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Breast Reconstruction

Model - Breast Reconstruction

If you are considering breast reconstruction, you are faced with making very personal decisions during an emotional time. It's essential that you engage the support of a team of caring medical professionals, and that your breast reconstruction surgeon is an accomplished specialist who can guide you through your options. At Houston Plastic and Reconstructive Surgery, we truly care about the physical and emotional well-being of our patients.

Women preparing for a lumpectomy or mastectomy to treat or prevent breast cancer in the Houston area, or who have already undergone the surgery, can learn more about their breast reconstruction options by requesting a consultation online to meet with us. You can also call our practice at (281) 282-9555 to schedule an appointment. Women visit us in Houston and Webster for breast reconstruction from Pearland and Clear Lake, TX and other nearby communities.

Timing of Your Breast Reconstruction

If you have decided to have one or both breasts reconstructed, you and your surgeon will discuss the timing of your procedure, which can either be immediate or delayed.

  • Immediate breast reconstruction is performed immediately after your breast surgeon completes the mastectomy. We work closely with your breast surgeon before, during, and after the procedure to ensure a smooth operation. Many women who choose immediate breast reconstruction benefit emotionally from having a reconstructed breast or breasts when they wake up after the surgery.
  • Delayed breast reconstruction is an option at any time after a mastectomy is performed. This may be appropriate for patients whose cancer treatment or other circumstances make immediate reconstruction difficult or impossible.

Once the timing of the reconstructive procedure is decided, your surgeon will explain the various techniques available to reconstruct the breast.

Your Treatment Options

Learn about the different approaches to breast reconstruction we commonly use.

Advanced Breast Reconstruction Techniques

Advances in microsurgery and other reconstructive surgical techniques enable us to offer more options than ever for women who choose to have breast reconstruction after a mastectomy or a significant lumpectomy. These techniques fall into 2 categories:

  • Implant reconstruction replaces the breast with a silicone or saline breast implant.
  • Autologous tissue reconstruction replaces the breast with the patient's own tissue. Women choose this option when they want to avoid having an implant. The result is a more natural-looking breast that is soft to the touch. Additionally, since the tissue is harvested from the patient's own body, the risk of tissue rejection is not an issue.

Breast Reconstruction With Implants

Patients who choose to have reconstruction with implants typically have the same breast implant choices as cosmetic breast surgery patients. Breast implants offer the benefit of a shorter recovery than a flap procedure because there is only one surgical site on the body. Reconstruction with an implant is usually a 3-step process:

  • Expander placement: A modified saline implant, called a tissue expander, is inserted in the small pocket created between the breast skin and chest muscle. This is done during the mastectomy operation if you are having immediate breast reconstruction, or sometime later if it's a delayed procedure. A valve attached to the expander allows your surgeon to add more saline gradually over several weeks or months.
  • Tissue expansion: During the ensuing weeks and months,your surgeon adds saline to the expander about every week, which gradually makes the tissues more pliable and the pocket bigger. The process continues until the pocket is able to accommodate the desired implant size.
  • Implant placement: In a second outpatient surgery, your surgeon removes the expander and replaces it with the long-lasting implant, which may be either saline or silicone.

Traditional Flap Procedures: TRAM Flap & Latissimus Flap

Traditional flap procedures such as the TRAM flap and latissimus flap were once the option of choice for breast reconstruction patients who wanted to avoid implants. These procedures involve forming a new breast mound by transplanting the patient's own tissue from a donor site to form a new breast at the mastectomy site.

A significant drawback to these procedures is that along with removing skin and tissue from another part of the body, muscle is removed as well. The TRAM flap involves removing part of the abdominal muscles, and the latissimus flap procedure uses breast implants and part of the back muscles (latissimus dorsi). While these procedures do make use of the patient's own tissues, the drawbacks include an increased risk of hernia, abdominal bulging, and limited physical movement.

Perforator Flap Reconstruction

Like traditional flap breast reconstruction, a perforator flap procedure uses the patient's own tissue and skin to recreate the breast after a mastectomy. For some women, the idea of breast implants is undesirable, and they feel that a flap procedure will produce a more natural result. Unlike traditional flap procedures, perforator flap procedures leave the muscles at the donor site intact. Additional advantages over traditional flap procedures include:

  • Quicker recovery
  • Less discomfort
  • No muscle impairment

During this procedure, we can harvest tissue, skin, and blood vessels from the buttocks area to use in the reconstructive procedure. Your surgeon then transplants and reconnects the flap at the mastectomy site using microsurgery. The flap is then sculpted into a new breast mound.

Breast Reconstruction Recovery

Recovery after breast reconstruction depends on the type of reconstructive technique used and varies between patients.

  • Implant-based reconstruction recovery may take longer for immediate reconstruction than for procedures performed at a later date. Patients can expect swelling and tenderness for the first few days following the procedure, but the majority of swelling will be gone after the first week. While most women report feeling fine after 3 weeks, it can take some women up to 6 weeks to fully recover and resume normal activities. In general, implant reconstruction requires less time, and the patient experiences less discomfort than after a flap procedure.
  • Flap procedures require 2 surgical sites: one at the breast and one at the donor area. Therefore, recovery is usually more complicated and takes longer than with implant reconstruction. Most patients stay in the hospital for 3 to 4 days after surgery and need to return to our office to have surgical drains removed. Most women are ready to resume their regular activities within 6 weeks.

At Houston Plastic and Reconstructive Surgery, we provide all patients excellent support throughout the recovery process and provide detailed instructions to help promote healing.

The Finishing Touches

Many breast reconstruction patients find it satisfying enough to have their breast size and shape restored; they simply want to look and feel complete in clothing. Others want their reconstruction results to look as close to their original breast as possible. Your surgeon can refine the breast contours through fat grafting and restore the nipple through nipple reconstruction to put the finishing touches on the reconstructed breast.

Fat Grafting

Fat grafting is a procedure in which your surgeon collects fat from one part of the patient's body using liposuction to enhance another area. Rarely do patients have enough fat to use fat grafting alone for breast reconstruction, but fat grafting can be combined with either a flap procedure or a breast implant to give the reconstructed breast more natural contours. Fat grafting can also be used to fill in depressions on the breast after lumpectomy. This advanced technique can enhance the shape of the breast for results that look more attractive and natural.

Nipple Reconstruction

While not required, many women choose to undergo nipple reconstruction after mastectomy. This is a personal decision that is entirely up to the patient. Nipple reconstruction is typically performed after the reconstructed breast has had ample time to heal, which is usually about 3 to 4 months after surgery. 

Nipple reconstruction is performed as an outpatient procedure and requires a few days of downtime. The nipple can be reconstructed using one or a combination of the following techniques:

  • Tissue from the body: A nipple can be reconstructed using tissue from another area of the body such as the chest or upper thigh. The reconstructed nipple can later be tattooed to have a more natural appearance.
  • Dermal matrix products: Made from a skin substitute, a dermal matrix can be used to construct a new nipple that looks similar to a real one.

Medical Tattooing

Instead of constructing a nipple, some women opt to have the nipple recreated on the new breast using medical tattooing. Our talented permanent makeup artist, Sherah, is certified in 3-D areola tattooing techniques. This option is less painful, the recovery time is faster, and the patient does not have to go through another surgical procedure.

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Meet Our Surgeons

With Dr. Clayton Moliver, Dr. Fred Aguilar, and Dr. Soumo Banerji, our practice is the proud home of 3 of the top plastic surgeons in the Houston area. Their combined expertise has brought beautiful results to thousands of patients — all with a genuine, 1-on-1 approach.

Meet Dr. Clayton Moliver Meet Dr. Fred Aguilar Meet Dr. Soumo Banerji

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    Houston Plastic and Reconstructive Surgery
    575 East Medical Center Boulevard
    Webster, TX 77598

    Houston Plastic and Reconstructive Surgery
    1801 Binz Street #300
    Houston, Texas 77004

    Houston Plastic and Reconstructive Surgery
    10907 Memorial Hermann Drive #340
    Pearland, Texas 77584