Breast Reconstruction

The diagnosis of breast cancer is devastating for any woman. At minimum, it represents a substantial threat to her health and femininity; at worst, it presents a serious risk to her life. There is no debating the imperative nature of treating the cancer, whether it is by a mastectomy or a lumpectomy with subsequent radiation therapy. The cancer must be eradicated by some means.

What can be difficult in a brief window of time filled with severe anxiety, emotional stress, confusion and confronting one’s own mortality is deciding on whether or not to pursue breast reconstruction at that time or possibly at some later date. So many questions arise and making a decision for these women can be painfully difficult. Our experienced breast surgeon—Dr. Steven H. Turkeltaub—offers and can comprehensively explain breast reconstruction options to women who have been just diagnosed with breast cancer as well as to those who have been treated sometime in the past for it.

• Breast Reconstruction Benefits
• Breast Reconstruction Considerations
• Nipple-Areolar Reconstruction
• Why Choose Dr. Turkeltaub For Breast Reconstruction?
• What Happens During a Breast Reconstruction Consultation?
• Breast Reconstruction Before-and-After Photos
• Breast Reconstruction Patient Testimonial Videos
• Frequently Asked Questions
• Additional Information About Breast Reconstruction from Dr. Turkeltaub

Breast Reconstruction Benefits

Undergoing a mastectomy or a lumpectomy as part of breast cancer treatment is not only physically disfiguring but also mentally and emotionally stressful—and for many, devastating. Consequently, no matter which breast reconstruction procedure is chosen, it can have a dramatic impact on a woman’s sense of femininity and overall psyche.

Many women who have previously been treated for breast cancer but did not undergo reconstruction at that time feel deficient, less feminine, unattractive and quite self-conscious about their appearance. Those who have yet to be treated for their breast cancer do experience similar thoughts and emotions. Fortunately, breast reconstruction can and most often is extremely beneficial in physically rebuilding breasts that have been removed or deformed and can be positively impactful in neutralizing and reducing the emotional and mental effects from the cancer that are inevitable consequences.

While a reconstructed breast may never perfectly replicate the look or function of the former natural breast, advances in plastic surgery have paved the way for results that can be quite outstanding.

Breast Reconstruction Considerations

There are three major breast reconstruction considerations:

1. Timing of reconstruction – immediate or late
2. Reconstructive techniques on involved breast
3. Procedures on the unaffected breast

Immediate Versus Late Reconstruction

Breast reconstruction can be performed concurrently with the mastectomy, providing advantages such as reducing the total number of separate surgical procedures needed for the final result, getting a head start on the reconstruction and facilitating a shorter overall time for the reconstruction and providing much better opportunities to obtain superior results that would be difficult to realize later on due to a variety of factors. Technological advancements like the incorporation of an acellular dermal matrix (ADM), such as Alloderm^® or Strattice^®, in the reconstruction have resulted in far better outcomes with more precise, predictable and “natural” results.

Breast reconstruction can also be performed at a later date—from months to even years later. There are several reasons why this course of action may be prudent in different situations.

The present day trend favors immediate reconstruction for most women. Regardless, the pros and cons of each approach, when relevant, can be discussed with you at the time of your consultation with Dr. Turkeltaub.

Reconstructive Techniques

There are four general groups that can be utilized to categorize the numerous breast reconstruction techniques available today:

• Oncoplastic reconstruction. This technique applies to women who are having/have had a lumpectomy rather than a mastectomy. With this breast conserving approach, where usually a limited amount of breast tissue is removed, the remaining breast tissue is contoured and reconfigured to provide an aesthetically acceptable reconstructive result. This technique can even employ a mastopexy or breast reduction when indicated. There are particular situations, however, where this approach would not be appropriate.
• Placement of breast implants. A breast implant is inserted for the reconstruction without the need for any preparatory procedure such as the usage of tissue expanders. This approach is frequently performed in conjunction with the use of an acellular dermal matrix (ADM) such as Allederm^® or Strattice^®. Silicone implants generally provide results that are far superior to those that can be obtained from saline implants.
• Insertion of tissue expanders. With this approach, temporary inflatable implants called tissue expanders are inserted initially. They are then intermittently filled with saline over a period of time in order to stretch the skin and stimulate new skin growth. Once the skin envelope has been expanded adequately, the permanent breast implants can then be placed.
• Flaps. These techniques entail the use of tissue taken from other areas—such as the back, abdomen (TRAM flap) or buttocks—to try to create a more realistic breast mound. Some flaps are able to remain attached to their main natural blood supply whereas others require microsurgical techniques to establish a new blood supply in order to successfully transfer the flap and maintain tissue viability. These procedures are far more “invasive” and time intensive and have substantially greater inherent risks including partial or complete failure. They are also associated with the need for several revisions. Results can be outstanding, though.

Procedures on the Unaffected Breast

In order to obtain or at least offer the best possible breast reconstruction results, both breasts should be considered and not just the affected side. The reconstructed breast may have an outstanding appearance by itself but if the other breast is quite different in size, shape, position, firmness, droopy skin and areolar location related to the chest wall and breast, this will severely detract from the overall outcome. It can also make it far more difficult to find an attractive, properly fitting bra. Furthermore, this can have a substantial impact on one’s self-confidence, sense of femininity, sexuality, emotions and relations with others.

Unless a woman has had a bilateral mastectomy and is undergoing reconstruction on both sides, the odds of the two breasts being fairly similar after a unilateral reconstruction are not very good. Therefore, in order to acquire greater symmetry, an appropriate procedure can be considered on this unaffected side. This could involve the insertion of a breast implant, a breast lift or a combination of the two. For a very large contralateral breast, a compensatory breast reduction may be beneficial.

It should be noted that many women do not want to have anything done on their uninvolved side and that is their prerogative. Just because the two breasts will be substantially different in appearance does not make it mandatory that something must be done. However, for those women who do want to pursue this symmetry procedure, you will be happy to know that your health insurance plan is required to cover it as part of the breast reconstruction.

Nipple-Areolar Reconstruction

Many women are quite satisfied with their reconstructed breast alone and have no desire to have an added nipple-areolar complex. Others feel incomplete without it and elect to have one reconstructed.

There are many surgical techniques that can facilitate the reconstruction of a relatively realistic appearing nipple-areolar complex including with a projecting nipple. This can be performed either as an isolated procedure during the final stage of the breast reconstruction or in conjunction with a revision procedure.

A non-surgical alternative for nipple-areolar reconstruction is three dimensional tattooing which can yield outstanding, natural-like results.

Why Choose Dr. Turkeltaub for Breast Reconstruction?

Breast reconstruction requires a complex blend of reconstructive and aesthetic surgical skills, as well as a high degree of emotional sensitivity. As a breast surgery specialist, Dr. Turkeltaub possesses an advanced understanding of breast aesthetics that can help you obtain desirable results within the framework of reconstructive constraints. In addition, he is also a compassionate and understanding individual who values honesty and transparency when communicating with patients.

Dr. Turkeltaub understands that having breast cancer is traumatic and the associated experiences can be quite overwhelming for women and their families. His goal is to serve as his patients’ advisor and be an advocate for each patient’s well-being. While making medical decisions is never simple, he tries to ensure that patients are aware of their options and the associated benefits and risks so that they can make the most informed and empowered choices.

Choosing Dr. Turkeltaub for your breast reconstruction ensures that you have a true partner in your care journey. At every step of the process, you can rely on him and his staff to provide honest and upfront answers to all of your questions.

What Happens During a Breast Reconstruction Consultation?

During your consultation with Dr. Turkeltaub, he will listen to your concerns, goals and other relevant issues. The nature of the consultation also depends on whether you are preparing for acute treatment of your breast cancer in conjunction with a general surgeon, seeking delayed breast reconstruction or already have had breast reconstruction and presently have concerns or issues.

For those who will be undergoing treatment for breast cancer by a general surgeon, Dr. Turkeltaub will need to gain a better understanding of your medical history, preferences and treatment plans going forward. This will involve collaborating with your surgeon and possibly other members of your cancer care team. Recommendations will be made based on all this information and what would be best for you.

For patients who have already undergone a mastectomy or lumpectomy and are seeking a delayed reconstruction, the consultation will focus more on treatment options. Dr. Turkeltaiub can assess the remaining breast tissue and provide a detailed overview of the different approaches so that patients can understand what is possible in their unique case.

Breast Reconstruction Before-and-After Photos

In over 30 years of practice, Dr. Turkeltaub has performed numerous breast reconstruction procedures using a variety of different techniques. Take a look at the images below to view some examples of the results he has achieved.

Due to social media policies, the following images have been censored. Please click on the image below to view the image.

Breast Reconstruction Patient Testimonial Videos

Additional Information About Breast Reconstruction from Dr. Turkeltaub

Read more about breast reconstruction from Dr. Turkeltaub’s breast surgery blog.

Schedule Your Consultation Today

If you are considering breast reconstruction surgery, please feel free to contact our practice today to schedule a consultation. Dr. Turkeltaub would be happy to meet with you in person at our office to answer any questions and discuss all details of potential treatment options as they relate to your particular case.