Breast Reconstruction Overview
Our board-certified plastic surgeon, Dr. Tsujimura, specializes in reconstructing the breast after cancer treatments by using a breast tissue expander or implants or utilizing the patients own body tissue to surgically create the breast. Patients can schedule a consultation in Scottsdale, AZ whether reconstruction is at the time of mastectomy or at a later date.
Things to Consider
During your first consultation to discuss reconstruction surgery, it is important to disclose where you are in the treatment process and which cancer surgeon is treating you, as well as provide any necessary pathology reports. The reconstruction process may take place in multiple steps if the skin needs to be stretched to make room for implants. This planning phase will help guide the reconstruction process so patients end up with a new breast that is the size, shape and look they want.
"Rhinoplasty - Scottsdale, AZ - I couldn't be happier with my new nose.I hated my nose for as long as I can remember, when I looked in the mirror or at pictures of myself that's all I saw. The first time I met with Dr.Holden he pin pointed my exact issues with my nose with out my having to tell him. He was very kind and patient and answered all of my questions. While talking to him it was obvious he knew what he was talking about and was an expert in his field. I felt so comfortable and confident with him that I canceled my other consultes (with another surgon I used in the past) and scheduled by surgery for the next week. Dr.Holden also saw me at every one of my follow up appointments, not some nurse, which was very important to me and helped with my post surgery anxiety. With being 34 years old and a mother of 3 it was very important to me for my new nose to look natural. It does. I am thrilled when I look in the mirror and the people close to me have all remarked how wonderful it looks. While people that I haven't shared my surgery haven't noticed or at least not enough to say "oh my gosh you got a nose job!" I still look like me. :)"- S. / RealSelf / Jul 30, 2015
"I Couldn't Be Happier! - Dr. Holden is a very talented physician. Not only is he exceptional at facial plastic surgery, he is kind, compassionate and caring. I am extremely pleased with my eye lift and face lift, I couldn't be happier. He makes you feel comfortable every step of the way explaining the surgery and recovery in detail. He has the best bed-side manner of any physician I've encountered!"- S. / RealSelf / Nov 28, 2018
"Dr. Holden for Rhinoplasty! - I had a rhinoplasty procedure yesterday, after years of wanting to have one, but not actively pursuing to do so. I wanted a small refinement to my profile. I chose Dr. Holden because of his warm and caring nature, and his close attention to detail. In the initial consultation and meeting with Dr. Holden, I knew I had chosen the right doc for the job. Not only is he a fantastic plastic surgeon..."- A. / RealSelf / Oct 18, 2018
"Dr. Paul Holden is a Very Gifted Plastic Surgeon. - Dr. Paul Holden is a fantastic plastic surgeon. I would highly recommend that anyone needing facial plastic surgery use him. My results were outstanding. Arizona is very fortunate to have him as a resource in our area."- D. / RealSelf / Sep 19, 2018
"Walking through the fear! - I initially went to talk to Dr. Holden in May of 2016 about straightening my septum and removing a bump on my nose from when it was broken when I was young. I got nervous and opted not to do it. A friend of mine went to see him for a similar surgery and went through with it. After seeing the results and the success that my friend had I opted to go through with it in March of 2017. Tonight I..."- B. / RealSelf / Sep 16, 2018
Breast Reconstruction Surgical Technique
Each reconstruction technique will be tailored according to the patient’s physical health, aesthetic goals, and personal preferences and cancer treatments. There are many factors playing into the approach that will be taken. The ultimate goal is to ensure the patient is healthy and happy with their final breast results.
There are two primary categories of breast reconstruction techniques:
- Procedures that involve using a breast implant
- Procedures that are autologous (use the patient’s own body’s tissue to reconstruct and recreate the breast)
- Procedures performed on opposite “native” breast to achieve symmetry.
Reconstruction With Implants
Breast reconstruction using silicone or saline implants is a common approach that generally starts with the use of a tissue expander to help form a suitable pocket for an implant. The expander may be inserted after the mastectomy procedure or during the same operative session. Over the course of several months, the expander will slowly be enlarged using a sterile solution injected through a port residing under the skin. During the scheduled reconstruction surgery, the expanders are removed and replaced with permanent implants.
If there is limited skin or there is radiation changes, tissue may be used from another part of the patient’s body for reconstruction. The most common areas for donor tissue is the abdomen and back. This is an autologous approach to breast reconstruction. The TRAM flap (Transverse Rectus Abdominus Myocutaneous) and the DIEP flap techniques involve taking skin and fat from the abdomen and relocating it to the breast. The Latissimus Dorsi Flap is another common method using tissue from the patient’s back.
During a mastectomy, the nipple and areola often cannot be saved. The loss of one’s nipple and areola can be as unnerving as the removal of the breast itself. However, reconstruction techniques have advanced greatly, allowing plastic surgeons the opportunity to recreate these areas of the breast to give a natural, aesthetically appealing appearance. In a separate procedure, the nipple is created using existing breast skin or from the abdominal or latissimus flap. The areola can be recreated using a tattoo technique or with a skin graft taken from the thigh or abdomen.
Breast Reconstruction During/After Surgery
Breast reconstruction surgery is performed under general anesthesia at an accredited surgical facility. Some patients may be required to stay in the hospital to be monitored. Patients who have had reconstruction using a flap technique will usually be required to stay in the hospital for 2-5 days. The recovery process can be somewhat lengthy, but many view it as the final step in their cancer journey thus the experience can be very rewarding. Most women are thankful to have had the opportunity to restore their breasts and are satisfied with their results.
Plan Your Procedure
Breast Reconstruction FAQs
This is a very specialized surgery that requires extensive knowledge, skill and experience. It is very important to research and find a qualified and reputable plastic surgeon who has experience with breast reconstruction surgery.
Can I Delay This Surgery?
In many situations, it is recommended to start the reconstruction process at the same time as the mastectomy. Therefore, it is a good idea to have your breast cancer surgeon and your plastic surgeon begin communicating about the steps that will follow. An advantage of doing the procedure immediately is waking up from your mastectomy surgery with the reconstruction process in place. The soft tissue that surrounds the breast will heal simultaneously with the reconstruction, which can enhance the final results. There are some circumstances that require a delayed reconstruction.
A reconstructed breast will not have the same sensation as the breast did before the mastectomy, limited sensation may return and will depend on the extent of the reconstruction process and will vary by patient.