Breast Reconstruction

A Guide to Breast Reconstruction Surgery

Breast reconstruction is a series of procedures designed to restore the shape and volume of the breasts. It is a vital step for many patients following breast cancer treatments like mastectomy or lumpectomy, and for those with congenital or acquired breast deformities. We understand that this is an important part of your healing journey, and our goal is to help you feel whole again. Breast reconstruction is known to significantly improve the quality of life for survivors and is strongly recommended.

In the United States, breast reconstruction is required by law to be covered by medical insurance. The two primary methods are implant-based reconstruction and autologous (own tissue) reconstruction.

Implant-Based Breast Reconstruction

This is the most common method used to restore breast shape after a mastectomy. The procedure can be done at the same time as the mastectomy (immediate reconstruction) or at a later date (delayed reconstruction).

• Direct-to-Implant Reconstruction: This single-stage procedure involves placing a permanent breast implant, often with a supportive dermal matrix, at the time of the mastectomy. It is best suited for individuals with healthy skin and breasts of a normal size and shape before cancer removal.

• Two-Stage Tissue Expander-Implant Reconstruction: This method involves two steps. First, a tissue expander (an empty silicone shell) is placed under or over the chest muscle. Over several weeks, this expander is gradually filled with saline to gently stretch the skin and create a pocket. In a second surgery, the expander is removed and replaced with a permanent saline or silicone implant.

Fat Transfer: To enhance results, fat transfer is almost always recommended with implant-based reconstruction. This involves using your own body fat to soften the edges of the implant and create a more natural transition between the implant and your chest wall.

Recovery for Implant-Based Reconstruction:
Most patients can go home the same day, though an overnight hospital stay may sometimes be recommended.

• Downtime: Plan for one to two weeks of recovery.

• First Few Weeks: Moderate swelling and bruising are normal. Small surgical drains are typically placed and removed after about two weeks.

• After One Month: Most of the swelling will have resolved. Discomfort from swelling and along the incision lines are the main complaints.

Autologous (Own Tissue) Reconstruction

This method uses a flap of your own tissue—including skin, fat, and blood vessels—from another part of your body (like the abdomen, thighs, back, or buttocks) to rebuild the breast. This is a longer, more complex surgery but can produce results that look and feel very natural. It is often the preferred method if you have had or will need radiation therapy.

• DIEP Flap: The Deep Inferior Epigastric Perforator (DIEP) flap is one of the most advanced and common techniques. It uses skin and fat from the lower abdomen to reconstruct the breast, similar to a "tummy tuck."

• Latissimus Dorsi Flap: This "workhorse" flap uses muscle, fat, and skin from your upper back. It is often used as a reliable option for breast reconstruction or to help in cases where complications arise with other methods.

Recovery for Tissue-Based Reconstruction:
A hospital stay of a few nights is required for close monitoring.

• Downtime: Recovery typically takes two to three weeks.

• First Few Weeks: Expect moderate swelling and bruising at both the breast and donor sites. Drains will be placed and are usually removed after two weeks.

• After One Month: The majority of the swelling will have subsided, though discomfort and pain along the scars are common.

Oncoplastic Reconstruction

This term refers to a variety of techniques used to reshape the breast after a lumpectomy (partial mastectomy). The goal is to remove the cancer while achieving the best possible cosmetic outcome. Procedures may include fat transfer, local tissue rearrangement, or a breast reduction on the opposite breast to create symmetry.

Who is a Candidate for Breast Reconstruction?

The best candidates are healthy individuals with realistic surgical expectations. Even if you have other medical conditions, you can often proceed safely with guidance from your primary care physician. For extremely thin patients, tissue-based reconstruction may be challenging due to a lack of available donor tissue. A thorough consultation will help determine the safest and most effective plan for you.

If you’re ready to explore your options, consult with Dr. Han Hoang, a board-certified, UCLA-trained plastic surgeon, to create a customized plan tailored to your unique needs.

📞 Call us at 714-584-3507
 📧 Email us at hanhoangmd@gmail.com