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Breast Reconstruction

What Is Breast Reconstruction?

imgThreeLadies1Breast reconstruction is a surgical procedure performed to recreate one or both of the breasts after a mastectomy or double mastectomy. Depending upon your individual circumstances, our breast augmentation surgeon, Neil J. Zemmel, MD, FACS, can perform reconstruction during the same surgery as your mastectomy so you do not ever need to experience the absence of a breast (direct to implant single stage reconstruction). For women who have been diagnosed with breast cancer and require a mastectomy, there are many reconstruction options available that feel and look natural. Most of our patients at Richmond Aesthetic Surgery believe that breast reconstruction has not only restored their physical appearance, but also improved their overall quality of life. Dr. Zemmel finds breast reconstruction one of the most rewarding plastic surgery procedures he performs.

What Are the Types of Breast Reconstruction?

There are two main techniques Dr. Zemmel employs for breast reconstruction surgery: reconstruction using breast implants or reconstruction using your own soft tissue (fat grafting).

Breast Reconstruction with Implants

With the help of a tissue expander, the remaining skin and muscles of the chest are gently stretched to receive an implant like those used in breast augmentation. The tissues are expanded gradually with weekly saline injections over the course of 6-12 weeks to create a new breast pocket for the permanent implant. Once the skin and muscles are sufficiently expanded, the permanent saline or silicone implant will be inserted. Sometimes referred to as prosthetic breast reconstruction, this technique does not require tissue from a donor site and consequently involves no donor site scarring. With a direct-to-implant single-stage reconstruction, there is no need for a tissue expander, and the operation can be completed at the same time as the mastectomy.

Breast Reconstruction with Fat Grafting

Flap reconstruction, also called autologous tissue reconstruction, uses fatty tissue from another part of your body to re-form the breast. Common donor sites include the abdomen, lower back, or buttocks. Once grafted, these tissues grow naturally with the rest of the body. Unlike implant reconstruction, there is no risk of implant rupture or implant maintenance required. Breast reconstruction with fat grafting can also achieve results that look and feel more like natural breasts. This option may also better achieve symmetrical results for women who require reconstruction on only one side.

In some cases, a combination of these two techniques can be performed. Since breast reconstruction is such a complex, personal decision, Dr. Zemmel uses your consultation as a time to understand your specific concerns and goals. To help you weigh the advantages and limitations of each option, he will make recommendations based on your unique body proportions, medical history, overall health, and whether or not you will undergo chemotherapy or radiation. Many patients are still able to have chemotherapy or radiation therapy after breast reconstruction, and this surgery should not impact your doctor’s ability to detect cancer recurrence.

I required bilateral mastectomies because of breast cancer. Dr. Z’s caring, guidance, and advice gave me results I never dreamed of! I am happier now with my body (at 55) than I was in my 30’s! I am SO glad I listened and took his advice. His concern and expertise are unmatched!

elizabeth chapman

June 11, 2012


What Are My Nipple and Areola Reconstruction Options?

Although not a necessary part of breast reconstruction, Dr. Zemmel can use a variety of techniques to reconstruct the nipple and areola for more natural-looking results. This is typically the last stage of the procedure and is performed about two to three months after the final shape of the breast or breasts is achieved. Some women choose surgical reconstruction of the nipple, in which case Dr. Zemmel will use local skin and fat tissues to create a nipple at the center of the new breast mound, located at the point of greatest projection. Once the healing process is complete, a new areola can then be tattooed to match the size and pigment of your natural areola. Other women may simply choose to tattoo a new areola and skip the surgical reconstruction of the nipple.

What Is the Breast Reconstruction Recovery Time?

Since breast reconstruction is typically completed in multiple stages, the entire process can take up to one year depending upon your unique circumstances. The recovery time will vary accordingly. When reconstruction is not performed the same day as the mastectomy, patients will need to wait about three months before beginning reconstruction surgery. If breast reconstruction is performed with implants, patients usually wait 10-14 days before resuming their normal activities. Any strenuous physical activity should be avoided for at least two to four weeks to allow the body to heal. If breast reconstruction is performed with fat grafting, the recovery time is about four weeks. Dr. Zemmel will provide more detailed instructions about your recovery during the preliminary consultation, based upon your customized surgical plan.

How Much Does Breast Reconstruction Surgery Cost?

Health insurance providers are required to cover the cost of breast reconstruction since the Women’s Health Care and Cancer Rights Act (WHCRA) passed in 1998. Covered procedures include mastectomy, reconstruction of the breast, breast surgery on the unaffected breast to enhance symmetry, and nipple/areola reconstruction. Patients may still be responsible for co-pays and deductibles according to their individual health insurance plans. If you would like assistance navigating your insurance benefits, a member of our staff can assist you. Plastic surgery financing options are also available for patients who could benefit a flexible monthly installment plan.

Contact Us

If you would like to schedule an appointment with Dr. Zemmel to discuss how breast reconstruction can help you achieve your goals after a mastectomy, please contact our office today.