Reconstruction after a mastectomy creates a new, natural looking breast to replace one that has been removed to treat or prevent breast cancer.
Patients who have undergone prior reconstruction and are dissatisfied with the outcome may be candidates for alternative techniques.
Breast reconstruction includes restoring the breast mound with the natural look and projection of a nipple and creating symmetry with the opposite breast when needed.
Breast reconstruction can be performed with many variations and specialized techniques:
- Reconstruction may begin at the time of your mastectomy, or may be delayed until Dr. Codner and your oncologist agree timing is right for you, or timing may be delayed until you feel ready.
- Reconstruction may be through the use of your own skin, tissue, fat and muscle, with the use of a tissue expander and breast implant or a combination of both.
- Specialized techniques and the use of tissue substitutes or fat grafting may be recommended to refine your reconstructions outcomes, if you lack tissue to cover an implant or require additional support for the implant.
- If only one breast is reconstructed, Dr. Codner may recommend a breast augmentation, breast lift or reduction to achieve symmetry between your natural breast and the breast that is reconstructed.
- Reconstruction of your nipple and areola are performed after your reconstruction. Through minor outpatient procedures, tissue grafts, injections and tattooing techniques may be combined to restore a natural size, shape, project and color of the nipple and areola.
Breast reconstruction is an in-patient procedure, under general anesthesia. One or more nights in the hospital will be recommended depending on the timing of your mastectomy and reconstruction, the technique for your reconstruction and your overall health.
Recovery from breast reconstruction depends on the techniques used. You can generally return to normal daily activities within 7-10 days and your regular routine within 4 weeks.
Results can be long-term, but weight loss/gain, implant changes, or natural aging may alter your appearance.
“I just wanted to express my gratitude for everything you and your staff have done for me. When I first began this cancer nightmare I didn’t know one plastic surgeon from another. I consider it my good fortune to have ended up in your care. I will never forget the first visit to you. I broke down in your examining room. I was so embarrassed and yet you and your nurse were so comforting toward me. You looked me straight in the eye and said, “We’re going to get you through this: and that is exactly what you did. I have come to respect you both as a physician and a human being. My life has been made better by having you in it.”
“I want to tell you how grateful and pleased I am regarding reconstruction after the mastectomy You are so gifted and such a positive person. 1 felt your strong and powerful lead through this whole ordeal. I never felt afraid. Thank you so much.”
Articles and Lectures
Chairman, Breast Surgery Symposium, “Advances Over a Quarter Century of Breast Surgery,” Moderator, Live Surgery: Breast Reconstruction with Latissimus Flap and Adjustable Implants; Fat Injection Panel: Review of the Basic Science; Moderator, Advancements and Safety in Breast Surgery, Moderator, Previous Breast Symposium Results, Panel: Review of the Basic Science, Atlanta, GA, 2009.
Chairman, Breast Surgery Symposium, “Raising the Bar,” Moderator, Live Surgery, Salvage of the Failed Breast Reconstruction, Periareolar Nipple Reconstruction, Atlanta, GA, 2007.
TRAM Flap Delay for Breast Reconstruction in the High Risk Patient, American Association of Plastic Surgeons, Philadelphia, PA, 1993.
Autologous Breast Reconstruction: A comparison of conventional pedicle and free flaps, American Society for Reconstructive Microsurgery, Kansas City, 1993.
Codner, MA, J Bostwick, and F Nahai. An Overview of Breast Reconstruction after Mastectomy. The Breast (4), 4-10, 1995.
Codner, MA, J Bostwick, F Nahai, JT Bried, and FF Eaves. TRAM Flap Vascular Delay for High Risk Breast Reconstruction. Plastic and Reconstructive Surgery 96 (7), 1615-1622.
Codner, MA and J Bostwick. Delay of the TRAM Flap. Operative Techniques in Plastic and Reconstructive Surgery 1(1), 58-65, 1994.
Ribuffo, D, MA Codner, and F Nahai. Obesity and Smoking: Different Indications to the use of Pedicle and Free TRAM Flaps in Breast Reconstruction. Rivista Italiana di Chirurgia Plastica 26: 291-294, 1994.
Codner, MA, G Ma, H. Richardson, and S Pacella. Single Stage Breast Reconstruction Following Areolar-Sparing Mastectomy.Plastic and Reconstructive Surgery 123(5), May 2009.