Breast Reconstruction in Sarasota

After a woman has had a mastectomy, the appearance of her breasts can have a very serious effect on her self-confidence and how she feels about her own femininity. The decision to undergo breast reconstruction surgery to rebuild the breast(s) after a mastectomy is a personal choice that will depend on each specific woman, and if you are in Sarasota and decide that a breast reconstruction procedure is right for you, we are here to help

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Key benefits of breast reconstruction

Emotionally rewarding
Helps many women feel like themselves again
Regained self-esteem and confidence
May help intimacy feel more comfortable
Clothing may fit more naturally
Helps many women move past the disease
High rate of patient satisfaction

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Breast reconstruction

After a mastectomy, many women find that their familiar clothing does not fit the same, swimwear shows off the deformity of the chest, and intimate relationships become uncomfortable. Some women find that they just don’t feel like themselves anymore. This is why breast reconstruction is so important.

Advances in surgical techniques now deliver natural, organic-looking breasts that feel soft and appear proportionate to a woman’s unique body. After the procedure, many women are able to once again take up their active lifestyle and feel good about themselves.

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When is Breast Reconstruction Done?

Breast reconstruction can be performed either during or very soon after the mastectomy. This is known as “immediate reconstruction”. Breast reconstruction can also be performed months or years after the mastectomy, and this is known as “delayed reconstruction”. Those who choose delayed reconstruction often do so in order to have more time to decide what they want to do. Many women aren’t comfortable weighing all the options while they’re struggling to cope with a diagnosis of cancer. Others simply don’t want to have any more surgery than is absolutely necessary at one time.

Furthermore, some patients may be advised by their surgeons to wait — particularly if the breast is being re-built in a more complicated procedure using flaps of skin and underlying tissue. In addition, women with other health conditions such as obesity, high blood pressure, or smoking may also be advised to wait. Women who postpone breast reconstruction may go through a period of emotional readjustment. Just as it took time to get used to the loss of a breast, a woman may feel anxious and confused as she begins to think of the reconstructed breast as her own. It’s important for every woman to go at her own pace when it comes to breast reconstruction.

Can I Have Breast Reconstruction if I Need Chemotherapy or Radiation Treatment?

Patients who require chemotherapy treatment after a mastectomy can still have breast reconstruction. However, the surgery date may need to change, depending on your chemotherapy treatment schedule. Your oncologist and plastic surgeon will decide in what’s best for you. If you’re having chemotherapy, it may also take longer for you to heal from incisions. Regarding radiation treatment, women who have implants are at higher risk for complications such as capsular contracture and implant loss, so this will need to be discussed during your consultation.

Planning your surgery

Patients can begin talking about breast reconstruction as soon as they are diagnosed with cancer. Ideally, you’ll want your general surgeon and Dr. Kreithen to work together to develop a strategy that will put you in the best possible condition for reconstruction. After evaluating your health, Dr. Kreithen will explain which reconstructive options are most appropriate for your age, health, anatomy, tissues, and goals.

Be sure to discuss your own personal expectations as well. Dr. Kreithen will describe your options and the risks and limitations of each. Post-mastectomy reconstruction can greatly improve your appearance and renew your self-confidence, but keep in mind that the outcome will be improvement — not perfection.

Your Consultation

Before deciding on a breast reconstruction, our surgeons at Holcomb - Kreithen Plastic Surgery will have a one-on-one consultation with you. Your medical history will be reviewed, a brief physical exam will be performed, and your aesthetic goals will be discussed. Other things will also be taken into consideration, such as if you will be having additional therapy. This consultation will be your initial opportunity to voice any questions or concerns about the surgery, home care, recovery, and follow-up appointments.

Preparing for your surgery

Your oncologist and Dr. Kreithen will give you specific instructions on how to prepare for surgery, including guidelines on eating, drinking, smoking, and taking or avoiding certain vitamins and medications. While making your preparations, be sure to arrange for someone to drive you home after your surgery and to help you out for a few days.

Breast Reconstruction Surgical Details

There are many options available for breast reconstruction. During your consultation, the right procedure for you will be determined. Breast reconstruction is performed as an outpatient surgery. A one- or two-night hospital stay is normally necessary. The exact length of surgery time will depend on the technique used in the surgery. Some reconstruction methods include:

Skin Expansion

Following a mastectomy, the surgeon will insert a balloon expander beneath the skin and chest muscle. Through a very small valve buried underneath the skin, a small amount of saltwater will be periodically injected into the breast. Over 1 to 6 weeks, this process will gradually expand the skin and tissue of the breast. Once the tissue has stretched to the desired amount, the expander will be removed. At that point, another surgical procedure will be used to place a breast implant. The areola and nipple can also be re-created and surgically positioned on the breast(s).

Flap Reconstruction

This method of breast reconstruction utilizes a skin flap formed with skin from another area of the body, such as the back or abdomen. The flap is extracted and placed in position on the chest. Then meticulously, the vessels are attached to those in the existing tissues. Another option allows the flap to remain attached at its original site, retaining its own blood supply. It will be slowly tunneled to the breast area, beneath the skin. Once in place, a pocket is created for an implant, or a breast mound is created from the relocated tissue.

What Risks Come With Breast Reconstruction?

In general, the typical problems of surgery such as bleeding, fluid collection, excessive scar tissue, or difficulties with anesthesia can occur — although they are relatively uncommon. And as with any surgery, smokers should be advised that nicotine can delay healing, resulting in conspicuous scars and prolonged recovery. Occasionally, these complications are severe enough to require a second operation. If an implant is used, there is a remote possibility that an infection will develop (usually within the first two weeks following surgery).

In some of these cases, the implant may need to be removed for several months until the infection clears. If this is the case, a new implant can later be inserted. The most common problem, capsular contracture, occurs if the scar or capsule around the implant begins to tighten. This squeezing of the soft implant can cause the breast to feel hard. Capsular contracture can be treated in several ways, and sometimes requires either removal or “scoring” of the scar tissue, or perhaps removal or replacement of the implant.

Reconstruction has no known effect on the recurrence of disease in the breast, nor does it generally interfere with chemotherapy or radiation treatment, should cancer recur. Your surgeon may recommend continuation of periodic mammograms on both the reconstructed and the remaining normal breast. If your reconstruction involves an implant, be sure to go to a radiology center where technicians are experienced in the special techniques required to get a reliable x-ray of a breast reconstructed with an implant.

Recovery

Patients should be aware that the breast reconstruction process does result in scarring — both at the breast and on the donor skin area (if used). However, any scars typically go unnoticed because of the dramatically improved breast shape and contour. You’re likely to feel tired and sore for a week or two after reconstruction. Most of your discomfort will be able to be controlled by medication. Depending on the extent of your surgery, you will be released from our care in 2 to 5 days. Surgical drains may be placed to control the buildup of fluids and blood, but these will be removed after the first week or two. Sutures will be removed after 7 to 10 days. Patients will generally feel well enough to return to work in about two weeks.

Follow-up Procedures

Most breast reconstruction involves a series of procedures. Usually, the initial reconstructive operation is the most complex. Follow-up surgery may be required to replace a tissue expander with an implant, or to reconstruct the nipple and the areola.

Many surgeons recommend an additional operation to enlarge, reduce, or lift the natural breast to match the reconstructed breast. But keep in mind that this procedure may leave scars on an otherwise normal breast and may not be covered by insurance.

Getting Back to Normal

It may take you up to six weeks to recover from a combined mastectomy and reconstruction, or from a flap reconstruction alone. If implants are used without flaps and reconstruction is done apart from the mastectomy, your recovery time may be less.

Breast reconstruction cannot restore normal sensation to your breast, but in time some feeling may return. Most scars will fade substantially over time, though it may take as long as 1 to 2 years. It’s important for patients to understand that the scars will never disappear entirely.

Be sure to follow Dr. Kreithen’s advice on when to begin stretching exercises and normal activities. As a general rule, you’ll want to refrain from any overhead lifting, strenuous sports, and sexual activity for 3 to 6 weeks following reconstruction.

Results

Your reconstructed breast may feel firmer and appear rounder or flatter than your natural breast. It may not have the same contour as your previous breast, nor will it exactly match your opposite breast — however, these differences will be apparent only to you. For most mastectomy patients, breast reconstruction dramatically improves their appearance, emotional health, and self-esteem.

Experience matters

As one of the most talented cosmetic surgeons Sarasota is home to, Dr. Joshua Kreithen specializes in many advanced breast procedures. In fact, his dedication and attentive patient care have helped him become renowned as a leading breast augmentation and breast lift surgeon in Sarasota. In addition, he has helped many Sarasota breast reduction and male breast reduction patients enhance their body contours.

Breast reconstruction in Sarasota from Holcomb - Kreithen Plastic Surgery

Breast reconstruction is a delicate process. At Holcomb - Kreithen Plastic Surgery, we understand that our patients have been through a lot and are now ready to get on with their lives. We offer the gold standard of breast reconstruction procedures available today, and we are widely considered the top cosmetic and plastic surgeons in Florida. As a board-certified plastic surgeon and a specialist in the area of breast procedures, Dr. Joshua Kreithen has the credentials, the experience, the skills, and the artistry to carry out safe breast reconstructive surgeries that achieve beautiful, natural-looking, life-changing results. If you’re in Sarasota and you’re considering a breast reconstruction, you will be in excellent hands with us. We have privileges at local hospitals to accommodate patients needing general anesthesia and/or overnight stays, and we also have a state-of-the-art, AAAASF-certified outpatient surgical facility in Sarasota.

Breast ReconstructionFrequently Asked Questions

Where will my breast reconstruction be performed?

Breast reconstruction usually involves more than one operation. The first stage — whether done at the same time as the mastectomy or later on — is usually performed in the hospital. The procedures will most likely be performed at our state-of-the-art AAAASF-certified outpatient surgical facility. Follow-up procedures may also be done in the hospital.

Does breast reconstruction make it more difficult to detect cancer?

Reconstructive surgery has not been shown to make it more difficult to detect if cancer recurs.

What if I’m unhappy with my breast reconstruction results?

It’s important for patients to understand that their breast(s) will not look exactly as before. However, if you are truly unsatisfied with the appearance, breast revision is an option once you have fully healed.

What type of anesthesia will be used?

The first stage of reconstruction — creation of the breast mound — is almost always performed using general anesthesia, so you’ll sleep through the entire operation. Follow-up procedures may require only a local anesthesia combined with a sedative to make you drowsy. You’ll be awake, but very relaxed.

Will I need surgery for my other breast?

We will try to create a new breast that matches your natural breast as best as possible. However, if you’re concerned about this, you should discuss the possibility of having surgery on your other breast to ensure the symmetry.

Who is a good candidate for breast reconstruction?

Most mastectomy patients are medically appropriate for breast reconstruction. The best candidates are women whose cancer, as far as can be determined, seems to have been eliminated by mastectomy. Those who should not undergo breast reconstruction are those who will require chemotherapy or radiation therapy; are substantially overweight; have medical conditions that may cause bleeding or infection, or are smokers.