At PIH Health, women who require surgery for breast cancer and who are candidates for breast reconstruction have options. Our goal is to perform the best breast reconstruction with the fewest operations and materials needed to achieve your desired outcome.
Team Approach to Breast Surgery & Reconstruction
The breast specialists at the Plastic Surgery & Aesthetic Medicine Center and the Patricia L. Scheifly Breast Health Center work together to provide comprehensive care to breast cancer patients. The breast surgery team includes breast cancer surgeons, oncologists, radiologists and plastic surgeons. Breast reconstruction can begin at the same time as breast cancer surgery or at a later date. It can be performed while other breast cancer treatments, such as chemotherapy and radiation, are in progress.
Breast Reconstruction Process & Options
Breast reconstruction with tissue expansion is either a one-stage or two-stage process. The two-stage process involves the use of a tissue expander that is inserted beneath the skin and, sometimes, beneath the chest muscle. Saline is gradually injected into the tissue expander to fill it over a period of weeks or months. This process allows the skin on the chest to be stretched over the expander, creating a breast mound. In most cases, once the skin has been stretched enough, the expander is surgically removed and replaced with a permanent breast implant. When the one-stage process is used, a permanent implant is placed at the time of the mastectomy. The technique used depends on the patient’s history, anatomy, goals and desires.
The shape and size of your breasts before surgery will influence both the recommended placement of the tissue expander and the final shape of your reconstructed breast. Tissue expander breast reconstruction cannot produce an exact replica of the removed breast. Breast symmetry surgery on the opposite breast may be needed to produce similar size. Depending on the diagnosis, patients may also have the option to choose a mastectomy surgery that spares the patient’s nipple, areola and/or skin.
PIH Health offers post-operative adjustable implants, which allows us to perform breast reconstruction in one trip to the operating room. These implants have a remote port that can be removed once an aesthetic reconstruction is achieved. PIH Health physicians can use a procedure known as “Autoderm” which allows us to use excess skin for patients with larger breasts sizes (C-cup and larger) for coverage of the implant. This procedure eliminates the need for a commercially available skin graft and may allow us to spare chest wall muscles, decreasing pain and discomfort with breast reconstruction.
We also offer a wide variety of reconstructive options for patients who have never had a breast reconstruction or who are unhappy with their results. Options range from fat grafting—where fat is removed from unwanted areas and placed in the breast—to muscle flaps for more complex problems due to infection or radiation.
Nipple reconstruction is an optional procedure patients may consider after breast reconstruction surgery. Typically, patients will need to wait three to four months after the final implant is placed to allow for healing. Various techniques are available, including reconstruction of the nipple and reconstruction of the nipple and the areola.
All of the procedures are performed at PIH Health Hospital. Some surgeries do not require an inpatient stay.
To learn more about breast reconstruction services available at PIH Health, call 562.789.5439.