Breast reconstruction is an option for women who have had one or both breasts partially or completely removed during mastectomy, or breast cancer treatment. Reconstruction restores the shape and volume of the breasts to create the most natural-looking appearance possible while restoring balance to the body. The breasts can be reconstructed with implants, the patient’s own tissue or a combination of both. Reconstruction may be performed at the same time as the mastectomy or following mastectomy, based on the advice of the patient’s medical team.
The surgeons of Chicago Aesthetic Surgery Institute and Medspa are highly experienced in breast reconstruction cases and very sensitive to the needs of women during this experience. Our Chicago breast reconstruction patients are treated with the utmost degree of compassion and respect as they make important decisions regarding their breast reconstruction. Our surgeons never rush patients into making a decision. Instead, our surgeons consider themselves a resource that patients can depend on at any time they have a question or a concern.
Surgery Candidates
Women who have lost one or both breasts to cancer or significant trauma are suitable candidates for breast reconstruction. If you would like to learn whether you can benefit from this procedure, please schedule a consultation with one of our experienced Chicago plastic surgery providers. Chicago plastic surgery providers.
The Procedure
There are several breast reconstruction methods:
With implants: If the patient has elasticity in her skin and relaxed muscle tone, the implants can be placed between layers of chest muscles. If the patient has tight chest skin and muscles, she may need to have a tissue expander placed prior to the permanent breast implants.
With the patient’s own tissue: Another breast reconstruction option is using the patient’s own tissue to recreate the breast. The tissue may be taken from a donor site like the stomach, back, thighs or buttocks. The most common donor sites are the stomach and the upper back.
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Nipple Resensation
Frequently Asked Questions on Resensation
Dr. Szczerba and Dr. Kapadia are on the forefront of providing nerve reconstruction to restore breast/nipple sensation.
With breast reconstruction, reconstructing nipple sensation represents yet another advancement possibility in restoring not just normal breast appearance, but also nipple sensation after nipple sparing mastectomy.
Surgery Candidates
When nipple sparing mastectomy is an option for surgical care, restoring nipple sensation may be an option. Breast size remains a limitation for nipple sparing mastectomy with larger and longer breasts likely needing nipple and areola removal due to lack of circulation after the mastectomy, however, if a nipple sparing mastectomy is an option, then nerve reconstruction to the nipple area may be possible.
The skin sparing mastectomy (instead of nipple sparing mastectomy) patient and the larger, longer breast patient is not likely a candidate for nipple resenation. As an alternative, a breast reduction may be performed initially removing any diseased breast tissue at the initial surgery. Once healed from the surgery a completion mastectomy as a nipple sparing mastectomy may be considered with nerve reconstruction.
The Procedure
During nipple sparing mastectomy, a breast surgeon and plastic surgeon carefully find the nerves that give sensation to the nipple area by looking on the side of the chest muscle as the breast is removed. The nerve can be then traced further to allow either preservation of the entire nerve or a segment of the nerve. The breast can be reconstructed with either implants or tissue expanding implants above or below the muscle. During the breast reconstruction process, the nerve is reconstructed either with a nerve segment or a nerve graft from the tissue bank.
Recovery
The recovery from breast reconstruction does not change if the nerve to the nipple is reconstructed; six (6) weeks is the normal time for the body to recover after surgery.
Benefits and Risks of Nerve Resensation
There are definite advantages of resensation of the nipple area with protective and erogenous nerve functions. Furthermore, without large areas of numbness after mastectomy, patients relay a more complete sense of recovery. Although additional time is required for nerve reconstruction, no other significant risks are associated with nerve reconstruction. If nerve reconstruction isn’t successful, the area of numbness is similar to when nerve reconstruction wasn’t an option.
Nipple and Areola Reconstruction
To complete the breast reconstruction, the nipple and areola are recreated using the patient’s own tissue, which is pigmented with tattoo ink. The tissue may be taken from the breast, opposite nipple, ear, eyelid, groin, inner thigh or buttocks.
Recovery
During the recovery phase, it is important that breast reconstruction patients follow the post-operative instructions of their surgeons. Although complications are rare, the risk of side effects can be further diminished if patients follow the post-operative guidelines of their Chicago breast reconstruction surgeons. These guidelines include getting plenty of rest, abstaining from exercise and heavy lifting for several weeks to a month, and carefully tending to the surgical incisions. Our practice will schedule several follow-up appointments with each patient to ensure that healing is proceeding smoothly.
Breast Reconstruction Risks and Benefits
Breast reconstruction can restore confidence and self-esteem in women who have lost one or both breasts to cancer. In some cases it may be performed at the same time as mastectomy, requiring only one round of anesthesia and surgical recovery period. The combined approach also reduces the psychological trauma because the breast is restored immediately.
As with all surgical procedures, there are several risks such as infection, bleeding, complications during the healing process, loss of sensation in the breast and problems at the donor site (if a tissue flap is used). All of the risks can be greatly reduced when the procedure is performed by a well trained and experienced plastic surgeon, such as a plastic surgeon from the Chicago Aesthetic Surgery Institute.
Nipple Inversion Correction
Candidates
Ideal candidates for nipple inversion correction are patients that breastfeeding is not a priority. Constricted or scarred breast ducts are the usual causes of nipple inversion; dividing the retracted duct allows the nipple to go to a natural everted position. Confirmed normal breast exam and a documented normal mammogram are important to rule out prior to treatment of an inverted nipple.
Nipple Inversion Procedure
The procedure is done with local anesthetic only. The nipple is then pulled out to the desired projection. A small needle puncture is made at the base of the nipple and subcision of the structures retracting the nipple are then divided. A small stitch is then used to keep the nipple everted.
Recovery
Recovery from nipple inversion treatment required keeping the area dry for 48 hours and protecting the projection with gauze for 4-6 weeks. Stitch removal is performed approximately 4 weeks after the procedure.
Risks and Benefits of nipple inversion correction
Typically there are no significant risks with the procedure. Standard risks of recurrence of inversion, bleeding, and a small risk of infection can be minimized with technique. Typically breastfeeding is not possible after after correction of nipple inversion.
