Breast reconstruction after cancer or other conditions is an important part of the healing process for many women. Restoring a sense of femininity and wholeness to someone is really quite an exceptional experience. It’s one of the most satisfying and humbling aspects of my work.
Breast reconstruction surgery can be a ray of hope in a difficult time. Mastectomies or other conditions that affect the breasts are often emotional events. Despite knowing that her body is beautiful no matter what, a woman may experience a deep sense of sorrow when confronted with losing one or both breasts. Important aspects of self-image — like femininity, sexuality, maternity or wholeness — might depend upon having breasts that look and feel a certain way. When these elements of identity are taken away by illnesses or accidents that are beyond a woman’s control, the opportunity to undergo breast reconstruction surgery can help restore her confidence and sense of self.
Watching our breast reconstruction patients take this journey is an exceptional experience that never fails to leave our team feeling awed and humbled. Dr. Andrews and his staff are proud to provide breast reconstruction surgery for women who have lost one or both breasts to cancer, illness or otherwise. We offer several different types of breast reconstruction procedures, and we work closely with each client to determine the approach that will deliver her best results. If you are interested in finding out if our breast reconstruction services are right for you, we encourage you to reach out to us to schedule an in-person consultation with Dr. Andrews.
Breast Reconstruction at Dr. Andrews Plastic Surgery
The initial consultation meeting is everyone’s first step before a procedure like breast reconstruction. During this face-to-face meeting with Dr. Andrews, you’ll discuss topics from why you’re interested in breast reconstruction, to your medical history, to what kinds of results you’re hoping to achieve. The information gleaned from this appointment will help Dr. Andrews recommend techniques that are most appropriate for your particular situation.
There are two main types of breast reconstruction that we provide: tissue expander reconstruction, and autologous or tissue flap reconstruction. Each option comes with certain risks and rewards — Dr. Andrews will help you understand the nuances of your choices, but we outline each procedure here so you can know what to expect.
Tissue Expander Breast Reconstruction
Tissue expander reconstruction with Dr. Andrews uses implants to create your new breasts. But implants require a certain amount of space in your breast tissue for safe and proper placement. Unlike a breast augmentation — where the implant is placed within your natural breast tissue — post-mastectomy reconstruction patients usually do not have enough natural body tissue left in the chest to safely cover a full implant.
In order to create the space for an implant, you will first undergo a surgery in which Dr. Andrews places a specialized expander implant in your breast area, below the skin and muscle. At weekly follow-up appointments over the course of about three months, Dr. Andrews or one of our nurses will non-surgically inject implant filler solution through a valve in the expander implant. Then, once the expander implant has been filled to the appropriate size, a second surgical procedure replaces the expander with a permanent implant of your desired material and shape.
Many women who explore this option worry that implants won’t look or feel like the natural breast or breasts they have lost. At Dr. Andrews Plastic Surgery, we most often use an implant known as a gummy bear silicone implant, which is highly regarded in our industry as the most natural-looking and -feeling implant available. These implants are filled with a soft silicone gel and have a full-on-the-bottom, teardrop-like shape that closely mimics a natural breast. Additionally, the silicone filler in our gummy bear implants is made with a cohesive gel technology that coheres — or sticks together — in the event of rupture, preventing potential harms from silicone gel leakage.
Tissue Expander Reconstruction Recovery
You should plan on taking about two weeks away from work or school following each tissue expander surgery. If you work from home or are a full-time family caretaker, you should arrange for help around the house during this time. You will be able to slowly build back up to normal activities under Dr. Andrews’ supervision. You will continue to have follow-up appointments so our team can monitor your healing, and Dr. Andrews will clear you for activities like driving, lifting or exercising as you progress through recovery.
The first surgery to place the expander implant usually involves a longer recovery — up to four weeks — while the second recovery is easier. Some women choose to have their expander implant placed during their mastectomy, which results in a recovery time of about six weeks. At Dr. Andrews Plastic Surgery, we specialize in delayed reconstruction for women who have already healed from their mastectomy; in these cases, recovery from tissue expander surgeries is usually faster.
Tissue Expander Reconstruction Overview
Benefits of tissue expander reconstruction include:
- Less intensive procedure and shorter recovery time compared to autologous reconstruction
- Predictable breast symmetry, especially for women who have had double mastectomies
- Highly customizable outcomes based on desired implant shape, size and type
- Usually performed on an outpatient basis (patients can return home the same day)
Some drawbacks to consider include:
- Requires two surgeries and weekly expander appointments over the course of a few months
- Not suitable for women who still need chemotherapy or radiation therapy
- Possible need for revision surgery
- Possible complications from implants/synthetic materials, such as capsular contracture or rupture
Autologous reconstruction uses your own body tissues to replace lost breast volume. During the surgical procedure for this type of reconstruction, Dr. Andrews will move a segment of fat and muscle from a donor site on your body to the breast area. Donor sites are most often on the abdomen, but alternatives include the hips, thighs or shoulder blade. While this type of reconstruction only requires one surgery, it is more intensive than either tissue expander procedure. You will have two surgical sites instead of one since Dr. Andrews will need to operate on both the donor site and your breast area.
One other consideration is that your body will naturally absorb some of the transplanted tissue, so your final results may be noticeably smaller than they appeared immediately post-op. It can be difficult to predict how much tissue will be absorbed, and it can differ from breast to breast, making this a somewhat riskier option for women who had a double mastectomy and are hoping for a symmetrical outcome. You may need to opt for a secondary procedure to reshape the breast once tissue reabsorption is complete.
With this technique, though, long-term results have very high rates of patient satisfaction. Your new breasts will look and feel incredibly natural because they will be made from your own body. Breasts reconstructed with an autologous approach will even change size and shape alongside your body with age or weight fluctuations. What’s more, many women carry extra fat on their abdomens, hips or thighs that they are happy to remove and put toward reconstructing their breasts. Depending on your body type, you may be able to achieve an overall more sculpted figure using this method of reconstruction.
Tissue Flap Reconstruction Recovery
Depending on where your donor site is located, you may need to stay overnight in the hospital for several days. When you return home, you should plan on taking about two more weeks away from most daily activities, such as a sedentary job or light housework. You should arrange for help around the house for a few weeks while you regain your energy and a full range of body movement. You will need to avoid strenuous activities like heavy lifting or exercising for six to eight weeks, or as advised by your plastic surgeon.
Tissue flap reconstruction surgery differs greatly from patient to patient, depending on where the donor site is, how much donor tissue is used and what their goals are for their new breasts. With this variety, it is difficult to pinpoint exactly how long your recovery will take. Dr. Andrews works closely with his autologous reconstruction patients to help them plan for their recovery based on the specifics of their surgery.
Tissue Flap Reconstruction Overview
Benefits of tissue flap reconstruction include:
- Natural-looking and -feeling results
- No synthetic materials
- Women can still undergo chemotherapy or radiation therapy
- Breasts that change over time alongside your body
- Can help remove some unwanted tissue (e.g., fat tissue) from the abdomen
Some drawbacks of tissue flap reconstruction include:
- Intensive surgery with a longer recovery
- Some of the transferred tissue can be absorbed, making it difficult to predict final results
- Usually requires an overnight hospital stay
- May require minor follow-up procedure(s) to put the “finishing touches” on the breasts once tissue absorption has finalized
- Possible long-term effects like visible scarring or muscle weakness at donor sites
What Makes Dr. Andrews Plastic Surgery Different?
The Dr. Andrews Plastic Surgery team values clear communication and patient education, so we will be sure that you understand our recommendations and agree with them before moving forward with anything. We encourage you to ask any and all questions you may have, no matter how small they may seem.
We also value compassion, empathy and respect toward each of our clients. We will never pressure you to have a procedure that you don’t want or don’t need; we deeply understand that breast reconstruction procedures, in particular, are a very personal matter. While to some women these procedures are empowering and exciting, others may approach them with apprehension or uncertainty. If you are unsure whether you want a breast reconstruction, you can use your consultation with Dr. Andrews to learn about the procedure and all of your options moving forward. Breast reconstruction is not right for everyone, and your decisions about your body are your own. No matter what you choose, we will respect your choice and will never make you feel anything less than confident and beautiful.
Contact Dr. Andrews Plastic Surgery
Breast reconstruction is an important part of both the physical and emotional healing process. Dr. Andrews has guided many patients through the reconstruction procedure and through recovery. As a board-certified plastic surgeon known for his exceptional skill and compassion, Dr. Andrews can help you achieve your ideal restoration outcomes. We proudly serve patients in the greater Cedar Rapids and Iowa City, Iowa area, with locations in Cedar Rapids and in Coralville. Contact Dr. Andrews Plastic Surgery today to schedule your consultation and learn more about the breast reconstruction process — call our team at 319-382-8230.