Restorative Techniques

BREAST RECONSTRUCTION TIMELINE

Regardless of which method of breast reconstruction you may select, two surgical procedures or stages will likely be needed to complete your full breast reconstruction, which may include nipple reconstruction as well as any procedure on the unaffected breast to produce symmetry. Most women prefer to have nipples reconstructed–usually as part of the second sage of reconstruction–as this minor procedure greatly enhances the aesthetic results and the natural appearance of their reconstructed breast. The diagram below shows what the timeline for breast reconstruction and recovery is typically like following perforator flap surgery, for example, with a DIEP flap.

If you do not need to have the nipple and areola removed and elect to have a nipple-preserving mastectomy, you may be able to have the reconstructive process completed in a single operation. And if you choose not to have nipple reconstruction, you may also be able to complete the reconstruction in a single stage.

With immediate breast reconstruction, the first stage takes place at the same time as the mastectomy surgery. With delayed breast reconstruction, the first stage occurs sometime after the mastectomy procedure.

Our practice offers breast reconstruction surgery in Manhattan and Connecticut. If you live outside of these areas, you can comfortably return home between stages of treatment. Our staff will help you coordinate your travel plans for each stage of your breast reconstruction.

Stage I: Microsurgical Perforator Flap Breast Reconstruction

At the first stage of natural-tissue breast reconstruction, transferring borrowed tissue to the mastectomy site restores a breast. The tissue is sculpted to restore the natural shape and form of the breast as closely as possible. If you want to have a procedure on the untreated breast, such as a lift, augmentation or reduction, this can sometimes also be done at this time. (By law, if your insurance plan covers the cost of your mastectomy, it must also provide coverage for reconstructive surgery as well as surgery on the unaffected breast done to produce a more symmetrical appearance.)

For the first few weeks after surgery, you cannot engage in vigorous or strenuous activity, but you can take walks and participate in other non-strenuous activity. Most patients are able to return to light aerobic activity about 4 weeks after surgery, and most are allowed to resume unrestricted physical activity 6 to 8 weeks after surgery. Find out more about what to expect when recovering from surgery.

Stage II: Refining Your Breast Reconstruction and Nipple Reconstruction

About three months after the first stage of reconstruction, a relatively short outpatient procedure can be done to reconstruct nipples and refine the shape of your reconstructed breasts. Dr. Greenspun will carefully refine the shape of your reconstructed breasts and, if necessary, the donor site, to achieve the best possible aesthetic results. You’ll be able to go home the same day as this procedure. If you have had only one breast reconstructed, and decide you want improved symmetry of the reconstructed and unaffected breasts, a breast lift, breast augmentation or breast reduction can be done on the unaffected breast at this time.

Stage II surgery is almost always an outpatient procedure so patients go home the same day and most women can return to work or most other activities after only a few days. For women whose work requires strenuous physical activity though, a bit more time will be needed. Most women are able to return to unrestricted physical activity within two weeks of surgery.

In order to allow the body to further recuperate, stage II is typically delayed a few months for women who require chemotherapy after the first stage of breast reconstruction.

Tattoo: Restoring Color to Your Reconstructed Nipple and Areola

Natural appearing color can be restored to reconstructed nipples and areole (the pigmented area that surrounds the nipples) about two months after nipple reconstruction. Pigment is applied as a medical tattoo in the comfort and privacy of our office. Topical numbing medication can be used to assure that the tattooing is painless.