Receiving a diagnosis of breast cancer and undergoing breast reconstruction can be a difficult time for patients. As a female plastic surgeon, Dr. Sandra Margoles understands what women are facing when undergoing breast cancer treatment. There is no single procedure best for everyone. That is why Dr Margoles works closely with the breast surgeons and cancer doctors for a team approach to your reconstruction, helping you decide which option is best for you.

Breast reconstruction for some mastectomy patients is a delicate matter and an extra gentle approach is often necessary. Dr. Margoles' experience in reconstructive breast surgery is extensive. In addition, a large number of her cases involve the revision of breast reconstructions conducted by other doctors, and her compassion and honesty make her patients feel safe and comfortable.

Benefits of Breast Reconstruction Surgery

Nearly all mastectomy patients are qualified candidates for breast reconstruction surgery. This procedure can be performed at the time of a mastectomy or it can be scheduled for a later date. Either way, breast reconstruction allows for a renewed self-confidence and a more positive outlook for the future.

Breast reconstruction surgery is best for:

  • Loss of one or both breasts
  • Revision of a poor initial reconstruction surgery

Types of Breast Reconstruction Surgery

Implant Reconstruction

Direct to Implant-with skin and nipple sparing mastectomy, and the use of an acellular tissue matrix  such as Alloderm has made direct to implant immediate breast reconstruction feasible. Dr Margoles has performed more single stage reconstructions than most surgeons in the area. The advantages are a safe and reliable reconstruction that avoids a second stage exchange procedure, with low overall rates, low incidence of capsular contraction, and a durable reconstruction with excellent symmetry.

Tissue Expansion-Two Stage Reconstruction

In cases where there is not enough skin and/or muscle to cover the implants, the tissue can be stretched over time with placement of a tissue expander implant.  During this procedure, and empty implant expander is placed under the chest wall muscle and over time filled with saline to stretch the skin and muscle. Once fully stretched, the expander is changed to a final implant. This has a quick operative time and easy recovery but requires a second stage implant exchange surgery.

Autologous Tissue flap Reconstruction

TRAM FLAP or transverse rectus abdominis muscle flap  uses muscle, fat, and skin  form the lower abdomen to place  under the mastectomy skin to create a new breast. It uses natural tissue for the reconstruction but has a long operative and recovery time and often a higher rate of complications.

Latissimus Muscle Flap   uses muscle, fat, and skin from your back to create the breast. This is a quicker and less invasive reconstruction than the TRAM flap, but often requires an implant to achieve the optimal result

Fat Grafting

This procedure is the latest advancement  in autologous tissue reconstruction and can be done either immediately or delayed following your mastectomy surgery.    It may involve the use of an external skin expander called BRAVA* ( pending FDA approval, current use for reconstruction use is off label ) that is worn at home for 8 hours a night for one month. This is followed by outpatient fat grafting sessions using liposuction  to obtain the fat from your  abdomen or thigh and is used to augment the breast. This results in natural breasts with you own tissue with minimal recovery time.  Other advantages include no foreign body, no cuts or incisions, no scars, the added benefit of liposuction and a quick recovery time.

Nipple Reconstruction

As a final stage of the resconstructive surgery, the nipple reconstruction is performed.  While some patients choose not do the nipple reconstruction, this final and last stage of the reconstruction will often help the patient restore her appearance and being to normalize her life after mastectomy.  This is a small,  office or operating room procedure that will dramatically enhance the look of your  reconstruction..  The nipple mound is carefully created using local tissue and often Alloderm tissue for projection and support.  After the incisions are healed, a simple areolar tattooing is performed in out office by our specially trained aesthetician and nurse.

Your Breast Reconstruction Surgery with Dr. Margoles

Most patients begin discussing their plastic surgery options at the time of diagnosis and just before their mastectomy. After evaluating your health, Dr. Margoles will explain which procedure options are most appropriate for your age, anatomy, tissues and goals. Individuals are provided with all the necessary details of your customized procedure at the time of your consultation.

Some reconstructive breast surgeries are performed using skin expansion and implant techniquesm latissimus or with or transverse rectus abdominis myocutaneous (TRAM) flap.  She is also proficient in the new use of BRAVA and fat transfer for reconstruction. TRAM flaps can create great and ideal breast shape; however, the results can leave a patchwork-like appearance. Patients are often pleased to discover that Dr. Margoles takes special care to prevent this effect and helps in revising previously conducted breast surgeries that are less than appealing.

What to Expect After Your Breast Reconstruction Surgery

Although follow-up surgeries are necessary, it is the initial surgery that is most complex and taxing on your body. Fatigue and soreness can last up to two weeks after your surgery which can be controlled with prescription medication. Patients should expect to be hospitalized for 1-2 days and have drains inserted to help with excess fluids. Any stitches that were applied will be removed in a week to 10 days.

Contact Us

Dr. Margoles specializes in providing reconstructive breast surgeries for women having undergone mastectomies. Currently, her highly specialized team of professionals treats patients from Stamford, Greenwich and throughout Fairfield County. She is also a renowned breast augmentation and liposuction surgeon. Contact our office today (203)869-2939 to schedule your consultation to learn more about Dr. Margoles' breast reconstruction procedure options.



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