Breast reconstruction surgery is performed on women who have lost one or both breasts to mastectomy, and sometimes those who have undergone lumpectomy. The goal of surgery is to rebuild the breasts, improving their size, shape, and appearance through the use of advanced plastic surgery techniques. However, patients who choose to undergo the procedure should be aware that surgical techniques are not capable of producing breasts that retain the exact same look and sensation as the natural breasts. The procedure can restore a patient’s feminine contours by rebuilding the breast mound and reconstructing the nipples and areolas. For most patients, breast reconstruction can be physically and emotionally rewarding, restoring a woman’s self image and quality of life.
Dr. John R. Griffin is a Bay Area plastic surgeon who has a particular passion for and expertise in breast reconstruction surgery. He is here to help guide the patient, and collaborate with the patient’s breast surgeon and oncologist, to determine the most appropriate treatment plan. Dr. Griffin understands that breast reconstruction is a highly individualized procedure. The timing of surgery and specific techniques depend upon the patient’s prognosis, healing rate, and cancer treatment plan. Dr. Griffin will tailor the reconstruction surgery specifically to the patient’s needs to ensure that her health is not compromised, and that the best reconstruction outcome can be achieved.
Breast Reconstruction Statistics
According to the 2013 plastic surgery statistics provided by the American Society of Plastic Surgeons, 95,589 women underwent breast reconstruction surgery that year, up 4 percent from the previous year. The majority of these patients underwent reconstruction with implants. In addition, almost 20,000 flap procedures were performed:
- Saline implants: 6,766
- Silicone implants: 69,312
- Implant alone: 7,471
- Tissue expander and implant: 68,607
- TRAM flap: 5,098
- DIEP flap: 7,220
- Latissimus Dorsi flap: 6,255
- Other flap: 938
The ASPS report also includes the age breakdown of women who underwent breast reconstruction surgery:
- 13-19: 521
- 20-29: 2,536
- 30-39: 11,607
- 40-54: 48,928
- 55 and over: 31,997
Breast Reconstruction after Single vs. Double Mastectomy
The breast reconstruction approach will differ in patients who undergo a single versus a double mastectomy. In patients who have undergone a single mastectomy, the goal is to rebuild the breast that has been lost to cancer treatment, and achieve symmetry between both breasts. In this case, one breast will be reconstructed using implant or micro-surgical flap techniques. Breast augmentation, lift, or reduction techniques may be recommended for the other breast to address any asymmetry problems.
Patients who undergo a double mastectomy will have reconstructive surgery on both breasts. In these cases, Dr. Griffin will rebuild both breasts, keeping the principles of symmetry and the patient’s desired outcome in mind.
Delayed vs. Immediate Breast Reconstruction
The decision to undergo immediate as opposed to delayed breast reconstruction will depend on the patient’s medical condition, stage of breast cancer, whether additional treatment such as radiation is being performed, and the patient’s personal preferences. With immediate breast reconstruction, the initial stage of reconstructive surgery is performed at the same time as mastectomy. In delayed procedures, the patient undergoes reconstruction surgery after the oncologist confirms that all signs of cancer are gone, and after any additional cancer therapy is performed.
Breast Reconstruction Techniques
There are a number of breast reconstruction techniques that can be performed, including:
- Breast implants: Saline or silicone implants can be placed to increase the size and shape of the breasts.
- Tissue expander: Patients who undergo mastectomy may need a tissue expander placed in the breasts to stretch out the skin so it can accommodate a breast implant.
- Allografts: Allografts are a dermal matrix that can be placed with an implant during immediate breast reconstruction surgery or an expander. The AlloDerm dermal matrix supports the breast implant so the skin envelope can withstand its weight.
- Fat grafting: The fat grafting procedure can be performed to add volume and shape to the breasts. To achieve the fullness that patients desire, several rounds of the fat grafting procedure may be needed.
- DIEP: Dr. Griffin is highly skilled in the DIEP flap breast reconstruction technique. In this approach, skin, fat, and blood vessels of the lower abdomen are transferred to the breast mound. Using microsurgical techniques, the blood vessels are attached the blood vessels in the chest, and the fat and skin are shaped to re-create the breast mound.
- Nipple and areola reconstruction: Patients who were not able to undergo nipple-sparing mastectomy can undergo reconstruction of the nipple and areola. Tattooing is a non-surgical option to recreate the areola. Other reconstruction options include the use a flap of skin or skin graft to re-create the nipple and areola.
To schedule a breast reconstruction consultation with Dr. Griffin, contact his practice today.