PLANNING

As there are a wide variety of surgical options for breast reconstruction, Dr. Kolker will thoroughly discuss with you all of the facets of the breast reconstruction procedures, enabling you to make the most informed decision. He will thoroughly review your medical history, carefully examine you, and make appropriate measurements. He will discuss the benefits, risks and alternatives of each surgical option for breast reconstruction.

Implant Breast Reconstruction
Breast implant reconstruction often requires a period of tissue expansion. Either as an immediate first stage breast reconstruction at the time of mastectomy, or as a delayed breast reconstruction months or even years following mastectomy, a tissue expander is placed beneath the pectoralis muscle and remaining breast skin. It is then gradually inflated in the office with saline water, most often beginning two weeks following surgery. The expansion process lasts for several months. After a three month waiting period for maturation of a capsule around the tissue expander, the expander is replaced with a permanent breast implant at a second operation. Most often, a silicone gel breast implant is used. In selected cases, a "direct-to-implant" breast reconstruction is possible, where the permanent implant is placed immediately without the need for tissue expansion. For many breast reconstructions with a tissue expander and breast implant, a dermal (skin) graft called AlloDerm may be used, which can improve the aesthetics and safety of breast reconstruction. Nipple areolar reconstruction as a subsequent office procedure completes the process.

TRAM Flap Breast Reconstruction
The TRAM (transverse rectus abdominus musculocutaneous) flap breast reconstruction is a procedure that involves the transfer of skin, fat, and muscle from the lower abdomen to the chest to create a new breast. The blood supply is derived from the rectus abdominus muscle. The benefit of this procedure is the slimming and toning effect on the abdomen, (tummy tuck), and that the reconstructed breast is completely of your own tissue. There are numerous techniques of breast reconstruction utilizing the excess soft tissues of the abdomen (Pedicled TRAM Breast Reconstruction, Supercharged TRAM Breast Reconstruction, Free TRAM Breast Reconstruction, or Perforator Flap Breast Reconstruction, i.e., DIEP Flap Breast Reconstruction). The nipple and areolar reconstruction is performed as an office procedure approximately three months following surgery.

Latissimus Flap Breast Reconstruction Breast reconstruction may also be performed with the transfer of muscle, fat, and skin from the back to the chest, creating a breast mound. Occasionally, enough of your own tissue may be present to complete this breast reconstruction (Total Autologous Latissimus Breast Reconstruction). More often, a breast implant is placed beneath the muscle and skin from the back (Latissimus Dorsi Breast Reconstruction with A Breast Implant). The nipple and areolar reconstruction is performed as an office procedure approximately three months following surgery. As there are many considerations for the various types of breast reconstruction, careful and extensive discussion between you, Dr. Kolker and your breast oncologist will be required, and together the breast reconstruction procedure that suits you best will be selected.

RELATED PROCEDURES

Breast Reconstruction is most often performed as an isolated procedure. For those individuals who desire additional plastic surgery enhancements, liposuction, tummy tuck (abdominoplasty), and facial rejuvenation procedures.

If you would like to learn more about correction of breast asymmetry in New York, we invite you to meet with Dr. Kolker for a private consultation at our office, located at Park Avenue and 70th Street in New York City, by calling 212-744-6500, or by scheduling an appointment online.