Your relationship with your breast surgeon is vital to the success of your reconstruction surgery.

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Breast Reconstruction Surgery

There were 232,670 new cases of breast cancer diagnosed in the United States in 2014, according to the American Cancer Society. Of those women who elect to have mastectomies done, 42 percent will choose breast reconstruction. The Women’s Health and Cancer Rights Act in 1998 guarantees insurance coverage for mastectomy reconstruction following a breast cancer diagnosis. While the recovery time is slightly longer than the mastectomy procedure alone, women say it’s an important decision “from an emotional standpoint.”

In recent years, many of the hang-ups people had about breast reconstruction have been assuaged. For instance, cohesive gel “gummi bear” implants hold a natural shape, rather than riding high and bouncy. Free tissue transfer implants use the patient’s abdominal tissue for a natural look without foreign substances like saline placed in the body. The NY Times reports that 64,114 silicone implants, 7,898 saline implants, and 19,000 analogous tissue implants were done in 2012.

A New York breast reconstruction surgery is a bright spot amid the clouds – something that makes a woman feel more confident and comfortable with her body after the invasiveness of cancer. Dr. B. Aviva Preminger is an Ivy League educated Manhattan plastic surgeon and mother of three. She lends compassionate care during this difficult time and breaks down the options in a clear way to help women make a decision they are comfortable with for years to come.

Watch a direct to implant breast reconstruction surgery performed by Dr. PremingerDCIS-breast-recon-thumbnail1

Preparation

All breast reconstruction surgeries begin with a consultation. This appointment helps patients feel comfortable choosing Dr. B. Aviva Preminger as their breast reconstruction surgeon and also ensures that they are good candidates for the procedure.

Breast reconstruction may be a good option for women who are able to cope with the diagnosis and treatment, do not have additional medical conditions that impair healing, and those who can take a positive outlook on the recovery process.

Patients should be prepared to discuss:

  • The reasons for wanting breast reconstruction
  • Expectations for the final outcome
  • Medical history, including conditions, drug allergies, past treatments, use of medications, and lifestyle choices

The surgeon will take detailed measurements, make notes on the skin quality and nipple placement, and take photographs for the medical records. Dr. B. Aviva Preminger will then go into detail about the different mastectomy reconstruction procedures available, the risk factors involved, the recovery process, and what sort of results can be expected.

Breast reconstruction surgery

All patients are put under general anesthesia or IV sedation for mastectomy reconstruction, so they are not awake during the procedure. Most breast reconstructions involve a series of procedures done over time. In some cases, follow-up procedures to replace tissue expanders or reconstruct the nipple and areola are necessary.

The exact steps depend upon the type of breast reconstruction method chosen.

Skin Expansion: This technique combines the stretching of healthy skin tissue, along with the insertion of a silicone or saline breast implant. The surgeon uses a balloon expander beneath the skin and chest muscle to inject salt-water solution that fills the

expander gradually over a few weeks or months. The expander is eventually removed through a second operation and a more permanent implant may be inserted. The nipple and areola are reconstructed later.

Flap Reconstruction: Tissue is taken from the back, buttocks, or abdomen and rebuilt in the breast region. Some techniques allow the tissue to remain attached to the original site and blood vessels through tunnels running beneath the skin. Other techniques use surgically removed tissue and reconnected blood vessels in the new region. An implant may or may not be needed.

Recovery

A hospital stay of two to six days is typical following breast reconstruction surgery. Most patients are up and running again in six to eight weeks. Sometimes surgical drains are put in place that require removal after about a week. Patients are sent home with support garments, prescription pain medication, and specific instructions for post-operative care. Swelling and bruising are common for the first eight weeks. Strenuous activities should be avoided for at least four to six weeks.

 

According to the NY Times, reconstructive surgery can take nine weeks, but the full recovery process takes nine months to a year. Immediate risks include infection, bleeding, anesthesia reaction, and persistent pain or tightness in the chest, back, and shoulder. In rare cases, implants may leak or rupture.

"Breast reconstruction is among the most emotional of all plastic surgery procedures, and also the most life-affirming. It's truly inspiring to help women through their journey to wellness and well-being."

- B. Aviva Preminger, MD

New York City breast surgeon

Results vary widely, which is why the choice of surgeon is paramount. Yet, even with the best surgeon, it is important for patients to understand that, while natural and shapely, their breasts will never be exactly like what has been replaced. There will be permanent scars at any incision and donor sites, though they will fade from purple to white over time. For many women, the desire to “feel whole again” outweighs these minor concerns.

It typically takes a little while to get used to breast reconstruction, no matter how good the results are. Dr. B. Aviva Preminger is here to listen to her patients’ concerns and assist in every way possible during this period. Past patients have referred to her as friendly, professional and caring with an “excellent bedside manner.”

Women interested in mastectomy reconstruction are invited to contact NY plastic surgeon Dr. B. Aviva Preminger at 212.706.1900 to schedule a private consultation.

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