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Your right to breast reconstruction

As a federal law, the Women’s Health and Cancer Rights Act (WHCRA) mandates that health insurance plans must provide coverage for women to undergo breast reconstruction if the plan covers mastectomy.

If you are scheduled for breast cancer surgery, we urge you to discuss breast reconstruction as early as possible in the process. In some cases, rebuilding the breast can take place in the same surgery.

Planning makes it possible for newer techniques, such as a “nipple-sparing” mastectomy to be performed, or other changes in your surgical plan that could benefit you in reconstruction.

Breast reconstruction candidates

Breast reconstruction candidates include women who have lost one or both breasts to cancer. To be a candidate, you must have been diagnosed with breast cancer by an oncologist, be in good enough health to tolerate surgery, and refrain from smoking.

Smiling lady pictured outside

What are my options for breast reconstruction?

There are many options for breast reconstruction, and the technique best suited for you will be determined by your surgeon and cancer doctor. We will likely utilize one of the following methods for your breast reconstruction:

Tissue expander

In some cases, this first step of treatment may occur at the same time as the mastectomy. The tissue expander will be placed in the breast pocket. At regular intervals, a saline solution is injected into the tissue expander, resulting in a gradual stretching of the pocket and the skin. When the tissue expansion treatment is complete, implants or the patient’s natural tissue are transferred to the breast pocket to create a stable, natural-looking breast.

Breast implants

Saline or silicone breast implants can be placed in the pocket to augment the size and shape of the breasts. Breast implants are a good option because they offer excellent control in the final breast size and shape.

TRAM flap

In the TRAM flap technique, fat, tissue, muscle, and skin is removed from the abdominal region and transferred to the breasts. The breast mound is reshaped to create the desired proportions. In this approach, the flap may be completely detached and moved to the breast pocket, or the flap may stay connected to its original blood supply source and simply moved up to the breast through the chest wall.

DIEP flap

When it comes to microvascular surgical procedures to reconstruct the breasts, the DIEP flap approach is now the gold standard. In the DIEP flap procedure, only fat and tissue are transferred from the abdomen. The muscles remain intact, reducing the severity of side effects after surgery and the likelihood of post-surgical complications. During surgery, the flap of skin is moved to the breast, and, with microvascular surgery, the blood vessels in the abdominal flap are connected to the supplying blood vessels in the chest.

Latissimus dorsi flap

In the latissimus dorsi technique, the flap of fat, tissue, muscle, and skin from the back remains attached to its original blood supply source; the flap is pulled away from the back, and used to create a new breast mound.

Why choose us?

The journey to health after breast cancer can be challenging. It would help if you had the full support of your plastic surgeon, both personally and professionally. At Mangat Plastic Surgery in the Vail Valley, our plastic surgeons are among the most respected in the nation, and have a genuine concern and care for every woman they treat in this vital step. We will work closely with your cancer surgeon and other doctors, and we are well-known throughout the medical community in the region. You can trust us to care for you with personal attention, focus, and dedication to helping you live all the years ahead in good health, and with your feminine figure restored.

Dr. Copit is both an educator and speaker, participating in the national and international arenas, and has remained at the cutting edge of surgical and technological advancement. Dr. Copit has a commitment to innovation in the plastic surgery field, and is excited to learn how he can help you on your road to full recovery.

What is the breast reconstruction procedure like?

The steps of a breast reconstruction procedure will vary based on the surgical technique employed. After the tissue expansion stage of treatment, the procedure has the following steps:

  • General anesthesia is administered
  • The creation of the flap, as dictated by the surgical plan
  • Tunneling of the flap or detachment of the flap from the harvest site and reattachment to the chest
  • Shaping the breast mound to produce a natural breast appearance
  • The flap transfer and reshaping processes repeated on the other breast
  • The breasts evaluated for symmetry, and adjustments made to make the breasts even in size and position
  • Incisions closed
  • Bandages applied to the breasts and tissue harvest site

What should I expect during recovery?

The recovery time will vary, based on the technique employed. If you have undergone a tissue transfer to rebuild the breast, you have two areas of the body that must heal: the donor site and the breast. Generally, you can expect from six to eight weeks for your recovery. You will have activity restrictions until your surgeon gives you clearance for exercise or other vigorous physical actions. In most cases, a hospital stay of at least one night will be part of the process. In some cases, a staged approach is used, with a series of surgical procedures performed over time.

You can expect to feel very tired and experience bruising, swelling, and discomfort, for which you will have prescription pain medication. For the incisions to heal quickly and without problems, you must avoid lifting your arms over your head. A drain may be in place to draw excess fluid and blood away from the incision site, which will be removed within a few days. We will provide you with full aftercare instructions and are always available to answer your questions or concerns. The basic steps to follow during your recovery are as follows:

  • Take one to two weeks off of work
  • Stay in a resting position, with your head elevated, for two or three days after surgery
  • Take pain medication as prescribed for your comfort
  • Use an ice compress, placed above the bandages
  • Wear a soft compression bra for several weeks after surgery
  • Take it easy for two weeks after surgery
  • Do not engage in strenuous activity for four to six weeks

What will it feel like?

After breast reconstruction surgery, it is common to experience the following:

  • Pain
  • Swelling
  • Bruising
  • Itching as the incisions heal
  • Numbness at incision sites

What are the risks?

Though rare, the following complications are associated with breast reconstruction:

Flap procedure complications

  • Loss or reduced sensation for the breasts and harvesting site
  • Blood clots
  • Vascular problems
  • Poor blood flow to the breast
  • Flap relocation failure
  • Reduction in abdominal strength (TRAM flap complication)
  • Weakness in the arm, shoulder, or back (Latissimus dorsi flap complication)

General complications

  • Bleeding
  • Infection
  • Poor wound healing
  • Allergy to anesthesia, pain medication, or bandages
  • Breast asymmetry
  • Excessive scarring

Implant complications

  • Formation of scar tissue around the implant
  • Implant deflation
  • Implant displacement
  • Implant rippling

Breast Reconstruction Results

Breast reconstruction surgery can help to restore the quality of life in patients that have lost one or both breasts to cancer, and you'll will notice an immediate difference in your breast contour after surgery, with your full results seen within three months to one year after surgery.

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