Dr. Birchenough has a special interest in breast cancer and breast reconstruction surgeries. Reconstructive breast surgery is an important option for women who have undergone (or who will undergo) breast cancer treatment with removal of breast tissue- either the entire breast (mastectomy) or a portion of the breast (lumpectomy or partial mastectomy).
Ideally, the breast reconstruction restores a natural, symmetrical appearance to the breast and helps maintains body proportion, allows clothes to fit better, and increases self-confidence for women who have had breast cancer. Other women may have had breast surgery for fibrocystic (lumpy) breast disease or benign (non-cancerous) areas, and require breast reconstruction.
While the best time to discuss breast reconstruction with Dr. Birchenough is prior to other cancer treatments (like breast surgery, chemotherapy, or radiation), many patients come in to discuss ways to improve their breasts after their cancer is fully treated.
There are new ways to approach breast cancer surgery, including the possibility of doing skin-sparing mastectomy or nipple-sparing mastectomy. Close discussions between the patient, the breast cancer surgeon and Dr. Birchenough will determine which type surgery is best for each individual.
Other reasons for breast reconstruction include congenital or developmental abnormality (like Poland’s syndrome), with one or both breasts not growing normally during puberty. Reconstruction can provide patients with a sense of health and well-being.
What Can I Expect During Breast Reconstruction Surgery?
Breasts can be reconstructed either by using your own tissue (from the abdomen or back), or by placing an implant to shape the breast. Occasionally, both methods are used together. Sometimes, a tissue expander is placed under the chest muscle. This is a special type of implant that is inflated in the clinic over a period of time to stretch the skin after mastectomy. The tissue expander is then replaced with a breast implant or with the patient’s own skin and fat.
Reconstruction can consist of multiple, staged procedures, the first of which involves creation of the breast mound. This is performed during or after mastectomy in a hospital under general anesthesia. Later surgeries (like fat grafting, reconstruction of the nipple and areola), may be done in the hospital or at an outpatient facility
Dr Birchenough has additional fellowship training in newer techniques using anatomically shaped (“gummy bear”) breast implants, acellular dermal matrix (ADM, or skin slings), and advanced fat grafting – liposuction of abdominal fat and reinjection to help recreate the breast.
If you have had breast reconstruction or breast cancer surgery and are not pleased with your results, come in to discuss your options with Dr. Birchenough.
Lumpectomies are the most common form of breast surgery for treatment of breast cancer in the U.S. Radiation is almost always used to supplement the surgery. The resulting breast shape or size may be different than expected. For appropriate patients, Dr. Birchenough can help improve the results.
Another area, prophylactic mastectomy (removal of the breast to help prevent cancer) may be recommended by your breast surgeon if you are at increased risk of developing cancer. Reconstruction should be considered for these patients, too.
In addition, Dr. Birchenough spends time discussing what procedures (breast lift or breast reduction, or even a breast implant) can be done to the non-cancerous, normal breast, to help improve symmetry if a patient has to have a single mastectomy or lumpectomy on the other side.
How Long Will It Take For Me to Recover?
The extent of the reconstruction and the type of reconstruction performed will affect the recovery time. Arm activity, again, is a limiting activity.
Drains are almost always used on breast reconstruction of any type. Recovery can last from four to eight weeks.
What Questions Should I Ask Dr. Birchenough?
- “Can I get a nipple-sparing mastectomy and immediate reconstruction?”
- “How does fat grafting work, and what does it do? Can my friend “donate” her fat to me for my reconstruction?”
- “Why would you use an anatomically shaped implant (“gummy bear”) versus another type of implant?”
What Does Breast Reconstruction After Cancer Look Like?
There are new ways to approach breast cancer surgery, including the possibility of doing skin-sparing mastectomy or nipple-sparing mastectomy. Close discussions between the patient, the breast cancer surgeon and Dr. Birchenough will determine which type surgery is best for each individual. Check out this collection of before and after breast reconstruction patients of Dr. Birchenough.