Breast Reconstruction
For many women, the loss of a breast due to cancer is a life-altering event—not only physically but also emotionally. Thankfully, remarkable innovations in reconstructive breast surgery create the possibility for beautiful, natural-looking results following mastectomy or lumpectomy.
At our practice, Dr. Steven Holzman has opted to concentrate on breast reconstruction methods that can work well for most women undergoing single mastectomy, double mastectomy, or lumpectomy. These include implant-based breast reconstruction after mastectomy and oncoplastic breast reduction for lumpectomy (both of which are detailed further down this page). Dr. Holzman’s experience with breast reduction, breast lift, fat grafting, and other techniques allow him to plan and execute the best reconstructive procedures needed to achieve balanced, proportionate results with favorable outcomes.
The breast reconstruction process begins with a full consultation with Dr. Holzman and includes a detailed interview concerning the plan of the breast cancer surgeon and how that will influence the reconstructive approach. Other factors—such as health issues, previous surgeries, scars, breast size, dimensions, and desires of the patient—will be discussed at length. At that point, Dr. Holzman will develop a plan that works best depending on these elements. He will also interact closely with the rest of the cancer team to help deliver the best choices and outcome. Underneath all of that is Dr. Holzman’s firm belief that he would not recommend anything for a patient that he would not suggest for his own family members.
“Dr. Holzman did my breast reconstruction after a double mastectomy. I had no complications, and I love the results. Everyone at the office is friendly and helpful.”
For details about the specific breast reconstruction options available at our practice, we invite you to take a look at the sections provided below. If you have any questions, or if you would like to schedule a consultation with Dr. Holzman, please feel free to contact Holzman Plastic Surgery today.
Implant-Based Breast Reconstruction After Mastectomy
Implant-based breast reconstruction is a highly individualized procedure that is customized to accommodate the particular needs of the patient. This method utilizes tissue expanders, silicone implants, and acellular dermal matrix (ADM) in the reconstructive process. There have been some remarkable advancements in implant technology—various densities, shapes, sizes, and surface treatments provide an endless number of options that can be selected. Experience is required to choose the right implant that will provide the optimal result.
How Is the Implant-Based Breast Reconstruction Procedure Performed?
Implant-based breast reconstruction surgery may be a single-stage direct-to-implant procedure, or a two-stage treatment with initial breast tissue expander placement followed by implant placement in a second procedure. Frequently, an acellular dermal matrix is used as part of the reconstruction surgery to add support to the new breast. Dr. Holzman has traveled and undergone specialized training with some of the nation’s leading experts in implant-based breast reconstruction. He has perfected the pre-pectoral approach to implant-based breast reconstruction.
Many women who have had breast reconstruction are happy to regain the size and shape of their original chest. Sometimes, however, patients choose to make their new shape even better than before by either enlarging or reducing their size. The most difficult aspect of the reconstruction is to make a breast implant look and feel natural. This is achieved using advanced techniques such as fat grafting, which removes fat from a donor site on the patient (usually the abdomen) and transfers it to the breasts to add softness and contour to the reconstructed breasts. In addition, breast reduction, breast lift, and scar revisions are tools and procedures that can be used by Dr. Holzman to help achieve symmetry of the two breasts.
Is Implant-Based Breast Reconstruction the Best Option for Me?
Although there are tissue-based options that are appropriate in selected circumstances, most women have a very satisfactory result from the use of implants without extended operative procedures and long hospitalizations. In fact, the vast majority of breast reconstruction surgeries performed today are breast implant-based.
That being said, if you are a better candidate for tissue-based reconstruction—such as the DIEP technique—Dr. Holzman will help guide you to the appropriate referral.
Oncoplastic Breast Reduction for Lumpectomy
Oncoplastic breast reduction combines the benefit of immediate plastic surgical intervention with breast surgical oncology. It is advantageous to the patient who requires a large lumpectomy that will leave the breast quite distorted. An oncoplastic breast reduction allows the breast oncological surgeon to resect the tumor, leaving the nipple and areola intact. The plastic surgeon then sculpts the remaining tissue to restore a natural breast shape and appearance. The opposite breast is then modified to achieve symmetry.
What Happens During the Oncoplastic Breast Reduction Procedure?
The surgical oncologist (breast specialist) will remove the tumor and lymph nodes in combination with Dr. Holzman, who performs an oncoplastic reduction by removing additional breast tissue from the cancerous breast. Then, a breast reduction or lift is performed on the non-cancerous breast to achieve symmetry.
The surgery involves making an incision around the areola with a vertical incision from the nipple to the lower fold of the breast. A horizontal incision is hidden in the lower breast (inframammary) fold. The incisions are identical to those used in breast reduction surgeries.
Occasionally, the surgical oncologist will not be able to preserve the blood supply to the nipple due to tumor size or location. In these cases, Dr. Holzman may perform a free nipple graft to preserve the nipple. Since the nipple is removed and then replaced to the breast (similar to a skin graft), the nipple loses sensation and cannot be used for breastfeeding. Free nipple grafts are used infrequently for tumors that are more difficult to remove. Your surgical oncologist and Dr. Holzman will discuss this option with you prior to surgery if they feel it may be necessary.
Why Should I Consider Having an Oncoplastic Breast Reduction At the Time of My Lumpectomy?
The advantages of having bilateral breast reductions or lifts at the same time that you are having your tumor removed are:
- It allows the surgical oncologist to remove a larger amount of tissue, which leads to less concern of positive margins.
- It allows the plastic surgeon to create symmetry in both breasts during the same surgery.
- It reduces the number of surgeries required to achieve a natural cosmetic result.
- The surgeries are completed prior to radiation, so the risk of wound healing problems is diminished.
- It gives patients the benefits of breast reduction (normal-sized breasts, less back and neck pain, relief from rashes, etc.).
What Is the Recovery Time After Oncoplastic Breast Reduction?
These surgeries do not usually require drain placement, and may be performed as an outpatient with the possibility of one night in the hospital or surgery center. Most patients feel better and are able to return to work in three to four weeks, with full recovery by six weeks.
Contact Holzman Plastic Surgery
For more information about breast reconstruction, please contact us today to book a consultation with Dr. Holzman.