At Sinno Center for Plastic Surgery, we understand what you are going through when you consider breast reconstruction. From the moment you start your initial consultation with Dr. Sinno until the day you have healed completely, our staff will work with you to provide you with superior care to support both your physical and your emotional needs.

What is breast reconstruction?
When should breast reconstruction be done?
Who is a good candidate for breast reconstruction?
How is breast reconstruction done?
What results can you expect with breast reconstruction?
How can you prepare for your breast reconstruction?
What can you expect when you are healing?
How long will results last?
What are the possible side effects or risks?
Are there other procedures that could be done along with a breast reconstruction?
Will insurance pay for breast augmentation?
Next steps …

WHAT IS BREAST RECONSTRUCTION?
Breast reconstruction is a surgical procedure that replaces breast tissue. Women seeking breast reconstruction may have lost a breast due to cancer or suffer from a breast deformity from injury or congenital defects.

At Sinno Center for Plastic Surgery, we can create a new breast for you that is very close in form and appearance to matching your natural breast. Breast reconstruction is usually a process that involves several steps to achieve the final result, and may include surgery on the opposite breast (normal side) to improve symmetry.

Often, you can have your breast reconstructed immediately following breast removal (mastectomy). That way, one major step in the breast reconstruction process is already completed before you awake from surgery.

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WHO IS A GOOD CANDIDATE FOR BREAST RECONSTRUCTION?
Most women who have had a breast removed are good candidates for breast reconstruction. The timing of the reconstruction surgery depends on your own readiness to proceed, and the general condition of your overall health.

The best candidates for breast reconstruction are women whose cancer seems to have been eliminated with removal of the breast.

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HOW IS BREAST RECONSTRUCTION DONE?
Several approaches can be used to reconstruct your breast. You will go over these in detail with our staff at Sinno Center for Plastic Surgery.

Skin expansion
This is one of the most common and easiest approaches to breast reconstruction. After your mastectomy, the Dr. Sinno will insert an expanding device beneath your chest muscle, under the skin. Over the next few months, saline (salt water solution) will be injected into it, causing the skin to gradually expand. In a follow up surgery, the expander is removed and a permanent implant is inserted. Your nipple and areola are reconstructed in a follow up procedure.

Flap reconstruction
This approach involves creating a pocket on your chest for the breast implant. Skin for the pocket is taken from another part of your body, such as your stomach, back, or buttocks. An implant is inserted into the flap, or pocket, to create a new breast.

Another possibility involves using your own tissue (skin, muscle and fat) to actually create the breast mound itself, instead of inserting an implant. When your breast is reconstructed using your own tissue, concerns associated with an implant are eliminated but the surgery is more extensive and invasive. The most common flaps used are the TRAM (abdominal tissue) and Latissimus dorsi (back tissue).

Implants
An implant is a device used to create a new breast. Dr. Sinno will discuss implant options with you. Breast implants are made of a silicone shell, filled with silicone gel or saline (salt water solution). You will be given information at that time about Food and Drug Administration (FDA) regulations pertaining to implant use and the advantages or limitations of each type of implant.

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WHAT RESULTS CAN YOU EXPECT WITH BREAST RECONSTRUCTION?

Sometimes the new breast does not have the same shape as your breast before the mastectomy, nor will it match the other breast.

These differences will not be obvious to anyone.

Many patients say they feel a sense of renewal once they have fully healed.

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HOW CAN YOU PREPARE FOR BREAST RECONSTRUCTION SURGERY?
Many women begin planning for breast reconstruction when they are diagnosed with breast cancer. Dr. Sinno and the staff at Sinno Center for Plastic Surgery will work closely with your breast surgeon so that you are in the best possible position for breast reconstruction after your mastectomy.

Initial consultation for reconstruction
You will have a comprehensive consultation with the staff at the Sinno Center for Plastic Surgery, which includes:

• Evaluation of your health
  
• Examination of your chest
  
• Discussion of reconstruction options and implants based on your health, age, anatomy and personal goals
  
• Discussion of potential risks and limitations of the surgery
  
• Outline of how the surgery is done, the anesthesia used for the procedure and what to expect
  
• Details about costs
  
• Answers for any questions you have

Be ready to provide the following information:

• Complete medical history
  
• List of medications you take, including use of aspirin and other over the counter medications, vitamins and herbal supplements
  
• Details about your tobacco and alcohol consumption

Before your surgery date

• Prepare yourself. Dr. Sinno will give you specific instructions on eating, drinking, smoking, and use of vitamin supplements or medications before surgery
  
• Live right. The best way to prepare your body for any surgical procedure is to make healthy lifestyle choices in the weeks beforehand. If you prepare your body for surgery, your “back-to-normal time” is often reduced.
  
• Exercise regularly.
  
• Get adequate sleep.
  
• Eat right.
  
• Take vitamin supplements.
  
• Reduce stress.
• Depend on someone. Arrange for someone to drive you home after surgery. You also may want to have someone to help you at home for the first day or two while you recuperate.

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WHAT CAN YOU EXPECT WHILE YOU ARE HEALING?

• Your breast and the area around it will probably be sore for 1-2 weeks. Use prescribed pain medication to help reduce your discomfort.
  
• You may feel tired or “washed out” for a week or two. Resume your normal activities slowly, doing what you can.
  
• Avoid direct pressure on the reconstructed breast.
  
• Dressings put on your chest after surgery will be removed at your first post-op visit with Dr. Sinno.
  
• The stitches are usually the absorbable type.
  
• If you are using a breast expander, you will feel a gradual increase in pressure or tension. This will disappear when the expander is removed and the implant inserted.

Getting back to normal

If you have a skin flap reconstruction—with time out from surgery after a mastectomy—your recovery time will be 6 weeks or more.

Recovery time is significantly less if you have breast reconstruction, using tissue expanders or implants. In any case, follow these guidelines after your breast reconstruction:

• No overhead lifting for 3-6 weeks
  
• No aerobic exercise for at least 3 weeks
  
• No sexual activity for at least 3 weeks
  
• Return to work when you are comfortable being at work the full time
  
• Resume light exercise in 7-10 days, only if you have no discomfort in the area treated. Otherwise, wait.
  
• Avoid sun exposure on the area treated until fully recovered

Diet and Nutrition
Good diet and nutrition will help your body heal better, and faster, after a surgical procedure.

• Drink plenty of water or clear fluids; up to 64 ounces a day is recommended
  
• Eat fresh fruits and vegetables with every meal
  
• Eat small amounts of protein with every meal
  
• Eat every 4-5 hours; do not wait longer to eat
  
• Eat more frequent meals, with fewer calories per meal
  
• Eat breakfast within an hour after you get up
  
• Use vitamin supplements, especially antioxidants, to promote healing and renew energy

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HOW LONG WILL RESULTS LAST?
Breast reconstruction attempts to give you a normal looking breast. You will look better and feel better about yourself. As with your other, natural breast, gravity will eventually cause some sagging or drooping of your reconstructed breast.

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WHAT ARE THE POSSIBLE SIDE EFFECTS OR RISKS?
All surgical procedures have some degree of risk. The specific risks and the suitability of each procedure can only be determined during your consultation with the doctor prior to performing the procedure.

You can reduce chance of risk by closely following instructions before and after the procedure that are provided by Sinno Center for Plastic Surgery.

Scars
You will see scarring where the incisions are made. Expect scarring to fade almost completely—but not entirely—in 1-2 years.

Sensation
Breast reconstruction does not restore normal sensation to your breast or nipples.

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ARE THERE OTHER PROCEDURES THAT COULD BE DONE ALONG WITH A BREAST RECONSTRUCTION?

Nipple reconstruction is usually done at a later time after the breast reconstruction (about 3-4 months later). It is most commonly done under local anesthesia using your own chest skin to create the nipple and using a tattoo machine to color the entire nipple-areola complex.

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WILL INSURANCE PAY FOR BREAST RECONSTRUCTION?
Breast reconstruction is normally covered by insurance. Check with your provider for details.

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ARE THERE ANY ALTERNATIVES TO HAVING BREAST RECONSTRUCTION?
The external breast prosthesis can be used in a special bra to give a normal chest appearance in clothing.

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NEXT STEPS . . .
Once you know that you will require breast reconstruction, please contact the Sinno Center for Plastic Surgery to set up a consultation appointment with Dr. Sinno to explore breast reconstruction in more detail. When you come in, he will do a comprehensive examination and talk with you about your needs. If you have not yet had your mastectomy, Dr. Sinno can work directly with your surgeon to arrange the breast reconstruction.