Exploring Your Breast Reconstruction Options

There are several options available for breast reconstruction. Dr. Alghoul follows an individualized approach to breast reconstruction and realizes that different patients have different needs, body types, and reconstructive goals. Based on your examination, breast and body analysis, and mastectomy method, a recommendation will be made on the reconstructive procedure that will best meet your goals and needs.

Dr. Alghoul performs the full spectrum of breast reconstruction procedures, including implants, local tissue flaps, free tissue flaps including the DIEP flap, and fat grafting. A flap simply represents soft tissue elsewhere in your body (muscle, fat or skin) that can be moved along with its blood supply to the chest and shaped to make a new breast. A free flap indicates that the tissue is moved from a distant location (most commonly the abdomen) and transplanted into the chest to make a breast. Dr. Alghoul specializes in performing the DIEP flap, which uses the skin and the fat of the lower abdomen (tummy tuck area) to reconstruct the breast while completely preserving the abdominal muscle. This procedure differs from the TRAM flap, which takes a portion or the entirety of the muscle.

The duration of the operation, hospital stay, and postoperative recovery all depend on the type of reconstruction performed. The majority of reconstructions require at least two stages (operations) for completion; however, single-staged reconstruction can be performed in certain situations.

Breast Reconstruction with Implants

Breast reconstruction with implants is a very popular form of reconstruction because of the relatively shorter recovery and potentially excellent results that can be achieved. It can be done in a two-stage approach, where a tissue expander is placed first to expand the breast and then later exchanged for an implant when the desired shape and volume are reached. A single-stage implant reconstruction can also be performed in what is commonly known as “direct to implant”. The implant is placed at the time of mastectomy without the need for an expander. The advantage of “direct to implant” approach is that it eliminates the need for the expansion process that usually requires multiple office visits.

Why then not do “direct to implant” on every patient who elects to have implant breast reconstruction?
Great question. “Direct to implant” is not for everybody. To explain this further it is important to understand how the breast skin gets its blood supply. It receives blood through the breast tissue underneath it. During mastectomy, the breast surgeon removes the breast tissue and therefore deprives the skin from its blood supply. The breast skin now will have to rely on the neighboring skin to get its blood and it will be “sick” for some time until it adjusts. During this period as the skin adjusts, we try to avoid placing too much pressure on it from underneath. Since we control the amount of fluid we place in the tissue expander (we can essentially deflate it as much as we want – think of it as a balloon), and we can minimize the amount of pressure it exerts on the skin. The implant, on the other hand, is already filled and can put more pressure on the skin. Therefore, the first condition for a patient to be a good candidate for a “direct to implant” procedure is that the skin after mastectomy has to be relatively thick and healthy looking.

Other factors that make a “direct to implant” procedure more favorable in certain patients include:

  1. If nipple preservation is possible.
  2. Good breast shape with minimal sagging.
  3. Breast size range Full B to Small D.
  4. Good skin laxity – it is easier to do “direct to implant” in breasts with loose skin than with tight skin.
  5. The patient does not desire significantly larger breasts.

In the more traditional two-stage procedure, a tissue expander is placed in a pocket under the chest muscle, the pectoralis major. The reason why it is placed under the muscle is to get additional soft tissue coverage over the expander, since the breast skin is thin. The tissue expander is typically filled to approximately 50% of its capacity. This varies depending on the tightness of the breast. During the procedure, two drains are placed per breast to help drain the fluid that accumulates under the skin after surgery. The patient stays in the hospital for one day and is discharged home with the drains. Follow up appointments are scheduled after that every week. The patient goes home on antibiotic pills and narcotics for pain control.

A very frequent question asked by patients is the timing of the second stage. Before we talk about the timing, we should explain the second stage or second surgery and what it accomplishes. In the second stage, the tissue expanders are removed and exchanged for the breast implants. The implants are chosen by the patient and myself based on the breast pocket dimensions and the desired volume and shape. In addition to exchanging the expanders for implants, fat grafting is also performed to smooth out the implant edges and fill in the hollow areas, which are frequently present in the breast. Nipple reconstruction can be performed during the second stage or can be done as a separate procedure on a different day.

Recovery from the second stage surgery is usually much easier than the first stage with mastectomy. The pain is definitely less and patients return to their daily activities quicker.

There are different types of implants available in the market. The two main types are saline and silicone gel implants. Silicone gel implants have a softer and better feel to them than saline implants. Implants come in different sizes and dimensions. The surface of the implant can be soft or rough and the shape can be round or teardrop (also known as shaped, anatomic, and gummy bear implants). Choosing the implants depends on the patient’s breast shape and size preference and is determined by a discussion between the patient and her plastic surgeon once the expansion is finalized. There are three major implant manufacturers in the United States and they are Allergan (Allergan, Inc., Irvine, Calif.), Mentor (Mentor Corp., Santa Barbara, Calif.), and Sientra (Sientra, Inc., Santa Barbara, Calif.). All three have FDA approved lines of implants. You will be given a card at the end of your surgery with all of the information about your implants on it. (Serial number, size, etc.) Make sure that you keep this for your records.

The most common complications related to implant reconstruction are capsular contracture, implant malposition, rippling, and seroma. Capsular contracture is the formation of scar tissue around the implant. The incidence of this happening is variable ranging from 3.4% to 25% over 8 to 10 years. When capsular contracture is severe enough it makes the implant feel firmer and can distort the shape and position of the implant. Treatment of severe capsular contracture involves removing the implant along with the surrounding scar tissue and placing a new implant. Implant malposition refers to change in the implant position where it drops to the side or downwards. Correction of implant change in position may also require surgery to fix the implant pocket. Rippling is visible wrinkling of the implant through the skin and is one of the most common complications of implant-based reconstruction. The most common cause of rippling is thin skin and is usually treated by thickening the skin with fat grafting. Seroma is fluid collection around the implant that may happen after several months or years. Occurrence of a late seroma may necessitate removing the implant and capsule and placing a new implant. All of the above complications can occur on the long term and are the reason why women with implant reconstruction may need a revision down the road. Another reason for implant removal or revision is implant rupture. Implant rupture is simply a break in the outer shell of the implant that contains the silicone on the inside. Implant rupture is a clear indication for implant removal and placing a new implant. Sometimes implant rupture is silent and happens without symptoms. Therefore all the above manufacturers recommend that patients with silicone implant get an MRI of the breast every 3 years to check the implants. The incidence of rupture is also variable and differs from on implant brand to the other. Different rupture rates are also reported between round and shaped silicone implants. The reported incidence of rupture is between 3 and 13% over ten year-period.

Shaped Implants

Shaped implants were FDA approved in 2013 for use in breast surgery. They are fifth generation implants that have a shape resembling the natural silhouette of the breast. Compared to round implants, shaped implants have less fullness at the top, are form stable, and contain highly cohesive silicone (firmer). Form stable means that the implant maintains its shape regardless of its position. For example, if you place a round silicone gel implant on a flat surface it looks round, however if you place it in a standing position it collapses and loses its round shape and forms wrinkles. On the contrary, shaped implants have the same shape whether flat or standing and therefore they have the ability to shape the breast. Shaped implants also have the ability to restore the projection of the breast even after nipple removal, more so than round implants. Although wrinkling may still occur, it is less frequent compared to round implants.

The disadvantages of shaped implants are:

  1. They are firmer than round implants
  2. They do not move as much, which some patients actually prefer
  3. They may rotate inside the breast pocket creating an unacceptable cosmetic appearance. If a round implant turns upside down the shape of the breast does not change, however if the same happens to a shaped implant, the shape of the breast changes dramatically.

Autologous Breast Reconstruction

This is the other side of the spectrum where no implant is used and the breast is made of the patient’s own natural tissue. The tissue is taken from somewhere else in the body, therefore creating another incision and subsequently a scar. Recovery is consequently longer than implant breast reconstruction. The most commonly used donor site is the abdomen or tummy. The type of autologous breast reconstruction that I prefer is the DIEP flap, which harvests the skin and fat from the lower tummy while preserving the rectus abdominis or the “six-pack” muscle. Surgery is longer in duration than an implant based reconstruction, and requires a hospital stay of several days. The skin and fat from the lower tummy is transplanted on the chest by connecting small blood vessels under the microscope. After that, the tissue is shaped to make a breast.

Using your own tissue has several advantages. The results are definitely more natural compared to an implant reconstruction, especially when the nipple is not preserved during mastectomy. One of the normal aesthetic features of a female breast is “ptosis” or sagging. Although sagging is generally not considered a good thing to have, a certain degree of tissue sagging gives a more natural look. While excellent results can be achieved with implants, the breasts can look more “augmented” – on the other hand, reconstruction with a flap can more closely resemble the look of a natural breast. The other advantage is that the patient does not have to worry about implants. Women undergoing implant-based breast reconstruction may need another procedure in the future due to formation of capsular contracture, wrinkling, late seroma, or implant position.

A good candidate for a procedure such as the DIEP Flap is a patient with extra skin and fat in the lower tummy. Women with prior pregnancies who gain weight in the lower abdomen are the ideal candidates. Having skin laxity is important so that skin and fat can be removed and the resulting gap closed in a “tummy tuck” fashion. The extra fat in the lower tummy is also important because this volume is going to make the breast volume. Patients who are undergoing mastectomy on one side only will need less volume than those who are getting double mastectomies. The simple reason is that when one breast is being reconstructed, the whole tissue under the belly button can be used for one breast, while if two breasts are being reconstructed, then the tissue will have to be divided in half and each half goes to a breast.

Autologous breast reconstruction can be performed immediately at the time of mastectomy. However, it may be delayed if we know there is a high possibility the patient will need radiation. One of the indicators of the need for radiation is the result of the sentinel lymph node biopsy from the axilla. If the lymph node is positive, the flap surgery is delayed and tissue expanders are placed instead. A few months after the patient is done with radiation, the flap surgery can be performed. I prefer to wait for at least 4 to 6 months after the completion of radiation before transferring a flap to reconstruct the breast.

There are two types of abdominal free flaps that are used to reconstruct the breast: DIEP and TRAM flaps. The difference is in muscle preservation. I am a proponent of the DIEP flap and perform it exclusively unless the patient’s anatomy does not permit complete muscle preservation. In the TRAM flap, a segment of or the entire rectus abdominis muscle are removed with the flap. I will frequently order a CT scan of the tummy to study the anatomy of the blood vessels before surgery.

The tummy incision is usually kept at or close to the bikini line, so clothes can hide it. The closure of the incision and belly button is done in a cosmetic fashion to resemble a tummy tuck closure. Sometimes when muscle is taken with the flap, a piece of plastic mesh is used to repair the abdominal wall to prevent hernias or bulges after surgery.

The average duration of surgery is between 5 to 6 hours for one side (unilateral) and 6 to 8 hours for two sides (bilateral). Patients who are otherwise healthy tolerate surgery well. Blood loss is typically minimal and no blood transfusion is required. It is customary for a patient to stay in the hospital for 3 to 4 days. Since we establish a new blood flow to the skin and fat taken from the tummy by connecting small blood vessels together, we monitor this blood flow very closely after surgery. We will check on your flap every hour to make sure that it’s healthy with good blood flow. In the unlikely event that blood flow stops for some reason, then you will be taken back to the operating room to fix the problem. The chances of this happening are low, and flap failure or loss in general does not exceed 2 to 5%.

Recovery from a DIEP flap surgery takes longer than implant reconstruction. There is additional pain where the flap is taken from in the tummy and it takes longer for patients to regain their energy and stamina. It takes up to 6 weeks for patients to start feeling like themselves again.

If you are not a good candidate for a DIEP flap and are still interested in autologous reconstruction, there are other options that Dr. Alghoul can discuss with you during consultation.

Reconstruction with Latissimus Dorsi Flap
The latissimus dorsi is a back muscle that helps with shoulder and arm movements. The latissimus dorsi muscle is a broad triangular muscle that is considered one of the widest muscles in the human body. Also known as the “lat,” it is a very thin muscle that is not used strenuously in common daily activities. However it is still an important muscle in many exercises such as pull-ups, skiing, and swimming. Its strategic location close to the breast makes it a very valuable and useful source of tissue for reconstruction. It can be simply transferred to the front to provide tissue for breast reconstruction. The amount of fat in the back area however is usually insufficient to fully reconstruct the breast and is combined with an implant. The amount of surgery and recovery involved is somewhere between an implant and autologous reconstruction. The procedure requires an incision on the back and results in removal of an island of skin, fat, and the muscle. The resulting scar usually heals well.

If I will need an implant with this flap, what is the advantage of doing this over implant-only reconstruction?
This is an excellent and frequently asked question. To understand the importance of combining a latissimus flap with an implant we have to understand the shape of the breast. When the nipple and areola are removed during mastectomy, the resulting circular defect is closed in a straight line, which flattens the breast. Think of the breast as a ball. If you cut off the top surface of a ball, you end up with a flat top. This flattening reduces the breast projection. Bringing in a circular piece of skin to replace the nipple/areola restores this curve and maintains the breast projection. It also restores the surface area of the breast. This is more important in women with small size breasts. In addition, the latissimus flap brings in fat and muscle that add an additional layer of soft tissue padding over the implant, which improves the overall feel and appearance of the breast. As a result, a smaller implant can be used when combined with a latissimus dorsi flap compared to implant alone.

The latissimus dorsi flap also plays a critical role in reconstruction of the radiated breasts. Radiation induces scar formation and affects the quality of the skin. When scar tissue builds around the implant, the breast becomes firm and the implant gets compressed and loses its ability to expand the breast envelope. Removing this scar tissue and bringing healthy, non-irradiated muscle from the back to cover the implant helps solve the problem. Additionally, radiation can also damage the breast skin, in which case new skin will be needed to rebuild the breast. This skin can be borrowed from the back along with the latissimus dorsi muscle to replace the damaged breast skin. Think of the latissimus dorsi flap as a lifeboat! This is why this flap is usually not offered at the time of mastectomy if the need for postoperative radiation hasn’t been determined yet.

Another advantage of the latissimus flap is that the back skin is thick and since it replaces the area where the nipple/areola was, it provides excellent skin for nipple reconstruction. The best looking reconstructed nipples are the ones made of the thick skin of the latissimus flap.

To summarize the advantages of the latissimus dorsi flap in breast reconstruction:

  1. Provides extra soft tissue padding over the implant, which improves the overall appearance and minimizes visible wrinkling.
  2. The imported skin with the flap replaces the missing skin when the nipple/areola are not spared and therefore restores the skin surface area, curved surface, and projection of the breast.
  3. The thick skin provides an excellent platform for nipple reconstruction.
  4. It provides healthy tissue to replace damaged irradiated tissue.

Surgery takes two to three hours per side and requires one to two days hospital stay. Two additional drains are placed in the back per side and are removed over the next one to two weeks as the amount of fluid decreases over time. The latissimus dorsi flap surgery is generally well tolerated and is commonly performed. Recovery from surgery and return to work takes approximately 4 to 6 weeks. Physical therapy is generally important for strengthening of shoulder muscles after surgery. There have been several studies looking at functional deficit in shoulder motion after removal of the lat muscle that showed conflicting results. Patients are usually able to resume their activities of daily living without significant restriction and are able to return to work within 4- 6 weeks. Removing the latissimus muscle however does cause some weakness in shoulder adduction, extension and internal rotation that is compensated in time and physical therapy by other muscles. Women who had a latissimus muscle flap reconstruction can complain of fatigue when the operated side was involved into prolonged overhead daily activities like painting above shoulder level, push up for a chair, weight lifting, and certain sports like swimming, tennis, golfing, volleyball, and climbing.

Fat Grafting in Breast Reconstruction

Fat grafting has become an integral part of any breast reconstruction. The fat is removed from other areas of the body where it’s presence in plentiful supply and is injected in certain areas in the breast, where it’s needed to smooth the edges and fill in dimples and irregularities. You can think of fat grafting as “icing on the cake”. For example, the upper breast is an area that often suffers in any breast reconstruction and often lacks volume. This is an area that is typically fat grafted to restore natural fullness.

The procedure is usually performed during the second stage of reconstruction. Fat is harvested through small cannula holes. The most common harvest areas are the abdomen, waist, lower back, and thighs. The fat is filtered and washed and is injected using certain techniques in the breast. Fat grafting is performed as an outpatient procedure. Recovery is usually fast with minimal pain, except for the fat harvest sites, which can be bruised and sore depending on the amount of fat removed.

Breast Symmetry Procedures

Symmetry is relatively easy to achieve in bilateral (both sides) mastectomy and breast reconstruction. It is, however, more difficult to achieve in unilateral or one-sided mastectomy/reconstruction. There are several aspects of symmetry – which include breast shape, volume, and ptosis or how much the breast sags. It is very important to achieve volume symmetry so that both breasts can fit comfortably in a bra. For the shape and degree of sagging the goal is to make the normal breast and reconstructed breast look as close as possible to each other.

Autologous reconstruction (with your own tissue) usually achieves the best symmetry because the breast is made of natural tissue (fat), therefore resembling what a natural breast is made of. It is harder on the other hand to match a breast implant to a natural breast. In order to achieve symmetry in this case, a smaller breast implant has to be placed in the normal breast, and sometimes combined with a breast lift. Symmetry is harder to achieve when the breast cancer side is radiated Radiation makes the breast skin tighter and therefore the radiated breast always looks more lifted than the non-radiated side.

Symmetry procedures are performed during the second stage of reconstruction. Even with autologous reconstruction, a symmetry procedure is usually needed to either reduce or increase the volume on the reconstructed side and tighten the breast skin to make it look similar to the normal side.

Nipple Areolar Reconstruction

The nipple is reconstructed from the breast skin or the flap skin used to reconstruct the breast. A certain pattern is marked, cut, raised, and sewn to create the shape of a nipple. The thicker the skin is the better the size and projection of the nipple since the reconstructed nipple tends to shrink and flatten with time. The latissimus dorsi flap skin produces the best-looking nipple since the back skin is the thickest on the body. The areola is either marked with a tattoo or created with a skin graft. A skin graft placed around the nipple gives a nice texture resembling a natural areola. The skin graft is usually taken from the lower abdomen or the inner thigh.

Tattooing of the nipple and areola is performed three months after the completion of nipple reconstruction. 3D tattooing is another option for patients who do not want to pursue nipple reconstruction.

Breast Reconstruction FAQS

What does a “mastectomy” procedure do to my breast?

Mastectomy is the surgical removal of breast tissue. Currently, the most commonly performed type is the skin-sparing mastectomy, which removes the nipple, areola and the breast tissue while preserving the majority of the skin. Imagine removing the nipple and areola (commonly referred to as the nipple areolar complex), then carving out the breast tissue on the inside while preserving the skin envelop. Sometimes, the breast surgeon will also remove an additional area of skin if it is close to or involved by cancer.

Can the nipple be preserved?

It depends on several factors. Yes, the nipple can be preserved in a certain group of patients in a procedure called “nipple-sparing mastectomy.” A good candidate for this procedure is a patient with a relatively smaller breast (typically not larger than a full C-cup) and a good nipple position on the breast mound. Obviously, the nipple should not be involved with or close to the tumor. Ask your breast surgeon if you are a good candidate for nipple preservation.

Is it desirable to preserve the nipple for the final reconstructive outcome?

There is no question that nipple preservation enhances the appearance of the reconstructed breast. The nipple is usually positioned on the most projecting point of the breast. When the nipple areolar complex is removed and implant reconstruction is planned, the resulting defect is closed in a straight line, which flattens the breast projection.

What is breast conservation surgery?

Breast conservation, also known as partial mastectomy or lumpectomy, is when a breast tumor is removed while preserving the majority of the breast tissue. Depending on several factors including the relative size of the tumor to the size of the patient’s breast, breast conservation can be a viable treatment option. Your breast surgeon will discuss this option if it is suitable for you.

Do I still need breast reconstruction if I decide to get a lumpectomy instead of a mastectomy?

This usually depends on the size and location of the resulting cavity created by a lumpectomy. When a cavity collapses and scar tissue forms, it can form an indentation in the breast and pull the nipple off the center. As a result, the breast shape becomes distorted, causing significant asymmetry with the other breast. The larger the cavity and the closer it is to the nipple or the skin surface the more substantial the potential deformity. This scar contracture is usually made worse by radiation therapy, which invariably follows a lumpectomy. To prevent this from happening, breast tissue re-arrangement is recommended at the time of the lumpectomy. This tissue re-arrangement is referred to in general as oncoplastic surgery.

What is oncoplastic surgery?

This term refers to breast tissue re-arrangement to fill in the void created after a lumpectomy. It usually involves making skin incisions to lift or reduce the breast. If the breast is large and saggy, a breast reduction can be performed and designed to fill in the cavity or void created by lumpectomy. If the breast is of sufficient size and the lumpectomy cavity is small, then a breast lift can be performed to serve the same purpose. A matching procedure is always performed on the other breast at the same time for symmetry. If the breast size is relatively small and/or the cavity is large, tissue can be burrowed from somewhere else in the form of fat or muscle to fill in the cavity. This tissue is usually taken from the back or the abdomen.

What are the main types of breast reconstruction after a full mastectomy?

The main types are implant-based breast reconstruction and autologous (your own tissue) breast reconstruction, or a combination of the two.

What is “implant-based breast reconstruction?”

This method relies on a breast implant to re-create the breast mound. It is usually done in two stages. In the first stage, which is done at the time of the mastectomy, a tissue expander is placed in a pocket created under a large chest wall muscle called the pectoralis major. The skin is closed and the patient follows up in the office on weekly basis. Starting two weeks after surgery, gradual inflation of the tissue expander with saline takes place in the office. Once the desired volume is reached, the second stage operation is planned, usually three months from the first operation. If the patient requires chemotherapy or radiation therapy after mastectomy, then the second stage is delayed until the treatment is completed. During the second stage operation, the expander is removed and an implant is inserted. Visit our breast augmentation page to learn more about the different types of breast implants.

Can implant reconstruction be done in a single stage?

Yes, this procedure is also known as “direct-to-implant.” It is, however, not suitable for every patient. Ideal candidates are patients with small to medium-sized breasts and minimal nipple and skin sagging, who do not require post mastectomy radiation. In a “direct-to-implant” reconstruction, a piece of skin called acellular dermal matrix (ADM) is used to cover the lower portion of the implant. It allows the implant to be well seated in the breast pocket to create a nice lower curve.

What is acellular dermal matrix (ADM)?

It is a piece of biological tissue most commonly harvested from human (cadaver) or pig skin. The product is rigorously processed and is used as a collagen matrix to provide additional tissue coverage over the implant. It is placed under the breast skin and sewn to the muscle.

What is autologous breast reconstruction?

This term refers to using the patient’s own tissue to reconstruct the breast. It offers the advantage of making a breast that is soft and natural with a shape and size that can be tailored to be identical to the normal breast. The two most commonly performed autologous procedures in the U.S. are the TRAM and the DIEP flaps.

What is the difference between a TRAM flap and a DIEP flap?

A flap simply represents soft tissue elsewhere in your body (muscle, fat, or skin) that can be moved along with its blood supply to the chest and shaped to make a new breast. A free flap indicates that the tissue is moved from a distant location (most commonly the abdomen) and transplanted into the chest to make a breast. Dr. Alghoul specializes in performing the DIEP flap, which uses the skin and the fat of the lower abdomen (tummy tuck area) to reconstruct the breast while completely preserving the abdominal muscle. This procedure differs from the TRAM flap, which takes a portion or the entirety of the rectus muscle. The rectus muscle is the “six-pack” muscle on either side of the midline of the abdomen.

Who is a good candidate for a DIEP or TRAM flaps?

An ideal candidate is a healthy patient with excess tummy skin and fat below the belly button. Generally, women with prior pregnancies and skin laxity who are candidates for a “tummy tuck” are good candidates for this procedure. However, other factors are taken into consideration that may complicate surgery, such as the patient’s history of prior abdominal surgeries, presence of hernias or an obese, thick abdominal wall.

What if I want to use my own tissue for breast reconstruction but I don’t have enough skin and fat in my abdomen?

Tissue can be taken from other areas in the body for breast reconstruction like the buttock area (SGAP & IGAP flaps) and the inner thigh (TUG flap). Patients who desire autologous reconstruction who are not good candidates for tissue transfer from the abdomen can be evaluated if the aforementioned flaps are suitable for them. Another important area where tissue can be used for breast reconstruction is the back. The latissimus dorsi muscle can be mobilized with an island of skin and fat and rotated to the front to reconstruct the breast. However, this flap does not usually have enough volume and is usually combined with an implant.

What is the recovery period from surgery and how much time do I need off work?

For a tissue expander reconstruction, patients will usually need two to four weeks to recover from surgery and go back to work. The recovery is much faster with the second stage exchange to an implant. In the case of a DIEP flap reconstruction, recovery is slightly longer and return to work is between four to six weeks. Since the operation is longer, it takes more time for patients to regain their stamina and feel ready to go back to work.

The durations above are an estimate and they vary among patients who have different pain and recovery thresholds. Double breast reconstruction requires a longer recovery period compared to one-sided reconstruction.

How do I make a decision on which reconstruction is right for me?

Breast reconstruction is a very personal and individualized decision. What works for you may not work for another patient, and the reverse is true. By the time you see a plastic surgeon for consultation, you are often overwhelmed with the diagnosis, trying to absorb and process a lot of new information and at the same time adjusting to the fact that you may lose your breast. On the other hand, replacing a breast with an implant or another tissue is often a foreign concept that is hard to grasp by breast cancer patients. Committing to a certain path of reconstruction is not easy when one cannot predict the way her new breast is going to look or feel. Add to that the potential risks and complications related to each procedure.

During your consultation with Dr. Alghoul, he will discuss with you in detail the advantages, disadvantages and potential risks and complications of each procedure.

Contact Dr. Alghoul

If you’d like to schedule a consultation with Dr. Alghoul to discuss breast reconstruction, please call (312) 695-3654.