Breast Reconstruction


Very few experiences are more traumatic than developing breast cancer. While a mastectomy or lumpectomy can often be an effective way to facilitate a full recovery, these procedures can also result in significant changes to your breast appearance. Many women find breast reconstruction to be an important part of the healing process, providing you with a way to feel confident in your breast appearance after a mastectomy.

Dr. Raymond Jean is a board-certified plastic surgeon with extensive experience performing breast reconstruction. He is sensitive to the ways that a mastectomy after breast cancer can impact you, and he can help you restore a beautiful breast appearance. This will hopefully allow you to move on psychologically after such a traumatic event.

Breast reconstruction is a complex procedure. While this page will provide you with a detailed overview, the best way to learn about your options and receive individualized treatment recommendations is to speak with Dr. Jean in person. Please call 484-222-0010 today to schedule a consultation. We serve patients in Bryn Mawr and throughout the Main Line of Philadelphia.

Am I a Breast Reconstruction Candidate?

breast cancer patient holding a pink ribbon after breast reconstructionMost women who have undergone surgical breast cancer treatments are candidates for breast reconstruction. This procedure is commonly performed to restore a natural looking breast appearance after:

  • Mastectomy
  • Double mastectomy
  • Lumpectomy

Women who have undergone prophylactic mastectomies as a precautionary measure due to genetic predisposition to breast cancer are also good candidates for breast reconstruction.

When is the Best Time to Undergo Breast Reconstruction?

There are two different options regarding when to undergo breast reconstruction:

  • Immediate breast reconstruction – Your procedure is completed when you undergo your mastectomy or lumpectomy.
  • Delayed breast reconstruction – Your breast reconstruction is performed at a different time, after the completion of your mastectomy or lumpectomy.

In most instances, Dr. Jean prefers to perform breast reconstruction at the same time as your mastectomy or lumpectomy since this option spares more of your skin and results in a shorter scar. As an added benefit, immediate breast reconstruction will help restore a whole breast appearance more quickly, which will expedite your emotional healing process.

However, there are certain situations when performing immediate breast reconstruction may not be ideal. If this is the case, Dr. Jean will recommend a delayed procedure. Both the immediate and delayed breast reconstruction options will deliver a beautiful outcome, and you will be able to undergo breast reconstruction at any time after your mastectomy. If you aren’t ready to move forward with your procedure at the time of your mastectomy, you can wait until you are ready without affecting your results.

Breast Reconstruction Options

infographic comparing breast reconstruction techniquesThere are two different techniques used to perform breast reconstruction:

  • Breast reconstruction using tissue expanders and breast implants
  • Autologous tissue reconstruction

The first option involves using a tissue expander to stretch the breast tissue before placing a breast implant to restore a full breast appearance. The autologous tissue option uses tissue from a different region of your body to reconstruct the breast mound. Often, the donor tissue is taken from the back, lower abdomen or buttocks. While autologous tissue reconstruction is a longer procedure and involves a more extensive recovery, it also often achieves a more natural looking and feeling outcome.

During your initial consultation, Dr. Jean will review both options with you in detail in order to help you determine the right choice for your unique situation.

Implant-Based Breast Reconstruction

There are two phases to this procedure:

  • Expansion of the breast tissue
  • Implant placement

During the first phase of this procedure, Dr. Jean will use tissue expanders to create the new breast mound. Tissue expanders are temporary implants that adjust in size over time. Saline solution is gradually added to the expander in 1-2-week intervals until your desired outcome is achieved. Tissue expanders provide Dr. Jean with greater control over your final breast size. Often, it may take 3-5 breast expansions before you are ready for the implant placement phase.

Once this phase is complete, Dr. Jean will remove the tissue expander and replace it with a breast implant. This typically occurs about 3 months after placement of the tissue expander. However, the specifics of your breast cancer treatment may require a delay in placement of the breast implant:

  • If you need chemotherapy, Dr. Jean will recommend waiting at least one month following the completion of chemotherapy before placing the breast implant.
  • In the event that you need radiation therapy, it may delay the placement of the breast implant for as long as six months.

In situations where the nipple was removed, nipple reconstruction will occur approximately two months after placement of the breast implant. During this process, Dr. Jean will use tissue from the chest wall to reconstruct the nipple and areola. You may also choose to undergo medical tattooing in order to more effectively conceal the scars after nipple reconstruction.

If you only need to reconstruct one breast, Dr. Jean may recommend breast augmentation and/or a breast lift on the other breast to ensure a more symmetrical looking appearance.

Benefits and Drawbacks of Implant-Based Reconstruction

Breast reconstruction using tissue expanders and implants is a much more straight-forward procedure than the autologous tissue reconstruction technique. This enables you to achieve the following benefits:

  • Less time spent in the hospital
  • Shorter recovery process
  • Less scarring

However, the use of breast implants also means that you will most likely need a revision procedure down the road to replace your implant. In most instances, you can expect your breast implants to last approximately 15 years. However, they may need to be replaced earlier if you experience:

  • Implant deflation (this only occurs with saline breast implants)
  • Implant rupture
  • Capsular contracture (firm scar tissue around the implant)

Also, autologous tissue reconstructions tend to produce more natural looking and feeling results than implant-based procedures. If achieving the most natural looking outcome is important to you, then you may want to consider the autologous tissue technique.

Autologous Tissue Reconstruction

Autologous tissue reconstruction involves using tissue removed from a different part of your body to rebuild the breast mound. This technique provides a more permanent outcome than can be achieved with breast implants. However, it is also a more complex and extensive procedure.

Dr. Jean can perform this procedure using a variety of techniques, including:

  • DIEP perforator flap – This technique spares the most amount of muscle.
  • Muscle-sparing microvascular free TRAM flap – More muscle must be removed than the DIEP flap technique, but this option spares more muscle than the traditional TRAM flap option.
  • Traditional TRAM flap – This technique removes the most amount of muscle. Dr. Jean must tunnel fat, muscle and skin from the abdominal wall to the chest in order to recreate the breast.

You can achieve excellent results with all three techniques. During your consultation, Dr. Jean will recommend the ideal technique to address your unique needs and goals.

Benefits and Drawbacks of Autologous Tissue Reconstruction

The primary benefit of choosing autologous tissue reconstruction is that it provides a more natural looking and feeling result. In addition, using your own natural tissue to rebuild the breast instead of an implant means there will be less maintenance necessary. You will be able to avoid the revision procedures that are required periodically to replace breast implants.

The primary drawback is that this technique results in the creation of a scar in two locations – the breast region and the donor site. However, many women find that having an additional scar is an acceptable tradeoff for achieving more natural looking and feeling results.

Combining Implant and Autologous Tissue Techniques

Dr. Jean can also use the implant technique in conjunction with the autologous tissue reconstruction technique. This approach will allow you to achieve more durable, long-lasting results than would be capable with implant-based reconstruction. This procedure involves covering the breast implant with fat, muscle and skin from the back. Covering the implant with your natural tissue provides two important benefits:

  • Additional support for the breast implant
  • An outcome that looks and feels more natural than can be achieved with an implant alone

This procedure is more complex than implant-based breast reconstruction. As a result, you should expect a slightly longer hospital stay and recovery period.

Infographic: Preparing for Breast Reconstruction

Why Choose Main Line Plastic Surgery

Dr. Raymond Jean considers it an honor and a privilege to participate in your journey towards recovering from breast cancer. He is very sensitive to the traumatic nature of your experience, and he will provide you with the compassionate, personalized care you deserve every step of the way. Dr. Jean will take as much time as necessary to thoroughly explain all of your options in order to make sure you feel comfortable with your treatment plan.

This highly compassionate care, combined with Dr. Jean’s extensive experience performing breast reconstruction procedures, have enabled him to help many women restore a beautiful breast appearance. This is often one of the most important components to healing emotionally after breast cancer.

Contact our Philadelphia Plastic Surgeon

Please contact Main Line Plastic Surgery using the form on this page or call 484-222-0010 today to schedule your breast reconstruction consultation. We serve patients in Bryn Mawr, Villanova and throughout the Main Line of Philadelphia.

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