomen because it feels most like the tissue in the breasts.

 

When is Breast Reconstruction Surgery Necessary?

Breast reconstruction surgery is important if a woman has lost one or both of her breasts to a mastectomy. This procedure can help you have more self-confidence, especially when wearing a swimsuit or other revealing clothing.

Reconstruction can help with certain activities, such as swimming where you may feel more comfortable with two full breasts. It also provides you with a feeling that you’re whole once again after dealing with breast cancer.

Delaying Breast Reconstruction

Your doctor may recommend delaying breast reconstruction after a mastectomy if you will be undergoing radiation. The flap or tissue that the surgeon will use during the restoration process can be adversely affected by radiation. Once all treatments have been completed, they can discuss reconstruction with you.

You may wonder, “How painful is delayed breast reconstruction?” Fortunately, the surgery can be done at any time, even years later after a mastectomy. Delaying reconstruction does allow the initial surgery to heal and for you to complete any additional treatments. To learn more about Houston breast reconstruction, you can discuss your options in a consultation with Dr. Lapuerta.

Breast Reconstruction After Mastectomy

When a breast cancer patient undergoes a mastectomy, a surgeon will remove the woman’s entire breast tissue to eradicate cancer or prevent its further spread. This can involve the removal of one or both breasts, depending on the treatment plan.

Mastectomy surgeries can be an effective treatment for patients with breast cancer as well as a preventative treatment for those at risk of developing it. A concern that many patients face with this surgery, however, is the end result of removing breast tissue — a flat chest without the appearance of breasts.

Breast reconstruction surgery after a mastectomy is a procedure that involves rebuilding and reshaping the breasts. Surgeons can provide a patient with the option to reconstruct their breasts with implants or with tissue from other parts of their body.

To understand your options and determine if breast reconstruction surgery after a mastectomy is right for you, schedule a consultation with Dr. Lapuerta.

What to Consider Before Breast Reconstruction Surgery

There are several steps and considerations patients should plan for when exploring breast reconstruction surgery.

To start, patients should come to their first consultation regarding breast reconstruction after cancer prepared to discuss where they are in the treatment process and which cancer surgeon provided treatment. Our office will require patients to provide any necessary pathology reports.

Additionally, patients should consider that the reconstruction process may take place in multiple steps if the breast tissue needs to be stretched to make room for implants. This discovery phase will help guide the reconstruction process so patients end up with a new breast that is the size, shape, and look they want.

Breast Reconstruction Surgery Techniques

Dr. Lapuerta tailors the reconstruction technique according to each patient’s physical health, aesthetic goals, and personal preferences. His ultimate goal is to ensure the patient is healthy and happy with their final breast results. Many factors play into the approach that he takes with each breast reconstruction surgery.

There are two primary categories of breast reconstruction techniques:

Procedures that involve using a breast implant and procedures that are autologous, which use the patient’s own body’s tissue to reconstruct and recreate the breast.

Reconstruction with Implants

Breast reconstruction using silicone or saline implants is a common approach that generally starts with the use of a tissue expander to help form a suitable pocket for an implant. The surgeon may insert an expander after the mastectomy procedure or during the same operative session. Over the course of several months, the expander will slowly be enlarged using a sterile solution injected through a port residing under the skin. Then, during the scheduled reconstruction surgery, the surgeon will remove the expanders and replace them with silicone or saline implants.

Autologous Reconstruction

If there is limited tissue inside the breast or limited skin on the outside, the surgeon may recommend using tissue from another part of the patient’s body such as the buttocks, thigh, or abdomen to supplement. This is an autologous approach to breast reconstruction. The TRAM flap (Transverse Rectus Abdominus Myocutaneous), the DIEP flap, and SIEA flap techniques involve taking skin and fat from the abdomen and relocating it to the breast. The latissimus dorsi flap is another common method using tissue from the patient’s back.

Additionally, nipple and areola restoration techniques are often required as part of a breast reconstruction process if the surgeon performing the mastectomy cannot save the nipple and areola. The loss of one’s nipple and areola can be as unnerving as the removal of the breast itself.

However, reconstruction techniques have advanced greatly, allowing plastic surgeons the opportunity to recreate these areas of the breast to give a natural, aesthetically appealing appearance. In a separate procedure, the surgeon creates the nipple using existing breast skin or from the abdominal or back muscle flap.

Using a tattoo technique, the surgeon recreates the areola with a skin graft taken from the thigh, abdomen, or back.

What to Expect During Breast Reconstruction Surgery

Before undergoing the actual procedure, the patient will first meet with Dr. Lapuerta to discuss breast reconstruction surgery options. Once they have decided on a treatment plan, the patient attends a pre-operative appointment to further discuss expectations and preparations, before scheduling the surgery.

On the day of the procedure, Dr. Lapuerta will perform the breast reconstruction surgery under general anesthesia at an accredited surgical facility. Preparation for the procedure can take roughly two hours, while the procedure itself may take up to six hours, depending on which technique the surgeon uses.

What to Expect After Breast Reconstruction Surgery

After surgery, some patients may be required to stay in the hospital to be monitored for complications. Patients who have had reconstruction using a flap technique will usually be required to stay in the hospital for two to five days.

Once Dr. Lapuerta clears the patient to go home, he will provide follow-up instructions and require the patient to attend several post-op appointments. During these appointments, he will assess the patient’s healing, update the treatment plan if necessary, and address any questions and concerns. Patients are sometimes recommended to wear a support bra that encourages healing and reduces swelling.

Breast Reconstruction Recovery

The recovery process can be somewhat lengthy, but many view it as the final step in their cancer journey and, thus, very rewarding.

It is important for patients to have realistic expectations of their “after.” While the surgeon will do his best to reconstruct and reshape the patient’s breasts, they may not look or feel exactly how they once did in their natural state. Most women are thankful to have had the opportunity to restore their breasts and are satisfied with their results.

Recovery itself will include immediate swelling, bruising, and soreness following surgery, It can take at least two months until the patient can comfortably return to normal activities. They may also experience limited mobility and restricted movements until they fully heal. The surgeon will likely prescribe pain medications to help ease the pain.

Breast Reconstruction Surgery Cost

The Women’s Health and Cancer Rights Act of 1997 has made it possible for many women to undergo breast reconstruction surgery without the burden of a heavy financial cost. The act states that insurance companies and managed care organizations are required to pay for breast reconstruction for women who have had a mastectomy. It supports all phases of the cancer treatment and reconstruction process. Dr. Lapuerta’s insurance and billing office will work with the provider to understand exactly what the coverage will be.

For those interested in learning more about breast reconstruction surgery options, schedule a consultation with Dr.Lapuerta. Having performed more than 20,000 surgical procedures, Dr. Lapuerta has over two decades of professional experience. He will discuss your health, concerns, and goals to help you decide if undergoing breast reconstruction surgery after cancer is an option for you.

How to Choose the Right Breast Reconstruction Surgeon

To find the best breast reconstruction surgeons, you’ll want to look for someone with experience in this type of surgery. Even if they have worked with other breast procedures, you want a surgeon who has performed many reconstructive surgeries. Ask for before and after photos where you can see how the reconstructed breast looks.

Once you have selected a surgeon, you’ll want to schedule a consultation. Don’t be afraid to ask questions about your options for breast reconstruction and recovery.

 

Call Us Today For a Consultation

Having performed more than 20,000 surgical procedures, Dr. Lapuerta has over two decades of professional experience for breast reconstruction in Houston. He has performed hundreds of procedures involving the breasts, such asbreast augmentation andbreast lift. Dr. Lapuerta is also experienced in handling issues that arise from breast surgery, includingbreast implant revision andcapsular contracture treatment. He will discuss your health, concerns, and goals to help you decide if undergoing breast reconstruction surgery after cancer is an option for you.

CTA: For those interested in learning more about breast reconstruction surgery options, schedule a Consultation with Dr. Lapuerta.

PLAN YOUR PROCEDURE

  • Recovery Time
  • 1-3 Weeks
  • Average Procedure Time
  • 2-6 Hours
  • Post-op Follow-up
  • 1 Week
  • Procedure Recovery Location
  • In & Outpatient

BREAST RECONSTRUCTION FAQS

HOW DO I FIND A QUALIFIED SURGEON?
This is a very specialized surgery that requires extensive knowledge, skill, and experience. It is very important to research and find a qualified and reputable plastic surgeon who has experience with breast reconstruction surgery. You can ask to see before and after photos to help you feel more confident about the surgeon’s experience and skill, read reviews online, and ask your primary healthcare provider to make a recommendation in their community.
CAN I DELAY THIS SURGERY?
In many situations, it is recommended to start the reconstruction process at the same time as the mastectomy. Therefore, it is a good idea to have your breast cancer surgeon and your plastic surgeon begin communicating about the steps that will follow. An advantage of doing the procedure immediately is waking up from your mastectomy surgery with the reconstruction process in place. The soft tissue that surrounds the breast will heal simultaneously with the reconstruction, which can enhance the final results. In some situations, it may be advisable to delay the reconstruction. If your oncologist recommends radiation, the reconstruction surgery should wait. Radiation can affect the breast flap that will be used in the surgery. You can also choose to delay the surgery if you want to focus on recovering from the mastectomy first.
BREAST SENSATION?
A reconstructed breast will not have the same sensation as the breast did before the mastectomy. However, over time, some of this sensation will return to normal. This will depend on the extent of the reconstruction process and will vary by patient. It may also depend on the type of reconstruction you have done. Skin and nipple sparing mastectomies focus on leaving as much of the breast skin and nipple area intact as possible, which will preserve much of the sensation. Your cancer doctor will help you determine which type of mastectomy is right to ensure all of the cancer cells are removed while doing the least damage to your breast area.
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