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Breast Reconstruction

Dr. George Min | Breast Reconstruction Surgeon, Bellevue, WA / Seattle, WA

Overview


  • Length: 2-8 hours per surgery. Most treatment programs require several staged procedures over 3-6 months.
  • In/Outpatient: Tissue flap procedures may require an inpatient stay. Surgeries with implants are generally outpatient
  • Anesthesia: General (nipple reconstruction can be local)
  • Normal recovery: Return to work in 2-3 weeks, Resume light exercise after 6 weeks, Swelling resolves completely after 6-8 weeks, Scarring varies and will fade over time
  • Possible side effects: Swelling, Bruising, Pain or Discomfort at points of incision.

Breast Reconstruction Surgery can be a physically and emotionally rewarding procedure for women who have lost one or both breasts to cancer or other conditions. The creation of a new breast can help you regain your self-image, self-confidence and quality of life.

Breast reconstruction is a highly individualized procedure that is generally achieved through several plastic surgery techniques that attempt to restore a breast to near-normal shape, appearance and size following mastectomy. Breast reconstruction can involve several procedures performed in multiple stages. It can begin at the same time as mastectomy, or be delayed until you heal from mastectomy and recover from any additional cancer treatments such as radiation or chemotherapy.

NOTE: It is generally advisable to make a plan for reconstruction prior to undergoing your mastectomy if possible (even if your procedure will happen later), and Dr. Min is happy to consult with the surgeon performing your mastectomy.

Women with breasts of all shapes and sizes benefit from breast lifts, but the type of procedure depends on several factors. Some of the key factors affecting breast reconstruction candidacy include:

  • Your overall health
  • The stage of your breast cancer
  • The size of your natural breast
  • The amount of tissue available for a flap procedure
  • Your desire to match the appearance of the opposite breast
  • Your desire for bilateral reconstructive surgery
  • Insurance coverage for the unaffected breast and related costs
  • The type of cancer treatment as well as choice of reconstructive procedure
  • The size of the implant or reconstructed breast

Dr. Min’s Approach to Breast Reconstruction

Dr. Min is passionate about helping women regain their confidence and their natural figure. Reconstruction is a very personal decision. Many of our breast reconstruction patients require several consultations, and we are more than happy to take all the time required to ensure our patients feel confident, informed, and comfortable with their treatment plan.

Dr. George Min is a board certified plastic surgeon with a passion and a reputation for excellence in breast procedures. He takes a conservative approach that focuses on patient safety and natural results. Dr. Min does not believe in cutting corners, and our state-of-the-art Bellevue facility is unlike any you will find in the Seattle or Bellevue area. Our on-site surgical suite is equipped with the latest technology and is one of only a handful of locations to meet the stringent new safety certification standards.

We pride ourselves in being the best, not only in surgery, but also in patient care and education.

Types of Breast Reconstruction Procedures

There are several different types of Breast Reconstruction Surgery, and our goal is not to match patients to procedures, but rather craft an approach that will deliver the results you’re looking for. In the case of breast reconstruction surgery, many factors, including your body type, pre-mastectomy breast size and your overall health may determine which procedure is right for you. All of the procedures will leave scars, but there are a number of techniques that Dr. Min can employ to minimize or ide scarring.

Breast Reconstruction with Breast Implants (Breast Augmentation)

Many patients choose to undergo reconstruction using silicone or saline breast implants. In some cases, a tissue expander (a balloon, much like a temporary implant) may be used to gently stretch the skin and tissue to make room for the more permanent implant.

Breast Reconstruction with Tissue Expansion allows a quicker recovery than flap procedures, but it is a more lengthy reconstruction process. It requires multiple office visits over 4-6 months after placement of the expander to slowly fill the device through an internal valve to expand the skin and muscle. A second surgical procedure is needed to replace the expander with a permanent implant (saline or silicone).

If you choose to go with implant-based reconstruction, Dr. Min will discuss with you the various options regarding implant types, shapes, procedures and sizes. Our goal is always to craft a treatment plan that fits your lifestyle and your goals.

Learn more about different types of Breast Augmentation procedures.

Breast reconstruction with tissue flap

Tissue flap procedures use tissue (skin, subcutaneous tissue, and sometimes muscle) from your stomach, back, thighs or buttocks to reconstruct the breast. The two most common types of tissue flap surgeries are the TRAM flap (transverse rectus abdominis muscle flap), which uses tissue from the stomach, and the latissimus dorsi flap, which uses tissue from the upper back.

The advantages of tissue flap reconstructions include a more natural result, and because it uses the body’s own tissue, it will generally grow or shrink proportionately when you gain or lose weight. The disadvantages may include more procedures and a longer recovery time (8 weeks)

  • A TRAM flap uses donor muscle, fat and skin from a woman’s abdomen to reconstruct the breast. The flap may either remain attached to the original blood supply and be tunneled up through the chest wall, or be completely detached, and formed into a breast mound.
  • Alternatively, it is possible to choose a perforator flap such as a DIEP or SGAP flap which do not transfer any muscle but only the subcutaneous tissue from the abdomen or buttock.
  • A latissimus dorsi flap uses muscle, fat and skin from the back tunneled to the mastectomy site and remains attached to its donor site, leaving blood supply intact. Occasionally, the flap has insufficient volume reconstruct a complete breast mound, and is often necessary to add a breast implant to provide the sufficient shape.

Fat Transfer Breast Reconstruction

Fat transfer reconstruction uses fat that is removed from your abdomen, buttocks, and thighs to form a breast that looks and feels normal. Before fat grafting, an external expansion device is worn over the chest to prepare your chest to receive the fat. Transferred fat is then injected through small needle holes into the breast area. Recovery is similar to any liposuction procedure and patients often go home the same day. This process may need to be repeated several times until the desired breast size is reached. There is minimal scarring and results often appear very natural.

Nipple & Areola Reconstruction

Nipple and Areola reconstructions are the final phase of breast reconstruction. The goal is to make the reconstructed breast more closely resemble the original or more closely match your desired appearance. This surgery is generally done under local anesthesia as an outpatient procedure. In most cases, your Dr. min will recommend patients wait until the reconstructed breast tissue has had time to heal, though in some cases nipple reconstruction can be preformed at the same time as a tissue flap reconstruction.

The tissue that forms the reconstructed areola and nipple is taken from the patient’s own body, generally an area of similar skin texture such as the inner thigh, buttocks or the breast itself. If desired tattooing can be used to more closely match the color of your natural nipple.

 

Your Initial Breast Reconstruction Consultation(s)

The role of the consultation—or consultations, many patients require multiple meeting—is to ensure that you feel informed, confident and excited, and we’ll take as much time as we need to get there.

During your initial consultation, Dr. Min will ask you about your health and your mastectomy procedure (post op or planned), and you will discuss the position, shape and size you are looking for, as well as any specific concerns you have about their feel or appearance. He will walk you through your options, explain the details of the different breast reconstruction procedures, and answer any questions you may have. You will have an opportunity to view extensive before and after photos and see examples of the different procedures you’ve discussed.

Dr. Min will then ask you questions about your health and lifestyle and assess your breasts for shape, size, symmetry, and areola position. He will share and explain his opinions with you about which surgical techniques are most appropriate for you based on your desired outcome and the results of your exam, and together you will decide on the details and timing of your procedure.

Finally, Dr. Min will make sure you know exactly what will happen on the day of your procedure, what you will experience while you recover, and what you can expect in the months and years to follow.

Safety & Risks of Breast Reconstruction Surgery

Our approach at Newvue is always to put our patients’ safety above all other concerns, and Dr. Min is a recognized expert with an impeccable track record for breast reconstruction. We have invested in absolutely state of the art tools, and our on-site surgical suite is one of the first in the region to be fully approved under the stringent new safety standards.

Nonetheless, we feel it is important that all our patients fully understand the risk associated with this—or any—surgical procedure. The most important thing to know is that Dr. Min and Newvue will stand by you should any complications arise and do everything we can to help you achieve your desired result.

Risks associated with breast lift surgery include:

  • Reaction to Anesthesia: Some patients experience an adverse reaction to anesthesia that may result in nausea or vomiting, allergic reactions and in very rare cases death. Be sure to discuss any medical allergies with your surgeon.
  • Infection: as with any surgical procedure, there is a risk of infection. Infection will generally occur within days or weeks of your procedure, and in most cases can be treated with medication. In rare cases, and additional surgery may be required to treat severe infections
  • Asymmetry or deformation: It is possible that, over time, your breasts could become asymmetrical or change their shape and appearance. These occurrences can almost always be corrected through a revision surgery.
  • Bleeding & Hematoma: Some patients are more prone to bruising than others and, in extreme cases, may experience excessive bruising, bleeding or skin death.
  • Flap Loss: (Tissue Flap Reconstruction) There is a risk that tissue transferred from another part of your body may die or be rejected, in which case an additional surgery will be required to remove it. The procedure can, in most cases, be repeated after you heal.
  • Implant Rupture: (Implant-based Reconstruction) Your implants are designed to be durable, but it is possible for a forceful impact or sharp object to cause them to rupture. In the case of saline implants, the liquid (salt water) will be harmlessly and quickly absorbed by the body. Silicone gel implants have not be shown to cause any adverse effects when they rupture, but the leaks may be slower and harder to detect, which is why the FDA recommends an MRI at 3 years and then every other year after that to check the integrity of your silicone gel implants.
  • Asymmetry or deformation: It is possible, with both implants and tissue flap reconstructions, that something may cause your breasts to become asymmetrical or changing their shape and appearance. These occurrences can almost always be corrected through a revision surgery.
  • Cancer Detection: Breast implants can make the early detection of breast cancer through mammograms more difficult.

Prior to Your Breast Reconstruction Procedure

Prior to your surgery, we will schedule a preoperative appointment with Dr. Min. The purpose of this meeting is to make sure that your procedure goes smoothly and efficiently. Our staff will review your consent forms with you, answer any questions you might have, and the risks and benefits of surgery will be thoroughly reviewed. You will be given your prescriptions to be filled prior to your surgery. You will be given a list of medications and supplements to avoid for two weeks before and after surgery. If you are a smoker, you will be advised to stop smoking at least two weeks prior to surgery. You should not smoke for at least two weeks following surgery.

Your Breast Reconstruction Procedure

We will do everything in our power to help you feel informed and relaxed on the day of your procedure. After you arrive at our Bellevue office, you will meet with Dr. Min and with your anesthesiologist. Once any questions you have are answered, you will be given medication to help you relax.

You will be brought into the surgical suite, where you will be prepped for surgery and given a general anesthetic.

You will wake up in the recovery room, where you’ll be closely monitored. We’ll let you know how everything went and advise you on what to expect as you recover. If your procedure is outpatient, you’ll want to be sure to arrange for someone to pick you up and stay with you for the first couple days as you adjust.

After Your Breast Reconstruction Procedure

You’re still our patient after you leave, and we will be there for you as you recover to answer any questions you may have and advise you on any side effects you may be feeling.

Implant Breast Reconstruction: You can expect to feel tired and sore after the surgery, and you will experience some swelling and discomfort at the point of your incision, both of which can be managed with medication.

Light activity is encouraged during your recovery, and you can resume regular, non-strenuous activity after a few days of rest. You should avoid strenuous activity or heavy lifting for at least 2 weeks, and avoid high impact activities (skiing, wakeboarding, contact sports) for the duration of your recovery (6-8 weeks). Your stiches will dissolve and be absorbed by your body, so you will not have to worry about getting them removed.

Tissue Flap Breast Reconstruction: Your procedure will likely involve a 2-3 day inpatient stay in a hospital. You can expect some pain and discomfort, which will be controlled intravenously. You will wear a surgical bra over your incisions for 2 to 3 days. Plan on very limited physical activity for at least six weeks. No lifting over fifteen pounds for 6 weeks. You will have drains that will require you to measure and record the fluid that your body expresses. These are usually removed in 1 to 2 weeks in the office.

Your follow-up visits will begin 3-4 days following your discharge from the hospital. During your postoperative visits, Dr. Min will review activity limitations, incision care and concerns you may have. You can expect follow up visits at 3 weeks, 6 weeks, 3 months, 6 months then every year thereafter. Surgical revisions and nipple reconstruction are frequently necessary to complete the final process.

Results

Dr. Min and the Newvue staff are always available to help you with any questions or concerns you may have, during your recovery and after. We want to ensure that you are completely thrilled with your new look, and we’ll consider you our patient for life.

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