Modern surgical technology makes it possible to construct a natural-looking breast after a mastectomy (breast removal) for cancer or other diseases. Breast reconstruction surgery is commonly begun, and sometimes completed, immediately following a mastectomy, so that the patient wakes with a new breast mound instead of no breast at all. Alternatively, reconstruction may begin years after the mastectomy. The reconstruction itself consists of multiple operations, the first of which involves creation of the breast mound and is performed during or after mastectomy in a hospital under general anesthesia. Later surgeries, if necessary, may be done in the hospital or an outpatient facility, with either general or local anesthesia.There are several ways to reconstruct the breast, both with and without implants. Dr. Dana Khuthaila, a plastic surgeon in New York City, will explain each method and help her patients feel confident and comfortable when making this important decision.
Things to Consider@headingTag>
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 breast tissue needs to be stretched to make room for implants. This discovery phase will help guide the reconstruction process so patients end up with a new breast that is the size, shape and look they want.
"24 and Baby Faced - I went to Dr. Khuthaila for "facial slimming botox" - it's a procedure where botox is injected into your masseter muscles (your jaw) and gradually paralyzes the muscle causing the muscle to atrophy overtime. For my first session i had 40 units put in, Dr. Khuthaila used a vibrating tool as a distractor as she administered the injection. It was completely painless and it was done in what felt like under two minutes. There was some slight bruising on the side of my face which I promptly covered up with makeup and went back to work right after. I have to preface this with this. I have a theory that I have especially hypertrophied masseters because I used to chew gum while I lifted weights. I've also always had a round wide-ish face and I've been looking into invasive asian cosmetic procedures for years. I decided to try this to see if I could go about it differently. I'm a personal trainer, fit, at my goal weight, 20% body fat and I know this is the smallest my face is going to get. You can make your face appear smaller by reducing your body fat, and I had just hit my ceiling. The first week really didn't garner a noticeable difference in my eyes. My face was still pretty round and not "v'd". I went back for a touchup (10 units) a week and a half later because Dr. Khuthaila noticed a bit of asymmetry with my jawline. (Probably because I chew with my right side, also a theory) About two weeks out I woke up and noticed that my chin looked especially prominent and I could not stop staring at myself throughout the day. It really was working. In fact, I felt like I had a new face. So all and all the procedure works, but it takes time and the changes are subtle. "- J. / RealSelf / Apr 08, 2017
"22 Year Old Unhappy with Profile of the Nose - I always felt that my profile was missing something but I didn't know what I wanted to correct. I realized after taking countless profile selfies that the tip of my nose was lacking perky-ness (If that any makes sense). I've thought about having a rhinoplasty to correct it but I didn't want to break my nose in the process being that all I wanted was structure to the tip. Dr.Khuthaila recommended we try a non surgical temporary treatment and we proceed from there. I was amazed with how quickly and instantly the results were! My nose has the perfect uplift I was looking for and she saved me from going under the knife when it truly was not necessary. The result is exactly what I wanted and I cannot thank her enough for all her help and support. <3 "- S. / RealSelf / Apr 06, 2017
"Best Plastic Surgeon in NYC! Love my Botox! - Dr Dana Khuthaila is amazing! After turning 30 I was interested in less invasive procedures to spruce up my face. I started to get annoyed at the lines starting to become permanent on my forehead. Dr Khuthaila suggested I try Botox in the forehead and between my eye brows to smooth everything down and get rid of those lines...(I also have thick forehead muscles that bulge up when I squint). Being a professional and expert injector she used the perfect amount of the Botox that gave my eye brows a nice little lift and totally smoothed out my forehead, I still have movement and I certainly do not look "overdone" which was one of my main concerns. Everyone keeps complimenting me on how refreshed and rejuvenated I look, even my husband can't quite figure out why I am looking exceptionally awesome these days! The injections were painless and she even used a really cool vibrating gadget that helped distract me from any pain (which I did not feel at all). She took her time, explained everything in detail and gave me great post op care instructions. Her office is spectacular with overlooking views of Central Park...million dollar view for sure! Her staff is warm,welcoming ,always smiling and so amazing at confirming appointments AND they even called me the next day to see how I was feeling after the injections...totally thoughtful follow up care, they make you feel like family! Hands down she is the best, her surgical work as well is beyond incredible. I will be back for more Botox and her injectable filler work is flawless as well."- M. / RealSelf / Mar 31, 2017
"I LOVE Dr Khuthaila. She is one of the very few doctors that will not only do an amazing and meticulous job, but will take her time to explain the procedure and answer all questions along the way, and do it with the integrity of a true professional and with the best interest of the patient in mind first and foremost. I saw many plastic surgeons before I found her, at the recommendation of a very close friend, and once you meet her, you will immediately understand why her patients love her so much. She's treated me and my mom, I've recommended her to friends and will keep going back to her. She is 5 star all around. As an added bonus, her gorgeous office overlooks Central Park and is close to wonderful restaurants and the nice shops on 5th and Madison. Thank you Dr Khuthaila!!!"- S.M. / Yelp / Aug 23, 2016
"Excellent experience - I am very picky, before the procedure I had 7 consultations with 7 different drs. She was by far the most detailed, honest and explained exactly what shall I expect. The procedure was very smooth, I didn't feel a thing, healing process was much faster than my friends who did it with other Drs I was able to go out 2 days after the procedureToday I am 2 weeks after And I have no visible scared or bruises Oh and the most important thing is She phoned to check on me and they have me a number to text or call if I have any questions and I did text many times and they reply fast and efficient Excellent experienceHighly recommended"- K. / RealSelf / Mar 30, 2017
Each reconstruction technique will be tailored according to the patient’s physical health, aesthetic goals, and personal preferences. 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)
Reconstruction With Implants@headingTag>
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.
A single-stage implant (SSI) breast reconstruction surgery is performed at the same time as the patient's mastectomy. This "one and done" approach minimizes the patient's total recovery time, office visits, and allows a better preservation of the nipple and areola.
If there is limited tissue inside the breast, or limited skin on the outside, tissue may be used from another part of the patient’s body to supplement this loss. The most common areas to support this process are the buttocks, thigh or abdomen. This is an autologous approach to breast reconstruction. The TRAM flap (Transverse Rectus Abdominus Myocutaneous), the DIEP flap and SIEA 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. Using a tattoo technique, the areola is recreated with a skin graft taken from the thigh, abdomen or back.
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 for complications. 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
- Recovery Time
- 2-3 Weeks
- Average Procedure Time
- 3-8 Hours
- Post-op Follow-up
- 1 Week
- Procedure Recovery Location
Breast Reconstruction FAQs@headingTag>
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?@headingTag>
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.
A reconstructed breast will not have the same sensation as the breast did before the mastectomy. However, over time, some of this sensation will return to normal. This will depend on the extent of the reconstruction process and will vary by patient.