Breast reconstruction is a procedure that can give the breasts a better shape after surgeries where the breast has been fully or partially removed. Usually, this removal is caused by breast cancer surgery such as mastectomy. Breast cancer is the most common cancer in the United States and affects as many as 1 in 8 women. ⁽¹⁾ Sometimes, parts of the breast or the whole breast can be removed when a woman has breast cancer.

A mastectomy is when a doctor removes a breast (unilateral), or even both breasts (bilateral), in order to treat breast cancer. Both of these surgeries are meant to make the lives of women with cancer better. However, losing a breast, or the shape of a breast, can make a woman feel like she has lost an important part of herself. It can change the way clothes, bathing suits, and bras fit, and this can make life for a cancer survivor harder than it needs to be.

At Advanced Concepts in Plastic Surgery in San Antonio, our team strives to help women feel good about their bodies after a life-changing surgery like a mastectomy. Dr. Suresh Koneru is a board-certified plastic surgeon who has more than 25 years of experience with surgeries like breast reconstruction.

To learn more about breast reconstruction or to schedule a consultation with Dr. Koneru, please call our office at (210) 499-5900 or fill out our contact form.

About Breast Reconstruction

Breast reconstruction is a highly sought-after procedure due to its ability to restore a woman’s breast contour and enhance her self-esteem and body image following a mastectomy. By undergoing breast reconstruction, you can regain a sense of normalcy and feel more confident in your appearance. At Advanced Concepts in Plastic Surgery, we utilize a few different ways to reconstruct the breast to make it look round and full again. These methods can include a tissue expander, a latissimus dorsi flap, a TRAM flap, or fat grafting. The best way for you will depend on the shape of your breasts and the surrounding skin. Some of these techniques can be combined for the best results.

Tissue Expander

In order to begin to reconstruct the breast, Dr. Koneru can use a tissue expander. ⁽¹⁾ A tissue expander is similar to a breast implant, but it is used to stretch the skin of the breast so that a permanent implant can be introduced later. ⁽²⁾ A tissue expander can be compared to a balloon, but it is made of a silicone material. Tissue expanders come in many different shapes and sizes, so patients can achieve the size and shape they want. ⁽²⁾

Latissimus Dorsi Flap

The latissimus dorsi is a muscle that stretches across most of the back. ⁽¹⁾ Dr. Koneru can use a flap of this muscle along with some of the fat and overlying skin in breast reconstruction surgery. To use the latissimus dorsi flap, Dr. Koneru will remove an area of skin, muscle, and fat from the back and move it into the breast–or breasts–that need shaping. This is a great option for people who would rather remove muscle from the back than from below the belly button for breast reconstruction. The latissimus dorsi flap can be used with or without an implant or tissue expander. Tissue Expanders, implants, or fat grafting might also be used in addition to the latissimus dorsi flap if the muscle flap is not big enough to make the breast look full. ⁽¹⁾

TRAM Flap

A TRAM flap procedure is similar to the latissimus dorsi procedure but uses a different muscle. TRAM stands for the transverse rectus abdominis musculocutaneous and uses the abdominal rectus muscle. ⁽¹⁾ A TRAM flap is performed by moving a flap of this muscle, along with some skin and fat, from its original place beneath the belly button and into the breast. ⁽¹⁾ Because this muscle is autologous, the result is more natural. Thanks to the removal of fat and muscle in this area, the abdominal area benefits from extra shaping as well. ⁽¹⁾

Fat Grafting

Fat grafting, or fat transfer to the breast, is another way Dr. Koneru can help make the breast look rounder and more full. Fat grafting is done by using liposuction, which is when we suction out fat with thin tubes, to take fat from other places on the body and move it into the breast. ⁽³⁾ fat grafting is usually done during other methods of breast reconstruction, like flaps and implants, but it can also be done on its own. ⁽³⁾ Fat is transferred in multiple sessions for the best results. Patients may get the results they are looking for in about 5-6 sessions if using fat alone or in 1 to 2 sessions if using fat to further contour one of the other reconstructive options. ⁽³⁾

One of the great advantages of fat grafting is that the end result feels and looks very natural.

Benefits of Breast Reconstruction

Breast reconstruction has the benefit of providing women with a better breast shape after breast cancer surgery. More specifically, benefits include:

Candidates

If you have had breast cancer surgery in the past or are planning on having a mastectomy soon, and want to improve the shape of your breasts after those surgeries, you may be a good candidate for breast reconstruction surgery. Ideal candidates are patients without high blood pressure or diabetes. Candidates should not be smokers because this can affect the blood circulation in the breast. Cigarette smoking and consuming other nicotine products can also affect the healing process negatively. Patients must not smoke or consume other nicotine products at least two months before the surgery ⁽¹⁾ and throughout their recovery period.

Personal Consultation

The first step in any breast reconstruction surgery is a personal consultation. This is where you will speak one-on-one with Dr. Koneru and ask him any questions you have about the procedure. Dr. Koneru will also let you know how breast reconstruction surgery is done, and how your breasts will be affected. Because all breast reconstructions are unique, a personal consultation is vital so that the treatment plan fits your unique situation. Please come to your personal consultation ready to discuss your medical history and medications with Dr. Koneru.

To schedule your personal consultation at our San Antonio location, please call our office at (210) 499-5900 or fill out our contact form today.

Preparation

After your consultation, Dr. Koneru will help you prepare for your upcoming breast reconstruction. He will give you specific instructions, which may include the following:

Procedure

Regardless of which breast reconstruction technique is in your treatment plan, your procedure will be tailored to your specific needs. Dr. Koneru will let you know exactly what will happen during your breast reconstruction surgery in the weeks before your appointment.

A breast reconstruction surgery may take around 2 hours to complete. However, depending on its complexity, the surgery could take up to 8 hours. This time is also influenced by the type of surgery and skin availability that the patient has.

Recovery

Different types of breast reconstruction surgeries have different recovery times. With breast reconstruction involving implants, the recovery time is a bit shorter than surgeries done with flaps. In any case, it will be at least 4 weeks before you can return to work and most other activities. However, it may take up to 8 weeks for other kinds of breast reconstruction surgeries.

During your recovery, you should wear loose-fitting clothing. You will most likely not be able to drive during your recovery or do any lifting or activities that could get in the way of a quick recovery. Depending on your surgery, you may need to wear a special kind of support bra after your procedure. Dr. Koneru will provide you with detailed guidelines to follow during your recovery. The team at Advanced Concepts in Plastic Surgery will be there for you every step of the way, in case you have any questions or concerns.

Results

Whether your breast is reconstructed using a tissue expander, a latissimus dorsi flap, a TRAM flap, fat grafting, or a mixture of these, breast reconstruction surgery will result in breasts that are rounder and fuller in shape. If you have one or both of your breasts partly or fully removed, we will make them both look similar to each other again. For the best results, Dr. Koneru may recommend a secondary procedure or other additional treatments such as nipple tattooing. Once Dr. Koneru is satisfied with the results of the breast reconstruction, nipple reconstruction can commence 6 months afterward. Dr. Koneru performs a small local flap, after which a tattoo artist will render realistic, 3D-appearing nipples.

Cost of Breast Reconstruction in San Antonio

The cost of breast reconstruction can change from patient to patient, as everyone’s situation is different. The different kinds of breast reconstruction also have different costs. In order to determine what your personalized breast reconstruction surgery will cost, please call Advanced Concepts in Plastic Surgery’s San Antonio location at (210) 499-5900 or fill out our convenient contact form.

We also accept financing options like Prosper, CareCredit, and Alphaeon Credit.

FAQ

References

1. Regan JP, Casaubon JT. Breast Reconstruction. PubMed. Published 2022. https://www.ncbi.nlm.nih.gov/books/NBK470317/
2. Cho MJ, Farhadi RV, Nash DW, Kaleeny J, Povoski SP, Chao AH. The current use of tissue expanders in breast reconstruction: device design, features, and technical considerations. Expert review of medical devices. 2023;21(1-2):27-35. doi:https://doi.org/10.1080/17434440.2023.2288911
3. Turner A, Abu-Ghname A, Davis MJ, Winocour SJ, Hanson SE, Chu CK. Fat Grafting in Breast Reconstruction. Seminars in Plastic Surgery. 2020;34(01):017-023. doi:https://doi.org/10.1055/s-0039-1700959