Undergoing a mastectomy for breast cancer is a stressful experience, and breast reconstruction is a very important part of the healing process. Dr. Samer Bassilios Habre is committed to providing you with the highly personalized, caring service you deserve. He believes that every patient is unique, and he takes the necessary time to evaluate and establish an individualized plan that might best help achieve your goals.
Dr. Samer Bassilios Habre is an expert in breast reconstruction. He has completed a fellowship in breast reconstructive surgery at the University of Tennessee Health Science Center (Memphis, USA), and uses state-of-the-art techniques in an effort to achieve the most natural result possible in the mastectomy setting.
Timing of Breast Reconstruction
You can undergo breast reconstruction at the time of your mastectomy or delay the procedure until a later date. In most instances, Dr. Samer Bassilios Habre prefers to perform reconstruction at the time of your mastectomy, as it decreases the sense of loss and expedites the process of restoring the breast. It also allows for more sparing of skin, possibly including the nipple and areola, a potentially shorter scar, and a potentially more aesthetic result.
However, there are certain situations when undergoing breast reconstruction at the time of your mastectomy may not be recommended. You can still often achieve a pleasing result in the delayed breast reconstructive setting. Dr. Samer Bassilios Habre will work closely with you, your oncologist, and your general surgeon to help you determine the right time for your procedure.
Breast Reconstruction Options
Breast reconstruction options are rapidly evolving and improving. The new, innovative techniques that have been developed in recent years enable you to achieve more natural looking and beautiful results than ever before. Dr. Samer Bassilios Habre offers the two general categories of breast reconstruction:
Expander and implant reconstruction
Autologous tissue reconstruction (use of own tissue) including microsurgery
Expander and implant reconstruction uses a breast implant to restore your breast appearance.
Autologous tissue reconstruction involves transferring tissue from another part of the body to create a potentially more natural feeling and appearing breast.
Expander and Implant Reconstruction
The first stage of implant reconstruction usually involves the placement of a temporary, adjustable volume implant called a tissue expander. The tissue expander is usually placed at the time of your mastectomy so that your breast reconstruction procedure can begin immediately.
Dr. Samer Bassilios Habre will place some saline (salt water) into the tissue expander to begin the creation of the new breast mound. Expansion is generally performed at 1-2 week intervals depending on patient comfort. In most cases, 3-5 expansions will be need in the plastic surgery clinic. Each expansion takes about 5-10 minutes.
Expansions will be performed until a pleasing size is reached. This process can be done during chemotherapy, and replacement of the tissue expander with a breast implant can usually be done about one month after chemotherapy treatments are completed.
Alternatively, permanent implants can be placed at the time of the mastectomy in some cases.
Replacing the Tissue Expander with a Breast Implant
Once the expansion phase is complete, our surgeon will replace the tissue expander with a breast implant. The timing will depend on the chemotherapy and radiation therapy, if needed.
If the nipple has been removed, our surgeon will often use the tissue on the chest wall to create the nipple and areola. After the new nipple has healed, medical tattooing is performed in an effort to hide scars and create a more natural looking appearance.
Autologous Tissue Reconstruction
Autologous tissue reconstruction (reconstructions performed with your own tissue) potentially results in a more natural looking outcome than expander and implant reconstruction procedures, but it is also a much more extensive surgical procedure and involves a scar in a location other than the chest.
Many women who choose autologous tissue reconstruction do so in order to avoid the use of breast implants with their breast reconstruction procedure. During this type of reconstructive procedure, Dr. Samer Bassilios Habre will remove tissue from one part of the body and use it to rebuild part or all of the breast mound.
These procedures tend to look and feel more natural than implant reconstructions. In addition, autologous reconstruction procedures are permanent in nature and unlike implant reconstructions, do not require maintenance (implant replacement).
Autologous tissue reconstruction procedures typically result in hospitalization for 3-7 days. While recovery varies with the individual, most patients can resume the majority of their normal activities, including exercise, by about 6 weeks.
Autologous Tissue Reconstruction Techniques
Dr. Samer Bassilios Habre uses a variety of techniques when performing autologous tissue reconstruction. These include:
Abdomen-based flaps: use the abdominal fat and skin (like in tummy tuck surgeries) to reconstruct the breast
Latissimus Dorsi flap: use the back skin and muscle to reconstruct the breast. The scar is hidden under the bra
Each of these procedures can potentially deliver excellent results. An abdominal scar similar to that of a full tummy tuck results in abdomen-based flaps. Overall abdominal contour is often improved.
Fat Grafting in Breast Reconstruction
Dr. Samer Bassilios Habre often uses liposuctioned fat, called fat grafting, to soften mastectomy defects and implant imperfections such as ripples. However, not every patient should have, or will choose to have, fat grafting. The amount of volume maintenance is highly variable and depends on the case.