Breast Reconstruction In Minneapolis St. Paul, MN
After a mastectomy, many women choose to have breast reconstruction surgery to restore the breast to a more normal contour and balance with the opposite breast. This is an increasingly selected procedure, and is often covered, at least partially, by insurance. Dr. McCue performs all types of breast reconstruction surgery, by referral from other physicians. If you have been referred to Dr. McCue for breast reconstruction, this page will provide basic information on breast reconstruction.
Each breast reconstruction is unique, and depends on many factors, including the nature of the mastectomy procedure, and can be complicated by radiation treatments following the mastectomy. A number of different techniques are used, depending on the individual situation.
Understanding Breast Reconstruction Surgery
Breast reconstruction restores breast appearance after surgical procedures to remove breast cancer. It helps women regain confidence by recreating natural-looking breasts using implants or body tissue.
Our board-certified plastic surgeon, Dr. Jonathan McCue, is an eminent expert in implant-based breast reconstruction and a highly respected author on this topic. His additional expertise in tissue-based reconstruction ensures that every woman gets a customized solution.
Choosing Breast Reconstruction Surgery
Breast reconstruction is typically for women who have:
- A Mastectomy: Removal of the entire breast due to breast cancer.
- A Lumpectomy: Removal of a tumor inside the breast. Lumpectomy can cause widely varied amounts of tissue loss depending on the tumor size and other factors, but even a smaller amount of tissue removal may leave breasts looking uneven.
- Other Reasons: Breast tissue can be damaged in accidents, particularly through direct trauma to the chest. Similarly, some congenital deformities cause misshapen breast tissue.
Breast reconstruction can restore the appearance of your breasts and help you feel more comfortable with your appearance.
Techniques Used in Breast Reconstruction
Dr. McCue uses several methods for breast reconstruction, including using implants, the patient’s tissue (flap surgery,) and a hybrid approach with both.
He personalizes each technique based on anatomy and patient preferences.
Exploring Implant-Based Breast Reconstruction
With implant-based reconstruction, Dr. McCue inserts silicone or saline implants into the chest to restore breast shape. In most cases, implant-based reconstruction involves two surgical stages.
The first is a procedure to insert a tissue expander. Dr. McCue then gradually fills that expander with saline to help stretch your tissues and create space for the implant. Then, a second procedure involves swapping the expander for a permanent implant.
Exploring Tissue-Based Breast Reconstruction
Tissue-based reconstruction, also known as flap reconstruction, uses skin, fat, and muscle from another body part to reconstruct the breast.
It avoids using implants and may provide the most natural appearance and feel.
Dr. McCue may transfer tissue from the immediate area or from another location, like the belly or thigh (free flap.) A free flap is a more complicated procedure because it involves microsurgery to connect blood vessels to the flap to supply blood.
Although this technique can be the most time-consuming, it can result in the most natural breast reconstruction in the long term.
Breast Symmetry Procedures
Breast symmetry procedures adjust the opposite breast to match the reconstructed breast. This may include procedures like breast augmentation or reduction to enhance symmetry.
Immediate Breast Reconstruction After Mastectomy
Reconstruction can be done at the same time as a mastectomy, reducing the need for additional surgeries. Dr. McCue can coordinate with your oncology specialist to schedule your reconstruction immediately after your mastectomy if desired.
However, you don’t have to opt for immediate reconstruction. Many women choose delayed reconstruction, which gives their bodies time to process and recover from cancer treatments before their reconstruction.
Considering Your Breast Reconstruction Options
Several factors influence the choice between implants and tissue-based reconstruction, including:
- Medical History
- Previous Treatments
- Body Type
- Available Donor Tissue
- Personal Wishes
- Available Recovery Time
Dr. McCue helps patients weigh their options to find the best solution.
Implant based reconstruction: Most breast reconstruction in the United States today is done with implants. They’re almost always silicone implants, as opposed to saline, because they have a more natural feel and appearance. Following a mastectomy, there is no breast anymore to hide the contours of the implant which may be visible under skin and subcutaneous tissue. You may see some rippling in the upper aspect of the breast, folding of the implant or the edges of the implant. In general, the thicker your skin is with subcutaneous fat, the better the implant appears.
On the other hand, patients who are overweight may have difficulty with implants as the size of the implant only gets so large and the heavier implants may weigh several pounds which can take a toll on the skin. The ideal patient for implant-based reconstruction is someone who is of relatively normal body weight with good quality skin and has a bilateral mastectomy with small to moderate sized breasts.
Over time, your body will change, the implant does not. Patients who have an implant-based reconstruction are more likely to have “revision” surgeries down the road. They may desire a larger or smaller implant based on changes in body weight and scar tissue will naturally form around the implant which may change its appearance. Also, the implant can leak at which point your surgeon is obligated to recommend removal and typically, replacement. Ideally, you should get at least 15 years out of an implant-based reconstruction before issues develop that will prompt a patient to have additional surgery. The good news is that these additional surgeries happen to be very easy to recover from and typically not that painful, at least relative to the original mastectomy. They are also covered by insurance.
Tissue base reconstruction: Another way to reconstruct a breast is to use your own tissue. This is usually done with lower abdominal tissue and is an attractive idea to many patients as this puts lower abdominal skin and fat to good use as a breast reconstruction. The breast feels and looks the most natural and changes with fluctuations in body weight. It also gives us the opportunity to replace skin that has been damaged from radiation or previously failed reconstructive attempts. It is the best way to reconstruct a unilateral mastectomy, where we are trying to match a natural breast on the other side. Patients who have this surgery may still have have one or two “tune up” surgeries (reconstructing nipples, liposuction), and then they are done.
The downside for the surgery is that it is more involved with a longer recovery and typically involves a three-night stay in the hospital. The donor site may have healing issues that require further surgery. Also, you have to have enough skin and fat to donate. (And no, your friend can’t donate it for you… unless they are your identical twin.)
There is risk with this surgery in that some of the tissue that is essentially transplanted may not survive for lack of blood supply. This doesn’t happen often, but it is impossible to make this risk zero. The patient may lose some or all of the breast reconstruction and have a donor site scar with nothing to show for it. For this reason, most patients who have a tissue-based reconstruction have some reason why implants may not be ideal. This includes: 1) patients who have received radiation therapy, 2) patients who have had skin loss following the mastectomy, or 3) patients philosophically opposed to implants. Dr. McCue has over 15 years of experience doing these surgeries with a high rate of success.
Unilateral or bilateral mastectomy?
This is a common question and a very good one. Most patients really only NEED to have a single breast mastectomy as they do not have positive genetic testing and only have cancer in one breast. Yet most patients have a bilateral mastectomy, why is this? The issue is that a reconstructed breast, even though it may look very good, does not necessarily look like a completely natural breast. A natural breast will have more droopiness as we age and will demonstrate less volume in the upper aspect of the breast (cleavage). A reconstructed breast will sit higher up on the chest wall and will project more. Therefore, to achieve better symmetry, patients often choose to have a bilateral mastectomy so that the breasts match. This is a personal decision that patients have to make, ideally with some guidance from the surgeon.
If you choose to have a single breast (unilateral) mastectomy, you can have surgery to the non-cancer breast to help it match. This is more challenging and may require one or two more surgeries following the mastectomy to make it satisfactory. Typical surgeries include placing another breast implant in the non-cancer breast or a breast lift or reduction to reduce skin. These surgeries, although they sound cosmetic, are in fact covered by insurance in this instance. Some patients are easier to get to match than others, this is where the plastic surgeon can offer real guidance.
Your Breast Reconstruction Procedure Is Unique to You
Every case is unique, and Dr. McCue will discuss a treatment plan for your specific needs during a consultation with you. After reviewing your medical history and the nature of your mastectomy, he will discuss all of the available options with you and make recommendations for a treatment plan, which may involve multiple procedures over a period of time. He will help you understand the probable outcome of your reconstruction and discuss risks and possible complications. You’ll also be provided with full information on the recovery process for your particular breast reconstruction. Contact Dr. McCue’s Minneapolis St. Paul office to schedule a breast reconstruction consultation.
What is Breast Reconstruction?
Breast reconstruction rebuilds the breasts for a natural, balanced appearance after cancer surgery or other breast damage. For millions of women, breast reconstruction offers both emotional and physical benefits as they recover.
At McCue Plastic Surgery, board-certified plastic surgeon Dr. Jonathan McCue is a breast reconstruction specialist who is uniquely attuned to the needs of women navigating breast cancer recovery.
His extensive experience in implant-based and tissue-based breast reconstruction, commitment to the highest ethical standards, and highly compassionate approach have established him as the foremost breast reconstruction surgeon in the Minneapolis-St.Paul area.
When Might Women Want Breast Reconstruction?
Some women opt for breast reconstruction to restore their breast appearance after losing breast tissue or experiencing conditions that affect the appearance of the breasts.
- Lumpectomy: Surgical removal of breast cancer that leaves the rest of the breast intact
- Mastectomy: Surgical removal of the entire breast
- Trauma: Any injury or event that results in breast damage
- Congenital Conditions: Any condition that affects breast development and appearance
When is Breast Reconstruction Scheduled?
Reconstruction is available whenever it suits the individual woman the best. For example, some women have reconstruction immediately after a mastectomy, while others delay it until they complete cancer treatments.
What Are the Different Types of Breast Reconstruction Techniques?
Dr. McCue uses a variety of techniques in breast reconstruction. The two main approaches are:
- Implant-Based Reconstruction: Using silicone or saline implants to restore breast volume and shape.
- Flap Reconstruction: Using the patient’s skin and fat to rebuild breasts. Tissue comes from a donor site, such as the abdomen. In some cases, the skin remains connected to its blood supply. In others, Dr. McCue creates a free flap in which he detaches the tissue completely before reconnecting blood vessels using microsurgery techniques.
Dr. McCue can perform breast reconstruction on one or both breasts. For example, after a mastectomy or lumpectomy, he can use implants or flaps to create a symmetrical, balanced appearance.
How Does Implant-Based Breast Reconstruction Work?
Implant-based reconstruction involves placing a silicone or saline implant under the skin and muscle to restore breast volume.
This surgery often has stages, starting with wearing a tissue-expanding device. The expander, an empty silicone shell, can gradually expand with saline to stretch the skin and ready it to hold an implant.
What Are the Benefits of Flap Reconstruction?
Flap reconstruction could be the right choice for women who prefer a surgery method without implants. Because it’s your tissue, flap reconstruction offers the most natural look and feel compared to implants.
But it’s important to note that implants have come a long way. Many silicone implants replicate the look and feel of natural breast tissue extremely well.
Can You Achieve Symmetry With a One-Breast Reconstruction?
Absolutely! Dr. McCue uses advanced surgical planning and specialized symmetry procedures to match the reconstructed breast to the natural one.
This may involve adjusting implant size, altering implant placement, using fat grafting to refine breast shape, or performing a breast lift or reduction on the opposite breast.
What is the Best Type of Breast Reconstruction for Me?
The best reconstruction method for your needs depends on your medical history, personal preferences, body shape, future treatment plans, and whether you have adequate donor tissue available.
Your ability to manage recovery can also play a big role. There’s no one-size-fits-all strategy. Dr. McCue strongly believes in a high degree of customization for all reconstructive procedures at our practice.
Does Breast Reconstruction Require Multiple Procedures?
In most cases, breast reconstruction involves multiple stages, including:
- Tissue expansion or flap transfer
- Refinements to enhance breast symmetry and shape
- Nipple and areola reconstruction, if desired
We carefully plan every step to help you achieve the best aesthetic result.
How Does Radiation Therapy Affect Breast Reconstruction?
Radiation therapy can affect skin elasticity and healing, possibly impacting reconstruction choices. Patients who have undergone radiation may benefit more from tissue-based reconstruction versus implants.
Does Insurance Typically cover Breast Reconstruction?
Breast reconstruction is generally covered by Insurance under the Women’s Health and Cancer Rights Act (WHCRA), ensuring that all mastectomy-related reconstruction costs are included.
Breast Reconstruction Consultations in Plymouth, MN
If you’re considering breast reconstruction and want to learn more about the process and how it could work for you, call McCue Plastic Surgery at 952-830-0089 to schedule a consultation.
