Breast Reconstruction
The breast is an important part of a woman’s body image and self esteem; one in eight women will go through the psychological and physical stress of breast cancer at some point in their lifetime. Due to the shocking statistics, doctors are seeing more and more cases everyday. The reconstruction process is one of the most rewarding procedures a plastic surgeon has to offer. Reconstruction surgery allows the woman the chance to get back what cancer has so abruptly taken away. There are several options available for you to improve the structure of the breast due to a mastectomy. Dr. Gonyon has had lots of experience and training in reconstruction surgeries and has become the talk of the town amongst all the women in Greeley and even surrounding cities and states. An important issue to note is breast reconstruction surgery is 100% covered by insurance and Dr. Gonyon’s clinic accepts all types of insurance for reconstruction procedures.
Your Options
There are several options that are available to women who choose to go through with breast reconstruction.
Tissue Expansion with Implant
Tissue expansion before inserting the implant is generally performed if you had a mastectomy more than a year ago and never had reconstruction, or, was unable to leave enough excess skin, and lastly, if you are wanting your implants to be larger than your breasts were prior to mastectomy.
In the event that you choose tissue expansion, a deflated tissue expander which is shaped like a teardrop with a magnetic valve, is placed under the skin during the first surgery. Over the course of 4-6 months, office visits are necessary to fill the expander(s); fills are done every 2 weeks to expand. Once at the desired expansion, the patient is then ready to undergo the last surgery, to insert the implants.
Even though tissue expansion is a more time-consuming process than the immediate implant and flap reconstruction, there is less scarring and results are very natural.
Flap Reconstruction
TRAM Flap
TRAM flap uses donor fat, muscle, and skin from the patients’ abdomen area to reconstruct the breast. The fat, muscle, and skin can either be moved by remaining attached or detached. The skin is tunneled under the abdominal skin and then can be molded into the optimal shape and size.
Scarring from a TRAM flap will appear very similar to a tummy tuck scar, which extends from hip bone to hip bone.
Latissimus Dorsi Flap
Flap procedure where the skin donor site is on your latissimus muscle instead of abdomen.
Decision for where to take the flap from all depends on where the patient has the most skin and fat available.
Immediate Implant
For patients that are not going to undergo radiation, the immediate implant is an option. Reconstruction may be performed at the same time as the mastectomy surgery for immediate restoration of shape and volume.
Patients may still have to undergo nipple reconstruction depending on the amount of the breast needed to be removed during the mastectomy. Nipples are created from your own skin and about 3 months later patients have the option to tattoo the areola.
Nipple Tattooing
In most cases, surgeons are unable to save a woman’s nipple during the mastectomy process. Dr. Gonyon has partnered with a tattoo artist who travels to his office once a month, to put the finishing touch on the reconstruction process. Rebecca has been in the business of nipple tattooing and permanent makeup for 10 years. With years of qualified experience, Rebecca is truly an artist and makes sure every patient leaves here looking and feeling fantastic.
Implant Type
Currently, women have the choice between saline and silicone implants. Both types of implants have an outer silicone elastomer shell. The difference between the implants is the material that is used to fill the inside of the implant. Saline implants are filled with a salt water solution where silicone implants are filled with a silicone polymer.
Common Questions
“Is silicone safe?”
After studying silicone implants thoroughly for the past decade, the FDA has determined that silicone implants are safe and has made silicone implants available for women who desire cosmetic breast augmentation. To review the FDA’s data, please visit their website (www.fda.gov/cdrh/breastimplants/).
“Which implant is better?”
This choice is highly patient and physician-specific. During your consultation with Dr. Gonyon he will show you examples of both types of implants. Most plastic surgeons agree that a good result can be obtained with either implant. Dr. Gonyon feels that silicone implants are preferable in certain patients such as those who desire a large increase in size or those with very little normal breast tissue. During your consultation, Dr. Gonyon will discuss with you your preferences and specific anatomy of your breast that may make saline or silicone implants more preferable.
Implant Shape and Size
Both saline and silicone implants are made in different diameters, heights and shapes. Dr. Gonyon uses only round implants as current data suggests that “anatomical shapes” or “teardrop” shaped implants, become round over time, therefore providing no advantage. In addition to providing no advantage, “teardrop” and “anatomical” shaped implants are more expensive.
Determining your goal size is one of the most difficult decisions for patients to make. Dr. Gonyon will discuss with you your goal size and shape during your reconstruction process. Dr. Gonyon will take several measurements of your breasts and chest wall and these measurements will be used to determine the best implant size and shape for you.
Planning your surgery
Once you have made a decision to have surgery, Dr. Gonyon’s office will provide you with the necessary information to plan for your surgery, including guidelines on eating and drinking, smoking, and taking or avoiding certain vitamins and medications.
You will be asked to sign consent forms to ensure that you fully understand the procedure you will undergo and any risks and potential complications of your surgery. There may be a waiting period of several days to weeks from the time of your consent to the day of surgery.
In addition to explaining your surgical procedure, Dr. Gonyon will discuss anesthesia, the recovery process and your obligations as a patient. You will also discuss where your procedure will be performed. Dr. Gonyon performs surgery at Harmony Ambulatory Surgery Center (Fort Collins), North Colorado Surgery Center, Medical Center of the Rockies, and the soon to be opened 25/34 Aesthetic Surgery Center (located at the I25–Highway 34 junction). You may choose to have surgery at any of these locations.
Surgery is usually performed under general anesthesia, so you will sleep through the entire operation. For some surgeries, you may choose to have sedation with a local anesthetic.
What to Expect Immediately After Surgery
Most patients stay for one night at the hospital or surgery center, following surgery. You are likely to feel tired and sore for 3 to 7 days following your surgery, and the majority of patients notice a tight feeling due to the stretching of the pectoralis muscles. You will be provided with a muscle relaxant to help alleviate some of this discomfort. You will slowly resume normal activities over a 5-6 week period.
Your Results
The vast majority of women are very satisfied with the results of breast reconstruction. Dr. Gonyon takes great pride in all cases and is truly an artist at recreating the breast(s). You will have regular scheduled visits with Dr. Gonyon to ensure that your implants are functioning correctly and that you have achieved your desired result.
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