Breast Reconstruction | Renewed Confidence

Breast Reconstruction at The Park & Rebowe Clinic for Plastic Surgery //

Nobody expects to receive a diagnosis of breast cancer. With that diagnosis comes grief, questions, uncertainties, and confusion. There seem to be so many large decisions to be made in such a short period. The information is vast and comes from so many different sources. It is a situation that can leave many women feeling vulnerable. Not only will we give an overview of many of the options available to you, but we also partner with the National Breast Cancer Foundation to help ensure that patients have access to the best resources possible.

It is in this setting that we, as plastic surgeons seek to provide hope to women faced with such difficult choices. Our goal is to help each woman along her journey to recovery. We seek to restore what cancer has taken, providing hope that after all of the treatment is done, every woman can feel confident like herself again. In this short introduction, we hope to provide you with basic information on breast reconstruction to help you along your journey. Of course, when you are ready, we will stand by you and help you decide which of these procedures will be best suited for you and your personal goals. Regardless of whether or not you choose to undergo Breast Reconstruction in Mobile, please know that we support you in your decision and will continue to be there to support you in your breast cancer journey.

At the bottom of the page, we also provide more information on our proud partnership with the National Breast Cancer Foundation and share with you how you might make a difference to someone else in need. Other times, “breast reconstruction” may involve oncoplastic procedures to reshape the breast at the time of a lumpectomy by your oncological breast surgeon. If a patient needs a breast reduction, this can sometimes be completed in conjunction with the lumpectomy. Similarly, a breast lift or other type of “reconstructive” procedure may be used to provide the needed lift or fill of the area being removed. We would rather do these reconstructions before radiation which is almost universally recommended after lumpectomy for breast cancer, than after.

The Basics

What is Breast Reconstruction? //

The term “breast reconstruction” typically refers to the process of surgically creating a new breast following a mastectomy or surgical removal of the breast. This involves creating a replacement for the breast mound and subsequently creating a nipple. There are many ways to perform this procedure, as we will outline shortly. However, the goal of each of the techniques is the same: to create a breast that matches the opposite, natural breast as closely as possible.

In cases where both breasts are removed, the objective is to restore the breasts as closely to their preoperative state as possible and hopefully to improve on that. While there is no way to make a breast look the same as it did before surgery, in clothes and undergarments, a reconstructed breast should provide natural proportions. However, breast reconstruction does add additional procedures to the process of breast cancer treatment. These procedures are well tolerated by the vast majority of women who choose to undergo breast reconstruction, however, this may not be ideal for women who have medical problems at baseline. Significant heart, lung, liver, kidney, or other major organ dysfunction is generally a contraindication for breast reconstruction. Common medical problems such as high blood pressure, diabetes mellitus, and high cholesterol typically will not prevent a patient from undergoing our Mobile Breast Reconstruction procedure, but they will need to be managed appropriately around the time of your procedure.

Types of Breast Reconstruction

Implant (Prosthetic) Based Reconstruction

The vast majority of women will be candidates for breast reconstruction utilizing a breast implant. To be a candidate for this type of reconstruction, the skin remaining after your mastectomy has to be of good quality. Typically this means that there can be no radiation injury, previous infection, or other issues with the mastectomy skin flaps. In this type of reconstruction, breast implants are utilized to restore volume to the skin once the breast tissue is removed. Because the skin is removed during a normal mastectomy, this procedure typically takes 3 stages.

In the first stage, a temporary expandable implant is usually placed, termed a “tissue expander.” When this expander is placed, it is either deflated completely or inflated only a small amount. This allows the skin to shape and form where we want it. It is not always trying to create extra skin by stretching it. Often, we are trying to redrape and reshape loose, stretched skin. Over time, saline (salt water) is then added to the expander in the clinic by placing a small needle through the skin and into the expander port. Since the breast skin is typically numb at this point, this procedure normally does not cause a significant amount of discomfort. In general, tissue expanders are harder and less natural-feeling than breast implants as they need to be tough enough to direct the desired shape and resist the compression of the expanding skin.

Additional Reading

Once the skin is completely expanded, typically after at least 3 months, the expander may be replaced with a permanent breast implant. Breast implants are made of silicone (plastic) shells filled with either silicone gel or saline (salt water). Each implant has its own set of benefits and risks that your surgeon will review prior to your definitive reconstruction. The breast implant is placed into the pocket created by the tissue expander during the second operation. At this point, the tough and relatively hard expander is replaced by a relatively soft breast implant. This second operation will give a more natural look and feel to the breast. It will take the breast implant approximately three to six months to “settle” into the correct place. Nipple reconstruction typically is the focus of the third operation.

Following placement of the permanent implant, there may be some irregularities around the implant or chest wall that are cosmetically unappealing or may cause clothes to fit uncomfortably. At that point, months following implant placement, minor adjustments may be made. These adjustments can be performed by removing fat from the abdomen (utilizing liposuction) and placing the fat into the breast or by removing excess skin. This is a normal part of Breast Reconstruction and should be expected. It is also expected that the implant may need some type of operative maintenance during the patient’s lifetime. These short outpatient surgeries are typically due to natural changes in a woman’s body and not by implant malfunction.

Autologous (Your Tissue) Reconstruction

The second option for Breast Reconstruction is utilizing your tissue to rebuild your breast, also termed “autologous” reconstruction or “flap” reconstruction. In this operation, tissue is taken from another part of the body and moved to the breast defect utilizing specialized surgical equipment and technique. Flap procedures are highly specialized and tailored to each woman. In general, women are candidates for this procedure if they have ample donor site tissue and a favorable comorbidity (baseline illness) profile. If you are going to receive or have received radiation to your breast, a flap procedure may be necessary to bring in new, non-radiated tissue to the mastectomy site to complete reconstruction after radiation changes have settled.

The tissue typically utilized is the abdominal tissue in the lower part of the abdomen. This is the same skin and fat removed during an abdominoplasty or “tummy tuck” procedure. Therefore, this procedure results in some abdominal contouring in addition to the reconstruction of the breast. Some loss of function of the abdominal musculature may be necessary depending on the patient’s anatomy, but advancements in surgical techniques have made this less likely. Tissue can also be taken from the thigh, buttocks, or lower backs, however, the non-abdominal donor sites are typically performed only at large tertiary care facilities as they are far less common procedures.

Additional Reading

Flap reconstructions can have many benefits. Because the abdominal tissue has many of the same characteristics as breast tissue, it can provide a natural-appearing reconstruction similar in shape and natural ptosis (droop) to the native breast. While this type of reconstruction still requires two to three operations to shape the breast, once these operations are complete, there is typically no long-term need for reoperation. Lastly, the contouring of the abdominal donor site is similar to that achieved with an abdominoplasty (tummy tuck procedure). However, as many patients know, natural is not always the most desired. The flap will be prone to the same gravity, skin stretching, and aging as normal tissues.

Types of Breast Reconstruction

Implant (Prosthetic) Based Reconstruction //

The vast majority of women will be candidates for Breast Reconstruction utilizing a breast implant. To be a candidate for this type of reconstruction, the skin remaining after your mastectomy has to be of good quality. Typically this means that there can be no radiation injury, previous infection, or other issues with the mastectomy skin flaps. In this type of reconstruction, breast implants are utilized to restore volume to the skin once the breast tissue is removed. Because the skin is removed during a normal mastectomy, this procedure typically takes 3 stages.

In the first stage, a temporary expandable implant is usually placed, termed a “tissue expander.” When this expander is placed, it is either deflated completely or inflated only a small amount. This allows the skin to shape and form where we want it. It is not always trying to create extra skin by stretching it. Often, we are trying to redrape and reshape loose, stretched skin. Over time, saline (salt water) is then added to the expander in the clinic by placing a small needle through the skin and into the expander port. Since the breast skin is typically numb at this point, this procedure normally does not cause a significant amount of discomfort. In general, tissue expanders are harder and less natural-feeling than breast implants as they need to be tough enough to direct the desired shape and resist the compression of the expanding skin.

Once the skin is completely expanded, typically after at least 3 months, the expander may be replaced with a permanent breast implant. Breast implants are made of silicone (plastic) shells filled with either silicone gel or saline (salt water). Each implant has its own set of benefits and risks that your surgeon will review prior to your definitive reconstruction. The breast implant is placed into the pocket created by the tissue expander during the second operation. At this point, the tough and relatively hard expander is replaced by a relatively soft breast implant. This second operation will give a more natural appearing look and feel to the breast. It will take the breast implant approximately 3-6 months to “settle” into the correct place.

Nipple reconstruction typically is the focus of the third operation. Following placement of the permanent implant, there may be some irregularities around the implant or chest wall that are cosmetically unappealing or may cause clothes to fit uncomfortably. At that point, months following implant placement, minor adjustments may be made. These adjustments can be performed by removing fat from the abdomen (utilizing liposuction) and placing the fat into the breast, or by removing excess skin. This is a normal part of Breast Reconstruction and should be expected. It is also expected that the implant may need some type of operative maintenance during the patient’s lifetime. These short, outpatient surgeries are typically due to natural changes in a woman’s body and not by implant malfunction.

Surviving and Thriving

Your Breast Reconstruction Consultation //

At The Park & Rebowe Clinic for Plastic Surgery in Mobile, AL, we are here to support you in your journey of surviving and thriving beyond breast cancer. Your Breast Reconstruction consultation is a crucial step towards reclaiming your sense of self and confidence.

During this consultation, our compassionate team, including esteemed surgeons Dr. Park and Dr. Rebowe, will listen to your unique needs and concerns. We'll provide you with detailed information about breast reconstruction options, guiding you through the decision-making process.

Embracing Life

Your Breast Reconstruction Procedure //

With Breast Reconstruction Mobile patients are taking a significant step towards creating a beautiful and confident future. Led by skilled surgeons Dr. Park and Dr. Rebowe, our commitment is to help you regain what breast cancer has taken from you. The procedure can vary based on the approach chosen, whether implant-based reconstruction or autologous tissue reconstruction. Dr. Park and Dr. Rebowe will use their expertise to sculpt your breasts to a natural, harmonious shape.

Restoring Wholeness

Breast Reconstruction Results //

Breast Reconstruction is a remarkable journey towards restoring wholeness. At The Park & Rebowe Clinic for Plastic Surgery in Mobile, AL, under the expertise of surgeons Dr. Park and Dr. Rebowe, we understand that the results go far beyond physical appearance.

Your breast reconstruction results are a testament to your resilience and inner strength. They grant you not only restored physical contours but also a renewed sense of self-confidence and beauty. Whether you choose implant-based or autologous tissue reconstruction, our goal is to provide you with breasts that look and feel natural, harmonizing with your body. Countless studies have shown that breast reconstruction enhances the quality of life and psychosocial well-being of women who choose this path. It's about more than just restoring what cancer has taken; it's about embracing a future with a complete sense of self and a newfound radiance. Your breast reconstruction results are the embodiment of your courage and your journey towards wholeness.

Breast Reconstruction & Mastectomy Frequently Asked Questions //

Is breast reconstruction right for me?

It is important to know that breast reconstruction is optional. You do not have to undergo breast reconstruction following mastectomy, and you do not have to decide to undergo breast reconstruction at the same time as your mastectomy. The decision on whether or not to undergo Breast Reconstruction is extremely personal for each woman. Only you can decide whether or not it is the right choice for you.

Exploring your Breast Reconstruction Options

Which reconstruction is right for me?

There is no one reconstruction that is correct for every woman. The type of mastectomy, the need for radiation, the shape of the native breast, unilateral versus bilateral, desired shape and size, and other factors will all play a part in this decision. This guide is meant to be a general introduction to Breast Reconstruction in Mobile. As your surgeons, we will continue to walk you through this journey and recommend a reconstruction that will provide the best option for you. We only hope that in reading this and perusing these photos, each woman will be able to better grasp breast reconstruction and make the best choice for herself along with her surgeon.

How much does breast reconstruction cost?

The cost of Breast Reconstruction varies because it is a highly individualized surgery tailored for each patient. The overall price may include anesthesia, operating room facilities, new breast implants, and other related expenses. Additional tests and imaging may also add to your total. Contact us for additional information.

When should I have breast reconstruction?

It is possible to have Breast Reconstruction “immediately” at the time of your mastectomy or in a “delayed” fashion many months or even years following your mastectomy. Both periods are feasible and can provide a good cosmetic outcome.

In general, reconstruction performed immediately or closer to the time of mastectomy will have superior aesthetic outcomes as the tissue is more pliable and more easily manipulated. This type of reconstruction can be done at the same time as your mastectomy or shortly after, within two to six weeks before scar tissue forms. However, immediate reconstruction is not always possible. Among other things, post-mastectomy radiation therapy, a history of smoking, or the need for immediate aggressive chemotherapy are common reasons to delay reconstruction.

Delayed reconstruction can still be very rewarding to women who either choose to pursue this option or if this option is necessary due to medical conditions or other treatment plans. Reconstruction during this period may require some extra steps to ensure that the tissue is of good quality, but the results can be just as good as immediate reconstruction.

Does the type of mastectomy that I have influenced the type of reconstruction?

A mastectomy or partial mastectomy (lumpectomy) is meant for only two purposes: to treat known cancer or to decrease the risk of developing cancer. It is important to keep this in mind during this process. The type of mastectomy will influence the type of reconstruction that you pursue.

If the mastectomy is “skin sparing,” your cancer surgeon will take the nipple and a small amount of skin around it. This will require the recruitment of additional skin with either an expander or flap during reconstruction (this will be covered later). If the mastectomy is “nipple-sparing,” then the nipple will be saved along with the skin. Because there is no skin missing, it may be feasible to place a flap or implant directly underneath the remaining skin. However, there are many instances in which a tissue expander may still be used in order to better control the remaining skin envelope. Many women will also consider a contralateral prophylactic (or preventative) mastectomy in addition to a mastectomy on the side on which they have cancer. Again, the decision to undergo a contralateral prophylactic mastectomy should be more about cancer reduction than reconstructive potentials. However, having a contralateral mastectomy may improve the symmetry between the two breasts. For women interested in flap reconstruction, it is important to note that many women do not have enough abdominal or thigh tissue to make two breasts of adequate size. This should be considered when contemplating a prophylactic mastectomy.

Patient Testimonial

Written on November 6, 2019

"In April 2016, I was diagnosed with breast cancer at only 37 years old. Dr. Christopher Park’s nurses and staff are absolutely fantastic and made one of the hardest times in my life extremely comforting and was always available to answer any additional questions I had through the process. After I had my double mastectomy and was released from the hospital, Dr. Park even personally called me throughout that weekend to check on me. I just thought that was so admirable as you would normally be contacted by a nurse if at all, but he becomes completely invested in you as a patient. Over the next months, I had to also do chemo and Dr. Park and his team let me do my saline expansions at my own pace… when I felt well enough, which was very comforting to not have any additional stress. In Feb. 2017, Dr. Park did my reconstruction and fat grafting to fill in divets from my mastectomy and I am so happy that I took this additional step. Dr. Park did absolutely excellent work!! I still cannot believe how great my reconstruction came out and the scars are barely noticeable. I just wanted to look as normal as possible and he far exceeded any of my expectations! I highly recommended Dr. Park and his team to everyone! From the girls up front to the team of nurses and assistants and Dr. Park himself, I have the utmost respect for each and every one of them and cannot thank them enough for not only the excellent work but for being such great people and helping me through such a difficult phase of my life."

— by Google Reviewer

Breast Reconstruction Conveniently Located to Serve Fairhope and Mobile, Alabama

Breast Reconstruction at The Park & Rebowe Clinic for Plastic Surgery //

Breast Reconstruction Before & Afters

What is Breast Reconstruction? //

What are the benefits of Breast Reconstruction? //

Types of Breast Reconstruction

Implant (Prosthetic) Based Reconstruction

Additional Reading

Autologous (Your Tissue) Reconstruction

Additional Reading

Related Videos

Implant (Prosthetic) Based Reconstruction //

Your Breast Reconstruction Consultation //

Your Breast Reconstruction Procedure //

Breast Reconstruction Results //

Breast Reconstruction Recovery and Aftercare //

National Breast Cancer Foundation //

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Breast Reconstruction & Mastectomy Frequently Asked Questions //

Is breast reconstruction right for me?

Which reconstruction is right for me?

How much does breast reconstruction cost?

When should I have breast reconstruction?

Does the type of mastectomy that I have influenced the type of reconstruction?

Related Content

Patient Testimonial

Designing A More Beautiful Future

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