Breast Revision / Reconstructive Surgery

Breast surgeries are some of the most challenging procedures in plastic surgery due to the delicate nature of the female breast and the fact that it is necessary to achieve symmetry between the two breasts. For this reason, it is often necessary to perform revision breast surgery to correct not only deformities from previous cosmetic procedures, but also deformities resulting from breast cancer surgery such as mastectomies. Fortunately, there are cutting edge techniques available today that offer women and their plastic surgeons a wide range of choices for breast reconstruction.

Reconstruction after breast cancer surgery.

Breast Cancer is the most common form of cancer among women of all ages and races. The mortality rate, however, due to early screening and advanced treatment options has been decreasing about 2.2% per year over the last decade. This means that women today can look forward to many healthy years after being diagnosed with breast cancer and many are considering the option of immediate or delayed breast reconstruction following a mastectomy. We find that it is very important for patients to have access to a team approach. Meaning that, before considering surgery, they should meet with their breast surgeon, their oncologist, as well as their plastic and reconstructive surgeon to discuss all the options available for breast reconstruction following mastectomy.

Today women have many options for breast reconstruction. They can have their breast reconstructed with a breast implant that can be either saline or silicone. Today there are many different types of silicone implants to choose from such as the cohesive silicone gels, also known as gummy bears, which offer a very natural feel and look to the reconstructed breast. Many women, however, opt to have breast reconstruction with autologous tissue meaning that the breast is reconstructed with their own tissue. The tissue is usually harvested from the abdomen also known as a TRAM flap or from the back, known as Latissimus Dorsi flap. The tram flaps, which are based off the rectus abdominis muscle of the abdomen, can also be done in a muscle sparing fashion or a free flap to preserve the function of the abdomen. All of these options with autologis tissue can offer a very natural looking breast with good symmetry which is why many women are choosing to have this type of reconstruction immediately following a breast mastectomy.

Fig 1A Mastectomy Site        Fig 2A Reconstructed Breast
1B Right Rectus Muscle              2B Scar around the new belly button
1C - Left rectus muscle used to      2C Abdominal scar from harvesting 
reconstruct the right breast in this case         the flap (similar to the tummy 
1D Island of skin and fat used in shaping                            tuck scar)
        the new breast      

Congenital Breast Deformities. 

All women have breasts that are different in some way.  No two breasts are completely identical.  Some women, however, have congenital deformities which significantly alter the appearance of one or both breasts.  One of the most common is the tubular breast deformity where the breast is very narrow and constricted at the base and the breast tissue is projected in a cone shape, thus the name tubular breast deformity.  Specialized techniques and breast reconstruction can be used to widen the base of the breast and give the breast a much more natural shape and projection using an implant which can be either a saline or silicone implant.  At the time of your consultation with Dr. Polynice, he will discuss with you all of the different sizes, types and shapes of implants that can be used to achieve the most natural look possible. 

Revision Breast Surgery following previous cosmetic breast surgery or breast reduction.

Many women who have had breast surgery in the past, whether it be a breast lift or breast reduction, may be unhappy or dissatisfied with the results.  Older techniques of breast reduction and breast lift left a very noticeable scar sometimes shaped like an anchor.  This scar would sometimes become hypertrophic and be quite visible along the anterior chest.  For this reason we have developed cutting edge techniques in breast sculpting and breast shaping that allow us to achieve excellent results as far as the projection and contour of the breast and also minimize the residual scars.  All of these latest techniques can be discussed with you in detail at the time of your consultation with Dr. Polynice.