Receiving a diagnosis of breast cancer and undergoing treatment, including the possibility of a mastectomy and breast reconstruction, is a very difficult and emotional time for patients. As a female plastic surgeon, Dr. Margoles is particularly sensitive to the stress and uncertainty her patients face. Knowing that each individual case is unique, Dr. Margoles works collaboratively with her patients, their breast surgeons, and oncologists to determine which treatment option will deliver the best outcome.
Dr. Margoles’ experience in reconstructive breast and breast reconstruction revision surgery is extensive. Her compassionate, honest approach helps her patients feel safe, and comfortable throughout the entire surgical process, from their first consultation, to each follow up visit. This is why Dr. Margoles is one of the most sought after surgeons in the Connecticut and New York region.
Breast Reconstruction Surgery Benefits
Nearly all mastectomy patients qualify for breast reconstruction surgery. Breast reconstruction can be performed at the time of a mastectomy or at a later date. Dr. Margoles will discuss all options during your pre-operative consultations. Breast reconstruction and breast reconstruction revision surgery help women discover a renewed sense of self-confidence and a hopeful, more positive outlook following their journey through breast cancer treatment.
Breast Reconstruction Surgery Is Best For:
- Restoration of one or both breasts following mastectomy
- Revision of a poor initial reconstruction surgery
Types Of Breast Reconstruction Surgery
One-Stage Reconstruction with Implant
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.
Two-Stage Tissue Expansion with Implant
Breast reconstruction surgery using a tissue expander and implant is a two-stage procedure. A tissue expander is an empty breast implant that will be filled with normal saline over a period of weeks. Dr. Margoles will make a pocket over or under a large muscle in your chest and place a tissue expander in that space. The expander will slowly stretch your skin and pectoralis muscle (large muscle in your chest). When the expander reaches the size you and Dr. Margoles have agreed upon, the expansion process will be stopped. The second stage of the process will take place after the expansion has stopped. During a second surgery the tissue expander will be removed and replaced with a permanent breast implant.
Autologous Tissue Flap Reconstruction
TRAM FLAP or transverse rectus abdominis muscle flap reconstruction uses muscle, fat, and skin taken from the lower abdomen and placed under the mastectomy skin to create a new breast. This surgery takes approximately 3-5 hours. Recovery is also longer and there is a higher chance of complication.
A second option is Latissimus Muscle Flap reconstruction that takes muscle, fat, and skin from your back to create the breast. This procedure is quicker and less invasive than TRAM FLAP, but often requires an implant to achieve optimal results.
Fat Grafting is the latest advancement in autologous tissue reconstruction and can be done either immediately following your mastectomy surgery, or it can be scheduled for a later date. Fat grafting is an outpatient procedure that removes fat from your abdomen or thigh using liposuction, which is then used to augment the breast. There are a number of advantages to fat grafting reconstruction including the use of your own tissue to create more natural looking breasts. Other advantages include minimal recovery time; and no cuts, incisions or scars.
Nipple reconstruction, the final stage of breast reconstruction, restores and dramatically enhances the appearance of your breast. During the procedure the nipple mound is carefully created using local tissue as well as Alloderm tissue for projection and support. After the incisions have healed, a simple areolar tattooing is performed to complete the reconstruction.
Breast Reconstruction Initial Consultation
Most patients begin discussing their plastic surgery prior to their mastectomy. Working in close collaboration with you, your oncologist and breast surgeon, Dr. Margoles will review which procedure options are best taking into careful consideration your age, anatomy, tissue consistency, and of course your ultimate goals. During your consultation she will review the details of your chosen procedure, taking care to answer and address any questions or concerns you may have.
Breast Reconstruction Surgery Aftercare & Recovery
lthough follow-up surgeries are necessary, it is the initial surgery that is most complex and taxing on your body. Patients will have drains inserted to help remove excess fluid and should expect to be hospitalized for 1-2 days. Fatigue and soreness, which can be controlled with prescription medication, may last up to two weeks.
You will receive detailed post-surgery care instructions and Dr. Margoles and her staff will be available to answer any questions or concerns. It is important to follow Dr. Margoles instructions carefully to ensure the best results and easiest recovery.
Contact Us To Learn More About Breast Reconstruction & Schedule A Consultation
To learn more about breast reconstruction options and to schedule your consultation with Dr. Margoles, call (203) 869-2939. Our Greenwich office is located minutes from the Merritt Parkway and I-95 making it easily accessible for those traveling from Fairfield County, CT and Westchester County, NY.