There are several surgical techniques for breast reconstruction. This plastic surgery journey helps women restore their body image for those who have lost a breast(s) to breast cancer or other medical reason.
Generally, rebuilding a breast consists of several plastic surgeries in an effort to recreate shape, volume and appearance.
Dr. Bolitho explains to his patents that breast reconstruction will not provide women with the same look or sensation as an original breast, incision scars will fade in time but will remain visible, and specific reconstruction techniques may leave scars at the donor site such as the abdomen and back.
Breast reconstruction is considered as one of the most rewarding procedures for both doctors and their patients.
Breast reconstruction involves multiple surgeries so it’s important that patients realize the journey length. It’s a personal decision.
Ideal surgical candidates for breast reconstruction include the following:
Depending on the type of breast reconstruction chosen, the completion of this cosmetic surgery may last up to a couple of years. This timeframe may vary if cancer treatments are needed.
Although breast reconstruction provides rewarding results, a period of emotional acceptance generally takes place.
In your initial consultation, Dr. Bolitho will review your overall medical history. Dr. Bolitho and his team understand how overwhelmed patients can be with the breast reconstruction process. You will have ample time to discuss your medical case and Dr. Bolitho will explain the various breast reconstruction techniques available to you.
Photographs for your medical file will be taken by his nurse and automatically downloaded to a state-of-the-art software program, TouchMD. They will then be uploaded to a touch screen in your examining room and Dr. Bolitho will utilize this software to get more in depth information regarding your reconstruction surgery. Dr. Bolitho will explain the surgical process with this touch screen and discuss the latest techniques he uses to achieve the most desired aesthetic outcome.
Dr. Bolitho’s office will also have “before and after” photographs available for you if you’d like to see the results of his previous patients.
If you choose to move forward with your surgery, your patient coordinator will schedule a preoperative appointment. During this appointment you will meet with Dr. Bolitho once again to review your breast reconstruction procedure and hospitalization following your first surgery. You will also receive pre and postoperative detailed instructions. Dr. Bolitho will also provide you with prescriptions prior to your surgery.
Breast reconstruction is a long journey and it’s important to Dr. Bolitho that you feel comfortable and confident while under his care.
Your consultation and preoperative appointments with Dr. Bolitho will determine which breast reconstruction procedure you will undergo. The first reconstruction surgery may be part of the mastectomy surgery or may begin at a later date for mastectomy healing or at the completion of cancer treatments.
There are various breast reconstruction techniques Dr. Bolitho performs.
A common procedure, the Flap Technique, is when the muscle, skin and fat on the patient’s body are used to create or cover the reconstructed breast.
The Flap technique may be necessary for some since the mastectomy surgery, or in some cases, radiation, may leave an inadequate amount of tissue to perform breast reconstruction.
One way to do this is through a TRAM flap. This type of reconstruction will utilize a woman’s muscle, fat and skin from her abdomen.
Another Flap technique alternative is either the DIEP or SGAP flap method by using tissue, and not muscle, from the abdomen or buttocks.
Alternatively, the latissimus dorsi flap procedure targets muscle, fat and skin from the back. This harvested portion stays intact while being transferred to the mastectomy surgical site. The goal of this reconstruction procedure is to also allow the blood supply for the patient to remain complete and unharmed.
Depending on the patient, this flap procedure can recreate a breast mound. Oftentimes, however, the flap procedure affords the muscle and tissue needed to maintain a breast implant.
Another reconstruction process is called Tissue Expansion. Although it offers an easier recovery process, the reconstruction course typically takes longer.
A tissue expander medical device is placed underneath the pectoral muscle. Over a three to six month period, you visit Dr. Bolitho’s office every few weeks for saline fills. Via an internal metal valve, saline is slowly pumped into the tissue expanders which allow the muscles to stretch.
Typically, there is a three month wait period after the last saline fill for the breast implant exchange.
This exchange, generally an outpatient procedure, is when the tissue expander is replaced for saline or silicone gel filled breast implant(s).
The last step for breast reconstruction is creating the nipple and areola. Skin grafting and other techniques are used to achieve this stage.
A short hospitalization stay may be required following the first breast reconstruction procedure. Bandages, gauze and postsurgical bra may be applied after surgery.
The postsurgical bra will help reduce swelling and support the reconstruction. A thin draining tube may be placed to help drain excess fluid and speed up healing.
Dr. Bolitho will also make the decision on whether a pain pump will be used for the interim to help reduce the need for oral narcotics.
Before going home, you and your caregiver will be given detailed instructions regarding the care of your surgical site, medications, and follow-up appointment with Dr. Bolitho.
The completion of breast reconstruction can help buffer the emotional impact from a
unilateral or bilateral mastectomy. While numerous successful breast reconstructions are performed each and every year, there are postoperative risks and complications which may be related to this surgery.
These complications may include:
Dr. Bolitho’s postoperative instructions will help reduce complications.
While majority of patients do not have these complications, Dr. Bolitho will discuss any concerns you have regarding their potential during your consultation and pre-op appointment.
Cigarettes may delay healing and increase complications, so it is strongly advised to stop smoking.