What is breast reconstruction?

Women identify strongly with their breasts as a part of their sense of femininity. For some patients, the loss of a breast can have more of a psychological impact than the actual cancer itself. Breast reconstruction surgery is not approached in the same way as cosmetic breast surgery, even though the goal is always an aesthetically pleasing end result. Reconstructive breast surgery focuses on creating a new breast that closely resembles one's natural anatomy.

Dr. Lampert Breast Reconstruction Maricela's Journey

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Before & After

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Dr. Joshua Lampert: Miami Breast Reconstruction Surgeon

Breast reconstruction requires coordination with the patient’s cancer surgeon (or surgical oncologist) so that reconstruction can be scheduled as soon as possible. Most of Dr. Lampert’s breast reconstruction patients begin the process the same day, immediately after the tumor removal.

There are many methods of breast reconstruction, from implant-based reconstruction to using the patient’s own fat and tissue -- or a combination of both. Dr. Lampert works closely with the surgical oncologist and patient to maximize safety and provide the best method of reconstruction for the individual.

Prophylactic Mastectomy and Breast Reconstruction

Frequently, patients undergo prophylactic mastectomy for genetic reasons. Some patients have a strong family history of breast or ovarian cancer. Genetic testing of these individuals (or their mothers) may reveal a mutation in one of the BRCA genes. BRCA genes normally help protect women from getting breast cancer. However, a mutated BRCA1 gene or BRCA2 gene that does not function correctly is associated with increased genetic damage that may lead to unregulated and rapid cell division. A mutation in one or both of the BRCA genes may be inherited and put the patient at a much higher risk for breast or ovarian cancer in their lifetime. Patients should consider BRCA genetic testing if they have a family history of any of the following:

  • Breast cancer diagnosed under the age of 50 years old
  • Breast cancer and ovarian cancer
  • Both breasts with cancer (bilateral breast cancer)
  • Multiple breast cancers
  • Males with breast cancer
  • Ashkenazi Jewish family descent
  • At least two primary types of BRCA1 or BRCA2-related cancers in one family member (pancreatic, fallopian tube, peritoneal, and prostate cancers)

Patients with any concerns or questions regarding breast cancer should seek genetic counseling with a healthcare professional who is experienced in this specialized field. Dr. Lampert can refer you to a qualified healthcare professional for such counseling if there is any question at all.
Patients with a harmful genetic mutation of the BRCA1 or BRCA2 on gene testing may elect to have prophylactic mastectomy performed. Patients having prophylactic mastectomy more frequently are able to have a nipple-sparing mastectomy.

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Dr. Lampert’s Approach

Dr. Lampert wants to ensure that each patient is treated with the kindness, care, and delicacy as he might employ when practicing on his own family members or loved ones. Every treatment is personalized to make sure it is a good fit and that it promotes the patient’s overall health and well-being long-term.

Dr. Lampert will never pressure a patient to undergo a procedure or try to upsell them so that they spend more money. On the contrary, he simply strives to educate and inform so that the client is empowered to make the best decisions for their future. From his natural-looking, elegant results to the outstanding patient experience that each person receives, Dr. Lampert is among the most sought-after plastic surgeons in the Miami area.

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Nipple Sparing Mastectomy: Who Is A Candidate?

The surgical oncologist’s job is to surgically remove all breast cancer and optimize the patient’s chances for cancer-free survival. Subsequently, the plastic surgeon’s job is to reconstruct the breasts to be as aesthetically pleasing as possible. Having two teams—and a specialist in each discipline—helps optimize the chances that the patient will be both cancer-free and have an aesthetically pleasing breast reconstruction without compromise to either goal. Although Dr. Lampert is able to reconstruct the entire nipple if necessary, there is a significant aesthetic and cosmetic benefit to nipple preservation during mastectomy.

A nipple-sparing mastectomy often results in a rather excellent aesthetic outcome using either implants or the patient’s own tissue. Some nipple-sparing reconstructions can actually resemble a cosmetic breast augmentation in final appearance. Nipple preservation will be determined by the surgical oncologist based on the stage, size, and location of the breast cancer. Whether a prophylactic, nipple-sparing, skin-sparing, or more extensive mastectomy is necessary, Dr. Lampert will take the time to discuss with you all reconstructive options and answer any questions.

Immediate One-Stage Reconstruction Concurrent with Mastectomy

This is an option for women who will not need radiation therapy and who have had skin-sparing or nipple-sparing surgery. Once the surgeon has completed removal of the breast tissue, an implant is placed immediately. Frequently, a mesh (or acellular dermal matrix) is placed to help position the breast implant properly. If the patient requires nipple reconstruction, this is usually performed 3 months later. Dr. Lampert considers breast reconstruction one of his greatest duties, not only to restore contour and form, but also to help with the psychological trauma associated with the loss of a breast.

Correcting Previous Breast Reconstruction

Dr. Lampert sees patients in need of breast reconstruction due to problems that have developed as a result of outdated surgical techniques. Some defects that he routinely corrects include:

  • Asymmetry
  • Shifting implants
  • Disfigurement such as divots, hollows, or prior failed breast reconstructions
  • Incorrectly sized implants
  • Implants that are placed too wide
  • Nipple and areola malformations
  • Large mastectomy scars
  • Capsular contracture
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Candidates for Breast Reconstruction Surgery

The vast majority of women who undergo a single or double mastectomy are candidates for breast reconstruction. However, not every woman wants to immediately undergo more surgery. Some may prefer to delay the decision. Less frequently, some patients have such invasive and metastatic disease that delayed reconstruction is the safest option. In addition, some women live very happily with a prosthesis and never have reconstructive surgery at all. Most patients, however, desire breast reconstruction to restore form and function and look great in their favorite evening dresses.

Recovery

After surgery, a surgical bra is worn to help minimize swelling and provide support to the reconstructed breast(s).

A drainage tube is placed, so that excess blood and fluid do not accumulate in the tissues. Pain and anti-nausea medications are ordered to ensure patient comfort.

Very specific instructions are provided concerning bathing, eating, when to resume normal activities, and when to return for the first postoperative visit. Dr. Lampert makes himself always available so that his patients have peace of mind knowing that they can communicate with him should the need arise between visits.

Breast reconstruction surgery is the final stage of recovery for women who have lost one or both breasts due to cancer. It is physically and emotionally stabilizing for a woman to feel normal when looking into a mirror or shopping for clothes. Breast reconstruction can help women enjoy their lives going forward with confidence after surviving breast cancer.

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*The content/images on this website are not a guarantee of individual results. Individual results may vary. The information provided on this site is for general informational purposes only, and does not replace the need for a formal consultation.

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