Breast Reconstruction After Mastectomy

Restoring Form and Confidence

Breast reconstruction restores the form and appearance of a woman’s breast after mastectomy or other breast-altering procedures. It can also provide significant emotional and psychological benefits, as numerous studies have shown. Yet the choice to have breast reconstruction is deeply personal—some women may decide to proceed immediately after mastectomy, while others may prefer to wait or choose not to reconstruct at all.

Our compassionate experts are here to guide and support you before, during, and after surgery. We specialize in innovative, advanced methods of breast reconstruction and have successfully performed well over 1,000 perforator flap breast reconstructions (including DIEP, Stacked DIEP, SIEA, SGAP, LAP, and PAP flaps). We also regularly perform implant-based reconstructions, recognizing that different approaches suit different patients’ needs.

Important Questions to Consider

  • Am I a good candidate for immediate reconstruction, or should I wait?
    Reconstruction can be done at the same time as the mastectomy (immediate) or after mastectomy and any additional treatments (delayed).
  • Do the advantages of having breast reconstruction appeal to me?
    You may prioritize your body image, emotional well-being, or returning to a sense of normalcy.
  • What kind of results can I reasonably expect?
    Factors such as your unique anatomy, health history, and treatment plan will affect the final outcome.
  • Should I consider surgery on the opposite breast for symmetry?
    Some women opt for procedures on the other breast to achieve a more balanced look.
  • Who should perform the reconstructive procedure?
    Experience matters. Our specialized practice has decades of combined experience in advanced breast reconstruction.
  • How long will it take me to recover?
    Recovery timelines vary based on the procedure chosen—some may return to normal activities fairly quickly, while others need more healing time.

Reasons for Breast Reconstruction

(If You Are “Unhappy with Breast Reconstruction After Mastectomy” or Considering a First-Time Procedure)

  • After Mastectomy
    Most women initially consider reconstruction when planning for or recovering from a mastectomy. Factors like radiation therapy, the extent of tissue removed, and personal preference all play a role in deciding whether to pursue immediate or delayed reconstruction.
  • Revision or “Corrective” Reconstruction
    Some patients come to us after a previous reconstruction that left them disappointed—whether due to implant complications, inadequate contour, or chronic discomfort. Advanced microsurgical techniques and revision procedures can often address these concerns and restore both comfort and appearance.
  • Physical and Emotional Well-Being
    Studies have repeatedly shown that breast reconstruction can help many women improve their self-image and emotional health. Our goal is to tailor a plan that fits your lifestyle, respects your body’s needs, and supports your personal priorities.

Two Main Approaches to Breast Reconstruction

1. Natural Tissue (Autologous) Reconstruction

Natural Tissue Reconstruction
Natural Tissue Reconstruction

One of the most important factors differentiating the various methods of natural-tissue breast reconstruction from one another is whether or not muscle is surgically removed from the site from which the tissue is borrowed. Perforator flaps such as the deep inferior epigastric perforator flap (DIEP flap) preserve muscle, while musculocutaneous flaps such as the free transverse rectus abdominus myocutaneous flap (free TRAM flap) sacrifice important muscles. (A) Preparation of a DIEP flap takes place without removing any muscle from the abdomen. (B) Preparation of a free TRAM flap requires removal of rectus abdominus muscle from the abdomen. It is important to note that muscle does not ever grow back, so operations that remove muscle produce life-long change. Lower insets show flaps in cross-sectional view.

One of the most important factors differentiating the various methods of natural-tissue breast reconstruction from one another is whether or not muscle is surgically removed from the site from which the tissue is borrowed. Perforator flaps such as the deep inferior epigastric perforator flap (DIEP flap) preserve muscle, while musculocutaneous flaps such as the free transverse rectus abdominus myocutaneous flap (free TRAM flap) sacrifice important muscles. (A) Preparation of a DIEP flap takes place without removing any muscle from the abdomen. (B) Preparation of a free TRAM flap requires removal of rectus abdominus muscle from the abdomen. It is important to note that muscle does not ever grow back, so operations that remove muscle produce life-long change. Lower insets show flaps in cross-sectional view.

Natural-tissue procedures rely on your own skin and fat, typically harvested from the abdomen, back, or other donor sites, to form a new breast.

  • Perforator Flaps: The most advanced methods (e.g., DIEP, SIEA, LAP, SGAP) preserve muscle while transferring living tissue. This often means a warm, soft breast that is forever part of your body.
  • Muscle Preservation: Because perforator flaps do not remove muscle, patients generally experience less postoperative pain and maintain more core strength compared to older flap techniques like the TRAM flap. (Note that muscle cannot regrow once removed.)
  • Long-Term Durability: Natural tissue can age along with your body. It does not require replacement like an implant eventually might. Our practice has approximately a 99.5% success rate with these sophisticated microsurgical procedures.

Learn More About Our Perforator Procedures

BREAST IMPLANTS

ADM wrapping Implant Reconstruction
ADM wrapping Implant Reconstruction

We perform a state-of-the-art method of implant reconstruction that preserves the pectoralis muscle of the chest in its natural form and places a breast implant into the same location that breast tissue is found (A). This method, known as prepectoral breast implant reconstruction, takes advantage of the space created by the removal of breast tissue at the time of mastectomy (B) to achieve a reconstruction without disrupting the pectoralis muscle. By placing a silicone-filled implant wrapped in specialized acellular dermal matrix directly into the space that results at the time of mastectomy (C), weakness and discomfort associated with traditional breast implant reconstruction (in which an implant is placed beneath the pectoralis muscle) is avoided. Additionally, with prepectoral breast implant reconstruction, the unsightly movement of implants known “animation deformity,” frequently seen with physical activity in women who have had traditional breast implant reconstruction, is avoided.

 

We perform a state-of-the-art method of implant reconstruction that preserves the pectoralis muscle of the chest in its natural form and places a breast implant into the same location that breast tissue is found (A). This method, known as prepectoral breast implant reconstruction, takes advantage of the space created by the removal of breast tissue at the time of mastectomy (B) to achieve a reconstruction without disrupting the pectoralis muscle. By placing a silicone-filled implant wrapped in specialized acellular dermal matrix directly into the space that results at the time of mastectomy (C), weakness and discomfort associated with traditional breast implant reconstruction (in which an implant is placed beneath the pectoralis muscle) is avoided. Additionally, with prepectoral breast implant reconstruction, the unsightly movement of implants known “animation deformity,” frequently seen with physical activity in women who have had traditional breast implant reconstruction, is avoided.

Some women prefer implant-based reconstruction—especially if they wish to avoid scars on areas other than the breast. Today’s state-of-the-art implant methods can often place the implant in a prepectoral position (just under the skin) instead of beneath the chest muscle.

  • Faster Initial Surgery: Placing an implant in the space created by mastectomy may be quicker than a full flap procedure.
  • Fewer Muscle Disruptions: If done prepectorally, the pectoralis muscle remains undisturbed, potentially leading to a more comfortable recovery.
  • Consider Long-Term Maintenance: Implants generally do not last forever; over time, complications such as capsular contracture, implant rupture, and the need for unplanned re-operations may arise.

Learn More About Our Reconstruction with Implants Procedures

Making an Informed Decision

Choosing a breast reconstruction option can feel overwhelming. Each method offers unique benefits and risks. Understanding the basics of different techniques—and discussing your goals with a highly experienced surgical team—can help you feel more secure as you decide what’s best for you.

Next Steps & Personalized Consultation

We recognize that no two patients are the same. Our approach is entirely individualized, factoring in your body type, cancer treatment plan, health history, and personal preferences.

  • Schedule a Consultation: Sit down with our experienced surgeons to talk through your concerns, goals, and all available options.
  • View Before & After Galleries: See real patient outcomes for both natural tissue and implant-based approaches.
  • Ask About Our Success Rates: Our team has performed over 1,000 perforator flap reconstructions and offers an extensive track record of helping women achieve the results they desire.

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