Breast Reconstruction

Offered at our convenient location in OKC

breast-recon-5At our Oklahoma City plastic surgery office, we perform several techniques in breast reconstruction, including breast implant-based reconstruction, and autologous tissue-based reconstruction techniques.

Autologous tissue breast reconstruction techniques use your own tissue to make breast – these techniques include the pedicle TRAM flap, the free TRAM flap, the muscle-sparing TRAM flap, and the DIEP flap.

Benefits of Breast Reconstruction Surgery

  • Women whose breast cancer has been eliminated
  • Those who have undergone mastectomy (surgery to remove breast)
  • Those who have undergone lumpectomy (surgery to remove lump in breast)

Breast reconstruction can be performed immediately after mastecomy, or it can be delayed and performed later. Plastic surgeon Dr. Bajaj can guide you on this decision and recommend a technique for your breast reconstruction.

Implant Options

Tissue Expansion and Implant Latissimus Flap and Implant TRAM Flap DIEP Flap TUG Procedure
Initial Surgery Moderate Involved Highly involved Highly involved Involved
Additional Surgery

Needed if tissue expander is not the final implant, need for nipple and areola reconstruction

Staged approach procedure, additional surgery will be needed for nipple reconstruction and symmetry of breast

Staged approach procedure, additional surgeries will be needed for nipple reconstruction and symmetry of breast

Staged approach procedure, additional surgeries will be needed for nipple reconstruction and symmetry of breast

Staged approach procedure, additional surgeries will be needed for nipple reconstruction and symmetry of breast

Hospitalization May stay overnight

Commonly 2-3 days

Commonly 3-4 days

Total of 3 days, 2 days in ICU and 1 day on the floor

Total of 3 days, 2 days in ICU and 1 day on the floor

Scars No additional scars

Scar located on the upper back

Scar located on the abdomen

Scar located on the abdomen

Scar located in groin

Shape and Feel

No ptosis (sagging) Firm, little motion, no change with weight fluctuation

Moderate to natural ptosis (sagging), less firm, more motion, little change with weight fluctuation

Natural ptosis (sagging), soft, normal motion, symmetric change with weight fluctuation

Natural ptosis (sagging), soft, normal motion, symmetric change with weight fluctuation

Soft, normal motion

Projection Moderate Mild Varies Varies Mild
Opposite Breast

Very difficult to achieve symmetry, due to implant giving more rounded appearance than natural breasts

Surgery for symmetry (optional)

Surgery for symmetry almost always optional

Surgery for symmetry almost always optional

Surgery for symmetry almost always optional

Impact of Radiation Severe Varies Varies Varies Varies
Secondary Gain

Flexibility with breast size in bilateral cases

None

Flatter Abdomen

similar to tummy tuck (but is NOT a tummy tuck since muscle is taken)

Flatter abdomen, similar to tummy tuck

No abdominal postoperative scarring, analogous to medial thigh lift

Average Back to Work time

2 weeks, however expansion every 1- 2 weeks until appropriate size

6-8 weeks 6-8 weeks 6-8 weeks 4-6 weeks
Impact on Activities of Daily Living

Mild, may see muscle contraction, implant movement when working out,also return to clinic frequently for expansion

Weakness of overhead motion and possible shoulder. Affects tennis, golf, mountain climbing, swimming

Lose abdominal muscle, unable to do sit ups, increase risk of hernias, buldges

Still able to do sit ups, minimal effect on abdominal strength , mild risk of hernia

Minimal effect on strength, smallest of the 3 thigh muscles, other two able to compensate

Procedure

It is very important that patients are informed about their options during breast cancer and subsequent breast reconstruction. After cancer diagnosis, you can begin discussing breast reconstruction. It may be ideal to have Dr. Bajaj work with your surgical oncologist, so they can develop a strategy for your reconstruction.

After a health evaluation, Dr. Bajaj will explain your reconstructive options, including the risks and limitations of each technique. Health insurance will typically cover the entire cost or most of the cost of breast reconstruction. Review your health policy to check for limitations regarding breast reconstruction.

Breast reconstruction surgery typically involves a series of procedures over time. The first stage is most complex, and is typically performed in a hospital under general anesthesia. Later stages of the operation can be performed at an outpatient facility with only local anesthesia. Follow-up surgery may be required to reconstruct the nipple and areola and to contour the new breast to the approximate size and shape of the natural breast.

Before & After Photos

Breast Implants and Tissue Expansion

Some patients do not require preliminary tissue expansion before receiving an implant. For these women, the surgeon will proceed with inserting the implant as the first step.

Following mastectomy, the surgeon will insert a balloon expander beneath your skin and chest muscle for tissue expansion. Through a tiny valve mechanism buried under the skin, a salt-water solution is periodically injected, gradually filling the expander over the course of several weeks or months. The balloon stretches the skin over the breast area, creating a pocket for a breast implant. Once the skin has stretched enough, the expander is removed and the implant is inserted. Some specially designed expanders can be left in place as the final implant. A third procedure is required to reconstruct the nipple and the dark skin surrounding it, called the areola.

Tissue Flap Reconstruction

Tissue flap breast reconstruction uses a flap of tissue from the back, abdomen or buttocks. The tissue may remain attached to its original blood supply or a new blood supply can be created. Skin, muscle and fat is tunneled beneath the skin to the chest, which may create the breast mound or create a pocket for a breast implant. Flap reconstruction is more complex than implant reconstruction, and it has a longer recovery time. However, using the patient’s own tissue yields natural results, without concerns about implant failure.

Recovery

After breast reconstruction, expect to spend two to five days recovering in the hospital, depending on the extent of your surgery. Surgical drains may be in place to remove fluids, and these, along with sutures, are typically removed in a week or two. Recovery may take up to six weeks when reconstruction is combined with a mastectomy.

Normal sensation may not return to the breast after reconstruction. Over time, limited sensation may return. Scars fade gradually over time. Possible complications of surgery include bleeding, fluid collection, excessive scar tissue or difficulties with anesthesia. Implants have risks such as infection or capsular contacture (tightening of scar tissue).

Learn More

Dr. Anureet Bajaj has special expertise in breast reconstruction. We encourage you to learn more about breast reconstruction by calling 405‐810‐8448 to set up a consultation.