Breast Reconstruction in Allentown, PA

Patients who undergo a mastectomy for breast cancer will often begin discussing the reconstructive process in the early stage of treatment. Dr. Guarino applies the latest breast reconstruction techniques to restore a natural appearance to the breasts following cancer treatment. Breast reconstruction surgery is now considered a pivotal step in the recovery process. Dr. Guarino will consult with the cancer surgeon to ensure that the patient is healthy and ready for plastic surgery. This surgery allows women to regain their self-confidence and reclaim their self-image following cancer.

During the first consultation to discuss breast reconstruction surgery, it is important for patients to disclose where they are in the treatment process and which cancer surgeon provided treatment. Our office will require patients to provide any necessary pathology reports. The reconstruction process may take place in multiple steps if the breast tissue needs to be stretched to make room for implants. This discovery phase will help guide the reconstruction process so patients end up with a new breast that is the size, shape and look they want.

Each reconstruction technique will be tailored according to the patient’s physical health, aesthetic goals, and personal preferences. There are many factors playing into the approach that will be taken. The ultimate goal is to ensure the patient is healthy and happy with their final breast results.

There are two primary categories of breast reconstruction techniques:

• Procedures that involve using a breast implant

• Procedures that are autologous (use the patient’s own body’s tissue to reconstruct and recreate the breast)

Breast reconstruction using silicone or saline implants is a common approach that generally starts with the use of a tissue expander to help form a suitable pocket for an implant.  The expander may be inserted after the mastectomy procedure or during the same operative session. Over the course of several months, the expander will slowly be enlarged using a sterile solution injected through a port residing under the skin. During the scheduled reconstruction surgery, the expanders are removed and replaced with permanent implants.

If there is limited tissue inside the breast, or limited skin on the outside, tissue may be used from another part of the patient’s body to supplement this loss. The most common areas to support this process are the buttocks, thigh or abdomen. This is an autologous approach to breast reconstruction. The Transverse Rectus Abdominus Myocutaneous (TRAM) flap, the DIEP flap and SIEA flap techniques involve taking skin and fat from the abdomen and relocating it to the breast. The latissimus dorsi flap is another common method using tissue from the patient’s back.

During a mastectomy, the nipple and areola often cannot be saved. The loss of one’s nipple and areola can be as unnerving as the removal of the breast itself. However, reconstruction techniques have advanced greatly, allowing plastic surgeons the opportunity to recreate these areas of the breast to give a natural, aesthetically appealing appearance. In a separate procedure, the nipple is created using existing breast skin or from the abdominal or latissimus flap. Using a tattoo technique, the areola is recreated with a skin graft taken from the thigh, abdomen or back.

Breast reconstruction surgery is performed under general anesthesia at an accredited surgical facility. Some patients may be required to stay in the hospital to be monitored for complications. Patients who have had reconstruction using a flap technique will usually be required to stay in the hospital for 2-5 days. The recovery process can be somewhat lengthy, but many view it as the final step in their cancer journey, making the experience very rewarding. Most women are thankful to have had the opportunity to restore their breasts, and are satisfied with their results. 

The Women’s Health and Cancer Rights Act of 1997 has made it possible for many women to undergo breast reconstruction surgery without the burden of a heavy financial cost. The act states that insurance companies and managed care organizations are required to pay for breast reconstruction for women who have had a mastectomy. It supports all phases of the cancer treatment and reconstruction process. Our insurance and billing office will work with the provider to understand exactly what the coverage will be.

This is a very specialized surgery that requires extensive knowledge, skill, and experience. It is very important to research and find a qualified and reputable plastic surgeon who has experience with breast reconstruction surgery.

In many situations, it is recommended to start the reconstruction process at the same time as the mastectomy. Therefore, it is a good idea to have your breast cancer surgeon and your plastic surgeon begin communicating about the steps that will follow. An advantage of doing the procedure immediately is waking up from your mastectomy surgery with the reconstruction process in place. The soft tissue that surrounds the breast will heal simultaneously with the reconstruction, which can enhance the final results.

A reconstructed breast will not have the same sensation as the breast did before the mastectomy. However, over time, some of this sensation will return to normal. This will depend on the extent of the reconstruction process, and will vary by patient.