Reconstructing one or both breasts after cancer can help restore self-confidence and positive body image after cancer. Many women find breast reconstruction an important part of the healing process.
Dr. Marco Ellis is one of the most sought-after breast reconstruction surgeons in Chicago. If you have faced or are facing breast cancer and want information about your reconstructive options, Dr. Ellis is happy to speak with you during an in-person consultation. He will help you find the approach that is right for you.
Breast Reconstruction Treatment Options
There are a few different ways to restore the form and shape of the breasts after cancer surgery. Your anatomy, goals and cancer treatment plan will influence the approach recommended to you. There are pros and cons of each, all of which Dr. Ellis will review with you.
Implant-Based Breast Reconstruction
One option is implant-based reconstruction, in which saline or silicone implants are placed to recreate the look of one or both breasts. Implant-based reconstruction may require two or three procedure steps, including the use of a tissue expander device to create room inside the chest wall to accommodate the breast implant. The expander is gradually filled with saline to stretch the skin and muscle envelope. After wearing a tissue expander for a few months, you will undergo a procedure to replace the expander with the implant.
Flap-Based Breast Reconstruction
Another reconstructive option is flap-based reconstruction, in which a flap of your own skin, fat and muscle is used to recreate one or both breasts. The flap may be taken from your back, abdomen or buttocks. It may remain attached to the underlying muscle and be tunneled under the skin to the chest, or removed and transplanted to the chest. Flap-based reconstruction is considered to be a more complex approach than implant-based reconstruction, and may require a short hospital stay and a longer recovery.
SGAP (superior gluteal artery perforator) flap reconstruction borrows tissue from the hips and upper buttocks. DIEP (deep inferior epigastric perforators) flap reconstruction uses surplus fat, skin and blood vessels from the lower belly. DIEP has largely replaced the traditional TRAM (transverse rectus abdominis) flap procedure, though the muscle-sparing microvascular free TRAM flap procedure may be appropriate for patients who are not good candidates for other flap procedures. This updated TRAM surgery uses only a small portion of the abdominal muscle.
You may also choose to reconstruct your breasts with a combination of your own tissue and implants.
The timeframe for breast reconstruction depends on the type of reconstruction chosen and the cancer treatment plan.
Sometimes breast reconstruction can be performed at the same time as a mastectomy; in other cases, it may be performed at a later date. Some treatment plans can be completed in a single surgery; others require several surgeries spaced out over a few months up to a year.
If only one of your breasts requires reconstruction, Dr. Ellis may recommend breast lift, breast reduction or breast augmentation for the opposite breast so that the breasts look symmetrical and balanced. This procedure may be performed at a later date on an outpatient basis.
Normally the last stage of breast reconstruction is to recreate the nipple and areola. Skin grafting and other techniques can be used to reproduce a very natural-looking nipple-areolar complex.
Breast Reconstruction Recovery
The recovery timeline differs from patient to patient, with the largest factor being the type of reconstruction that Dr. Ellis has performed. On average, implant-only reconstruction heals more quickly than flap reconstruction. You may take pain medication to manage any discomfort you experience following surgery.
Most likely, you will require one or two weeks of rest and relaxation before feeling well enough to return to work. Dr. Ellis will monitor your healing progress to let you know when it is appropriate to restart strenuous activity like exercise or lifting heavy objects.
Costs of Breast Reconstruction
All health insurance plans should cover breast reconstruction for women who have had mastectomies since that is required by United States law. This applies not only to women who choose to reconstruct their breasts immediately after a mastectomy, but also to those who decide to have breast reconstruction several years later. Dr. Ellis accepts insurance from many large providers, including Medicare. His team can confirm whether he is “in-network” for your plan or whether some out-of-pocket expenses can be expected.
Why You Should Choose Dr. Ellis for Breast Reconstruction
Breast reconstruction is a specialty of Dr. Ellis’s; his experience is evident in the consistently outstanding results he produces for his patients. If you choose to harvest fat and tissue from another part of the body, Dr. Ellis will use his advanced plastic surgery techniques to ensure that part of the body looks as appealing as the newly reconstructed breasts. Moreover, Dr. Ellis is a kind, compassionate professional who cares about the emotional well-being of his patients. He understands that breast reconstruction is a difficult decision and process for many women. He takes the time to explain options in great detail so that each patient makes a choice that feels right for her.
Testimonials from Breast Reconstruction Patients
“I first met Dr. Marco Ellis during my battle with breast cancer. He assisted my surgeon with my double mastectomy. I later became his patient again when it was time for my breast reconstruction surgery. My latissimus flap surgery turned out GREAT! I did not have any complications. I was not expecting the results I received because my cancer was aggressive. I actually have breasts again and they look normal! I would highly recommend Dr. Marco Ellis: he is definitely the best there is!”
– Carmella Y.
“After my double mastectomy, Dr. Ellis spent time with me to thoroughly go over my options for breast reconstruction. I decided to proceed with flap reconstruction and I couldn’t be more pleased with the results. Dr. Ellis is an artist and a perfectionist who takes pride in his work. Thank you, Dr. Ellis, for making me feel whole again.”
Breast Reconstruction Frequently Asked Questions
What are the pros and cons of implant-based reconstruction?
Implant-based reconstruction is a shorter surgery with less recovery time. It produces a beautiful breast shape with fewer scars.
On the other hand, implants usually require periodic maintenance. As time goes on, the risk of implant rupture and leaking increases (by approximately 1 percent per year). If you opt for implant-based reconstruction, there is a good chance you will need future surgeries to replace the implant(s).
What are the pros and cons of tissue-based reconstruction?
Tissue or flap-based reconstruction also creates a beautiful breast that looks and feels like natural tissue. There are no risks of capsular contracture or other implant-related complications. Furthermore, the area from which the tissue flap is taken looks slimmer and more sculpted after surgery.
The disadvantages of flap-based reconstruction are a longer and more complex surgery and, often, a longer hospital stay. Flap-based reconstruction also leaves additional scarring, as both the breast and donor area have scars.
What is the difference between immediate and delayed breast reconstruction?
Immediate reconstruction is performed at the time of mastectomy. Delayed reconstruction takes place after healing from mastectomy and any additional cancer treatments. Many women prefer immediate reconstruction as it reduces the overall number of surgeries needed.
Can I get implants if I need radiation?
Research suggests that radiation after implant-based reconstruction can increase the risk of complications such as capsular contracture. If you need radiation but want to use an implant to reconstruct the breast, you should discuss your options carefully with Dr. Ellis.
How can you make my other breast “match” the reconstructed breast?
Dr. Ellis will try to match the other breast closely to the reconstructed breast. He can accomplish this by reducing the other breast, increasing its size or lifting it in line with the reconstructed breast.
Can my nipple and areola be reconstructed?
Techniques such as skin grafting or three-dimensional tattooing can be used to recreate the appearance of a natural nipple and areola. Nipple-areolar reconstruction typically takes place two to three months after breast reconstruction.
When can I resume work after breast reconstruction?
It depends on the type of surgery you have and the type of work you do. In general, women who have implant-based reconstruction and work desk jobs return sooner than women who have flap-based reconstruction and/or physically strenuous jobs.
When can I drive after breast reconstruction?
You can drive as soon as you are no longer taking pain medication and have enough range of motion to feel confident in your driving ability.
Will I have sensation in the reconstructed breast?
You may develop sensation in the reconstructed breast, depending on the type of surgery you have. Restoring sensation is possible if your own tissue is used to reconstruct the breast, as the blood vessels and nerves can be reconnected to grow through the transferred tissue to the skin (whereas they cannot grow through an implant). Consider that it can take a long time to reclaim sensation, and sensation may be minimal. If this is a concern of yours, Dr. Ellis would be happy to discuss it in more detail with you during a consultation.