For some breast cancer patients, mastectomy (removal of the breast) is a necessary part of treatment. Even though this procedure may save your life, it is still a very emotional and difficult decision. Understanding your surgical options for breast reconstruction can be empowering, and may help with the healing process.
For women who have had or who will undergo mastectomy, there are numerous surgical options for reconstructing the breast, and determining the right one requires the expertise of an experienced breast reconstruction surgeon. Dr. James Romanelli has over 18 years of experience specializing in breast surgery on Long Island. He understands the unique physical and emotional challenges that come with breast reconstruction, and he will work with you to select the best surgical method to achieve your desired results.
For help weighing your breast reconstruction options, click here to request a free surgical consultation with Dr. James Romanelli, board-certified plastic surgeon specializing in breast reconstruction on Long Island.
Immediate Reconstruction Procedures
Immediate reconstruction is breast reconstruction surgery that is performed at the time of mastectomy. One of the great advantages of this option is the preservation and utilization of much of the breast skin. Also, choosing one of these methods means you will awake from your surgery with either complete or partial breast volume, which can help to ease the trauma of mastectomy.
Direct to Implant Breast Reconstruction
The placement of a permanent breast implant at the time of mastectomy has become an increasingly viable option for many of Dr. Romanelli's Long Island breast reconstruction patients. "Direct to implant" breast reconstruction, allows the breast surgeon and Dr. Romanelli to conserve most of the breast skin, reduce recovery time, and possibly eliminate the need for future surgeries. By providing immediate restoration of breast volume, this procedure spares the patient the feeling of deformity that can accompany mastectomy. Patients have their choice of breast implants at our Long Island practice; either saline or silicone can be used, but most patients find that silicone implants provide a more natural look and feel.
Immediate Tissue Expansion
If too much skin has to be removed during mastectomy, the placement of a final implant may not be an option. In this case, a tissue expander - a device similar to a balloon - is placed under the pectoral muscle at the time of mastectomy. The tissue expander is filled with saline, and will provide some immediate volume. Over the next few months, Dr. Romanelli will inject the expander with more saline, causing it to gradually stretch the skin. After the tissue expansion process is complete, Dr. Romanelli will remove the tissue expander and replace it with the either a saline or silicone-gel filled implant in an outpatient procedure.
Autologous Tissue Reconstruction
The most complex reconstruction option involves using a patient's own tissue - from the back, the abdomen, or, rarely, the buttocks - to sculpt the new breast. In this case, a section of skin, muscle, fat, and blood vessels is removed from one area of the body and transferred to the chest to create a viable breast mound. This tissue is either left attached to its original blood vessels, or disconnected from them, and reattached to new blood vessels nearer the chest. Due to the intricate nature of this surgery, it requires a longer operating and recovery time. Perhaps the most popular of these "flap surgeries" is the Tummy Tuck or TRAM (transverse rectus abdominal muscle) flap breast reconstruction, which has the added benefit of flattening the lower abdomen.
Delayed Reconstruction
Not every woman chooses immediate reconstruction, either due to medical or personal reasons. Some women simply need time to heal from their mastectomy and carefully consider their reconstruction options. Others may be prevented from pursuing immediate reconstruction by their health status and/or treatment needs, such as radiation. When reconstruction is deferred, you may still choose tissue expander breast construction or one of the flap surgeries if you are a good candidate. Dr. Romanelli will guide you through all of your options, helping you to select the procedure that is right for you.
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Secondary Surgeries
Creating Symmetry
It is not uncommon for a woman to require additional procedures to achieve the best results from her breast reconstruction. Oftentimes, this involves making adjustments to the opposite breast to create symmetry. These adjustments may include breast lift, breast reduction, or breast augmentation. Treatment of the opposite breast should be covered by your health insurance, as Federal law requires that insurance companies cover all aspects of breast reconstruction. Click here for more information about breast reconstruction insurance options.
Nipple Reconstruction
Once the newly formed breast has settled into shape, and you are satisfied with your breast symmetry, you might want to consider nipple reconstruction. In this procedure, the nipple and areola are reconstructed using tissue from the breast itself or from another location, such as the inner thigh. The nipple is placed in symmetry with the opposite nipple, and the skin is then tattooed to make it more closely match your natural nipple and areola.
If you are ready to move forward with your plans for breast reconstruction, click here to request a free surgical consultation with Dr. James Romanelli, a board-certified plastic surgeon specializing in breast reconstruction on Long Island. You may also schedule your appointment by phone at 631-424-3600.
