Breast Reconstruction

Bergen County, New Jersey

Breast reconstruction restores a natural, symmetrical appearance to the bosom, maintains body proportion, allows clothes to fit better, and most important of all, boosts self-confidence for women who have lost one or both breasts to mastectomy or who lack breasts due to a congenital or developmental abnormality. Reconstructive surgeons strive to create a new breast and nipple that resemble the woman's natural breast as closely as possible in shape, size and position.

Women whose cancer seems to have been eradicated with mastectomy are the best candidates for breast reconstruction. Those with health problems such as obesity and high blood pressure and those who smoke are advised to wait. Others prefer to postpone surgery as they come to terms with having cancer, consider the extent of the procedure, or explore alternatives.

The reconstruction itself consists of multiple operations, the first of which involves creation of the breast mound and is performed during or after mastectomy in a hospital under general anesthesia. Later surgeries, if necessary, may be done in the hospital or an outpatient facility, with either general or local anesthesia.

There are several ways to reconstruct the breast, both with and without implants; Dr. Ferraro will work with you in deciding which is the best for you.

Breast Reconstruction Procedures

The most common technique combines skin expansion with implant insertion. First, Dr. Ferraro inserts a balloon expander beneath the skin and chest muscle where the reconstructed breast will be located. A saline (salt water) solution is then injected into the expander through a tiny valve beneath the skin over a few weeks or months, eventually filling it and stretching the skin. The expander may then be left in place or replaced with a permanent implant. A final procedure reconstructs the nipple and areola (dark area of skin around the nipple). Some patients do not require tissue expansion and begin with the implant.

Another, more complicated type of implant reconstruction involves the creation of a skin flap using tissue from other parts of the body. If the flap is not large enough to serve as the new breast by itself, an implant is then inserted beneath it. Tissue for the flap consists of skin, fat and muscle from the back, abdomen or buttocks and may either be surgically removed and reattached (free flap, requiring a microvascular surgeon) or remain connected to its original blood supply and "tunneled" through the body to the chest (pedicled flap). Advantages over implant insertion are a more natural look and feel for the breast and abdomen, and elimination of any risks associated with silicone implants; disadvantages are scars at the breast and donor-tissue site, and longer recovery.

Both implant insertion and tissue flap surgery are followed by nipple and areola reconstruction. The reconstructed breast will probably look and feel different from the natural breast. Further surgery may be desired to adjust the natural breast to better match the reconstructed one, although a perfect correspondence in size, shape and height is unlikely.

After Breast Reconstruction Surgery

Most patients are tired and sore for a week or two, and recovery can take up to six weeks, but you will be released from the hospital in two to five days. Stitches are taken out in a week to ten days. A surgical drain may be left in place to prevent a build-up of fluid in the reconstructed breast; this will be removed after a week or two.

The reconstructed breast will be numb following surgery, but it is possible that some sensation will return as time passes. Scars will fade, but not disappear. Periodic mammograms with a radiologist trained to examine breasts with implants are recommended.

Risks of Breast Reconstruction

Breast reconstruction has not been proven to affect the recurrence of cancer or other diseases, chemotherapy or radiation treatment.

Nevertheless, in addition to the complications possible from any surgical procedure (bleeding, fluid collection, excessive scar tissue, or difficulties with anesthesia), there are some risks inherent in breast reconstruction, including infection around the implant, if an implant is used, and capsular contracture, when the scar (capsule) around the implant tightens, causing the breast to feel hard. Treatment for capsular contracture varies from "scoring" the scar tissue to removing or replacing the implant. Some patients may need time to come to terms emotionally with their new breasts.

Testimonial

"Two years after a breast surgery I decided to ask to have a breast reconstruction done at the hospital in my home country. Here I was told there was a year wait for the procedure. Then I decided to contact Dr. Ferraro. Within 2 weeks I was all set for surgery, which then took place a month after the initial inquiry. I have never met a doctor who was so quick to respond and having it all set up in no time! I would like to thank you once again for everything. I am deeply grateful for your work regarding my reconstruction surgery. Thank you for doing an excellent job you helped me regain some of my self-worth after my experience with cancer, which means everything to me. Thank you for all the support I received along the way, thank you for so promptly answering any emails and phone calls. Thank you for your kindness your concern and your willingness to listen and ... I decided to ask to have a breast reconstruction done at the hospital in my home country. Here I was told there was a year wait for the procedure. Then I decided to contact Dr. Ferraro. Within 2 weeks I was all set for surgery, which then took place a month after the initial inquiry. I have never met a doctor who was so quick to respond and having it all set up in no time! I would like to thank you once again for everything. I am deeply grateful for your work regarding my reconstruction surgery. Thank you for doing an excellent job you helped me regain some of my self-worth after my experience with cancer, which means everything to me. Thank you for all the support I received along the way, thank you for so promptly answering any emails and phone calls. Thank you for your kindness your concern and your willingness to listen and help at any time. Dr.Ferraro, I would recommend you to anyone who would need your advice and expertise. You are a great doctor, very exceptional, very down to earth and very qualified. You listen to and treat your patients excellent; you make them feel at ease.

Thank you for everything! "

Sincerely, Ruth

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