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Author: Breast Reconstruction Associates

DIEP flap breast reconstruction, highlighting benefits of natural tissue use and long-term advantages.

DIEP Flap vs. Implant Breast Reconstruction (Updated For 2024)

Written by Breast Reconstruction Associates on . Posted in Breast Implants, Breast Reconstruction, DIEP Flap Reconstruction. No Comments on DIEP Flap vs. Implant Breast Reconstruction (Updated For 2024)

Breast cancer patients now have a plethora of options when it comes to reconstructive surgery. Choosing the right type of breast reconstruction can be overwhelming but understanding the differences between the DIEP flap and implant breast reconstruction can help you make an informed decision.

What is DIEP Flap Reconstruction?

The Deep Inferior Epigastric Perforator (DIEP) flap is an advanced method of breast reconstruction that uses your abdominal tissue to replace the soft tissue and skin removed during a mastectomy. Unlike the TRAM flap procedure, the DIEP flap preserves all the muscles of the abdomen, resulting in a less invasive and more natural reconstruction.

Why Choose DIEP Flap Over Implants?

  • Natural Tissue Use

With DIEP flap reconstruction, the patient’s own skin and fat are utilized to replace the breast volume removed during the mastectomy. This eliminates the need for implants, providing a more natural look and feel.

  • Long-term Benefits

Implant reconstruction may lead to complications such as implant ruptures or capsular contracture (breast hardening), often requiring maintenance surgeries over time. In contrast, DIEP flap reconstruction tends to result in softer, more natural-feeling breasts that typically do not require further surgical interventions.

  • Sensory Nerve Reconstruction

One of the advancements in DIEP flap reconstruction is the potential for sensory nerve reconstruction, which aims to restore sensation to the transplanted tissue. While not performed routinely, it is available in select cases, and your surgeon can discuss its pros and cons to determine if it should be included in your reconstruction plan.

  • Pain Management

Post-operative pain is often a concern for patients considering DIEP flap reconstruction. Contrary to popular belief, our experience at Breast Reconstruction Associates shows that recovery and healing post-DIEP flap reconstruction are often easier than anticipated. We employ an effective post-operative pain protocol that usually manages pain without the need for narcotic pain medications.

What to Expect at Breast Reconstruction Associates

At Breast Reconstruction Associates, we pride ourselves on offering state-of-the-art breast reconstruction through individualized and compassionate care. Located in Fort Worth, Austin, Oklahoma City, Bozeman, our experienced team is dedicated to ensuring you receive the best possible treatment.

Many of our patients choose to go home after a one or two-night hospital stay, and they often find the recovery significantly easier than expected. We strive to make your experience as comfortable and seamless as possible, ensuring you feel supported every step of the way.

The DIEP flap is an excellent breast reconstruction option for women, providing a natural-looking and feeling breast after mastectomy while avoiding the use of implants. If you’re looking for the “gold standard” in breast reconstruction, look no further. For more information and to discuss your options, contact us at Breast Reconstruction Associates, your DIEP flap experts in Dallas Fort Worth, Texas.

Sources: BreastCancer.org

Feel free to reach out to us and take the first step toward a natural and confident you.

Patient considering breast reconstruction surgery with a checklist of important factors to discuss with a doctor.

Before Undergoing Breast Reconstruction Surgery, 10 Things to Consider

Written by Breast Reconstruction Associates on . Posted in Breast Cancer, Breast Reconstruction. No Comments on Before Undergoing Breast Reconstruction Surgery, 10 Things to Consider

Breast reconstruction surgery is a crucial step in the recovery process for many breast cancer survivors. But with the overwhelming amount of information available, it can feel like trying to drink from a fire hydrant. Here’s a concise checklist to help you make informed decisions about your treatment plan.

1. Research Thoroughly

When faced with a breast cancer diagnosis, it’s natural to want to expedite your treatment. However, taking the time to understand all your options is vital. Consult reputable sources and discuss your choices with your doctors to ensure you’re making well-informed decisions.

2. Talk to Your Doctor

While online support groups and patient forums can provide valuable support, every patient’s situation is unique. It’s essential to address questions specific to your care directly with your doctor for the most accurate and personalized information.

3. Make the Best Decision for You

Breast reconstruction is a highly personal decision influenced by various factors. Involve your spouse, family, or support system in consultations to help weigh your options. Ultimately, the decision must be best for YOU in your current situation.

4. Plan Ahead

Surgery requires a recovery period that varies depending on the type of work you need to resume. Discuss the expected recovery time and post-op restrictions with your surgeon to adequately plan with your support system and employer.

5. Choose Your Breast Size

Your pre-operative body habitus will influence the size of your breast reconstruction. During your consultation, your surgeon will discuss your ideal breast size and show you photos of patients with similar body types to help set realistic expectations.

6. Know Your Timeline

At Breast Reconstruction Associates, our goal is to complete your reconstruction in as few surgeries as possible. Ask your surgeon how many surgeries they anticipate and the timing of each one. This timeline may need adjustment to prioritize your cancer treatment.

7. Understand Your Post-Surgery Appearance

Looking at photos of other patients who have undergone the surgery can alleviate fears. At Breast Reconstruction Associates, we review photos with patients to provide an accurate visual of what to expect regarding scar patterns and overall appearance.

8. Ask Questions

Don’t hesitate to ask any questions you have. Make a list of all your concerns and go through them with your doctor to ensure you have clarity and peace of mind.

9. Consider Your Nipples

Some patients may have the option of keeping their nipples through a nipple-sparing mastectomy, depending on the tumor’s location and nipple position. If not, options like nipple reconstruction or 3D nipple areola tattoos can complete your reconstruction.

10. Understand the Goal of Reconstruction

Discuss realistic expectations with your plastic surgeon and understand the difference between reconstructive and cosmetic surgery. The goal is to restore what cancer took away, allowing you to fit clothing evenly without needing a prosthesis. It’s a life-changing experience that requires time and perspective to accept and love your new reconstructed self.

Conclusion

Take the necessary time to research and understand your options before moving forward with breast reconstruction surgery. For more information, visit Breast Reconstruction Associates.

Smiling woman with curly hair having a conversation during a consultation, seated indoors with a clipboard visible in the foreground.

Answers to Your Breast Reconstruction Questions

Written by Breast Reconstruction Associates on . Posted in Breast Reconstruction. No Comments on Answers to Your Breast Reconstruction Questions

Undergoing breast reconstruction surgery can be a daunting experience, filled with uncertainty and anxiety. Even if you think you’re well-prepared, it’s natural to have questions. At Breast Reconstruction Associates, we’ve been caring for patients like you since 2014. We aim to make you feel comfortable and well-informed about what autologous breast reconstruction can offer. Below are some of the most common questions we receive to help you better understand your decision to undergo breast reconstruction.

What to Expect After Breast Reconstruction Surgery

How Much Pain Can I Expect After Surgery?

Most patients experience a very manageable level of post-operative pain. Our pain management regimen, aligned with the Enhanced Recovery After Surgery (ERAS) protocol, has proven to be remarkably effective. Most patients can carry out their regular activities and sleep with mild to moderate discomfort. Generally, patients stop needing regular pain medication after about two weeks.

What Will My Breast Size Be?

During the initial reconstruction surgery, the width and height of the flap can be controlled to create the breast. The depth, or projection, of the flap largely depends on the abdominal tissue’s depth. Your surgeon should be able to estimate how close to your current breast size you will be during your consultation. Adjustments to size and shape can be made after the initial reconstruction if needed.

Will I Have Drains After Surgery?

You can expect to have a drain in each operated breast and 1-2 drains in your abdomen. Typically, patients go home with all drains in place. While inpatient, your nurse will educate you on emptying, recording drainage, and general care of your drains before you go home. Once at home, our team is available to address any questions or concerns. Most patients have their drains removed 1-2 weeks after surgery.

What Kind of Bra Should I Wear After Surgery?

You will be given a hospital-issued post-surgical bra after surgery, eliminating the need to purchase one beforehand. After surgery, you may be fitted for a compression bra in our office for proper sizing and comfort.

When Can I Start Exercising Again?

After surgery, we ask that you limit your activities to light walking, avoiding core muscle use, and lifting weights less than 10 pounds. Once you reach four weeks post-op, you may start cardio activities such as using a stationary bike or elliptical machine. After this point, consult your surgeon to guide you on how and when to resume more strenuous activities. Generally, most patients are free of restrictions and may use their core muscles again 12 weeks after surgery.

Additional Resources and Support

Have more questions? Make a list! We are happy to be your resource for breast reconstruction information. Contact one of our offices in Fort Worth, Austin, Oklahoma City, Bozeman for more information or to schedule a consultation.

Keywords

  • Breast Reconstruction FAQs
  • Post-Surgical Recovery
  • Surgical Pain Management

Feel empowered to make informed decisions about your breast reconstruction surgery. We’re here to support you every step of the way.

Breast cancer awareness and prevention tips for 2024

How Common is Breast Cancer? Updated for 2024

Written by Breast Reconstruction Associates on . Posted in Breast Cancer, Womens Health. No Comments on How Common is Breast Cancer? Updated for 2024

Breast cancer is the most common malignancy affecting American women, with one in eight women diagnosed during their lifetime (12.5% risk). There are several risk factors that can affect a woman’s risk, some of which are modifiable while others are out of our control.

Modifiable Risk Factors

  • Body Mass Index (BMI): Weight can significantly increase a woman’s risk for developing breast cancer as adipose (fat) tissue stores estrogen. Being overweight or obese increases estrogen exposure and cancer risk. Maintaining a healthy BMI is essential not only to lower your breast cancer risk but also to decrease the risk of recurrence if you are a breast cancer survivor. A balanced, nutritious diet and avoiding processed foods play crucial roles in achieving this.
  • Alcohol Consumption: The more alcohol you consume, the higher the risk of developing breast cancer. Limiting your intake to less than 3 to 4 drinks per week is recommended.
  • Tobacco Use: Nicotine use increases breast cancer risk and inhibits wound healing. It’s crucial to quit all nicotine products before undergoing surgical management.
  • Physical Activity: A sedentary lifestyle can increase your risk for breast cancer. Aim to engage in at least 150 minutes of exercise per week, though ideally, you should aim for 300 minutes for optimal risk reduction.
  • Hormone Replacement Therapy (HRT): Combination HRT (estrogen/progesterone) increases breast cancer risk. Most women must stop these medications once diagnosed. It’s especially important to perform routine self-breast exams and screening mammograms while taking HRT.

Non-Modifiable Risk Factors

  • Age: Breast cancer is predominantly diagnosed in women over the age of 50.
  • Gender: While women are overwhelmingly more affected by breast cancer than men, men constitute 2% of all breast cancer diagnoses each year. Men should also be aware of this risk and practice breast awareness.
  • Genetics & Family History: Certain genetic mutations like BRCA1 and BRCA2 can increase the risk of developing breast cancer. Other genes include CHEK2, PALB2, and ATM. Even if genetic testing is negative, a family history of breast cancer can still place you at higher risk.
  • Lifetime Estrogen Exposure: Early menstruation (before age 12), late menopause, delaying childbirth after age 30, or not having children at all increases estrogen exposure and breast cancer risk.
  • Atypical Breast Cells: Not every breast biopsy is malignant; many are benign like fibroadenomas or cysts. However, some biopsies reveal high-risk lesions like atypical ductal and lobular hyperplasia and lobular carcinoma in situ.

While breast cancer rates have been increasing, more women are surviving this diagnosis thanks to increased awareness, early detection, and improved treatment options. If you have been diagnosed with breast cancer or a genetic mutation and are considering breast reconstruction surgery, reach out to us at our Fort Worth, Austin, Bozeman, or Oklahoma City offices. At Breast Reconstruction Associates, we are committed to our patients’ overall health and reconstructive goals.

Learn more about breast cancer prevention and modifiable risk factors to take proactive steps in reducing your risk.

For more information and personalized advice, book a call with one of our specialists today!

When Should You See A Breast Reconstruction Surgeon? | DIEP Flap TX

When Should You See A Breast Reconstruction Surgeon?

Written by Breast Reconstruction Associates on . Posted in Breast Reconstruction.

The timing of breast reconstruction is often determined by the stage of cancer and the oncologic treatment recommendations. However, in general, we refer to the timing as immediate or delayed.

Immediate breast reconstruction

Refers to reconstruction occurring at the same time as the mastectomy. There is a two-fold benefit of immediate reconstruction. The first, it provides a breast mound and avoids a flat chest wall. The second, the skin envelope can be utilized via a skin-sparing mastectomy, thus allowing for a potentially better aesthetic outcome.

Delayed breast reconstruction

Refers to reconstruction that is performed at another time following the mastectomy. A mastectomy without reconstruction is frequently performed when a woman has advanced cancer, requires radiation therapy, or has multiple medical comorbidities.

In general, it is best to see a breast reconstruction surgeon soon after your diagnosis. Many factors contribute to the timing of reconstruction, and involving the plastic surgeon early in this decision making will help to provide the best outcome. This is true regardless of your type of cancer or expected treatments.

Lastly, if you have already had a mastectomy and have completed the recommended adjuvant treatments, you are still a candidate for reconstruction. We are happy to assist you with your reconstructive needs at any point along your journey. If you would like to get in touch with a plastic surgeon regarding the best timing for your reconstructive breast surgery, please contact us in Fort Worth, Austin, Oklahoma City, or Bozeman.

Common Plastic Surgery Risks | Breast Reconstruction Associates

Secondary Flaps: PAP and SGAP

Written by Breast Reconstruction Associates on . Posted in DIEP Flap Reconstruction.

Some patients may not be a candidate for the DIEP flap reconstruction. These patients may have a history of previous abdominal surgery that may have affected the DIEP vasculature. Examples of such procedures could be a prior abdominoplasty (aka tummy tuck) or liposuction. Other patients may have more volume at the other donor sites of the buttocks or thighs when compared to the abdomen. 

In these instances, patients may be candidates for autologous reconstruction from a secondary site.  Our commonly preferred secondary sites include the PAP (inner thigh) and SGAP (upper gluteal region) flaps.  Just as is performed with the DIEP procedure, both the PAP and SGAP flaps involve harvesting the skin and fat from these various regions along with their respective blood supply to reconstruct a more natural-appearing breast.

Various factors can influence a patient’s candidacy for these secondary flaps, which include having an adequate volume from the donor site.  In some instances, you may benefit from a combination implant and autologous reconstruction with a secondary flap.  While the incisions can be hidden in clothing, patient acceptance of scar patterns is important for all autologous reconstructive cases.

At Breast Reconstruction Associates, we would be happy to discuss your reconstructive needs and design the best plan using a secondary flap if the DIEP flap is not an option for you.  Please call your local Forth Worth, Austin, or Oklahoma City office to schedule a consultation today.

How Do You Make a Nipple?

Written by Breast Reconstruction Associates on . Posted in Breast Reconstruction.

Nipple reconstruction is usually a part of the final stage of breast reconstruction. A nipple reconstruction can be done as an office procedure, but sometimes is incorporated with revision of the reconstruction in the operating room. In our practice we perform the nipple reconstruction, and then tattooing of the areola as a separate procedure.

In simple terms, the nipple is made from elevating skin and folding it in a way that leaves a ‘nub’ of skin that looks like a nipple. In medical terms we refer to the skin elevation as “elevating a flap”, and the flaps described for nipple reconstruction are numerous. We may use a different flap design based on the needed size, width, or projection – either to match the other side (for one–sided reconstruction) or based on the patient’s goals (for two–sided reconstruction). Importantly, though the final product may strongly resemble an actual nipple, the reconstructed nipple does not have sensation or ability to change with temperature changes, and lacks erogenous sensation.

You can also watch the following 9 min video to see the specific steps involved in a nipple reconstruction done in the office.

Oncoplastics Breast Surgery | Breast Reconstruction Associates

Oncoplastic Breast Surgery: What Is It? Am I a Candidate?

Written by Breast Reconstruction Associates on . Posted in Breast Reconstruction, Womens Health.

Oncoplastic breast surgery is a surgical approach that integrates breast cancer surgery with plastic surgery techniques. Historically, breast conservation therapy, or the combination of a lumpectomy and radiation therapy, was performed to preserve a portion of the breast and still offer patients equivalent survival rates as a mastectomy. However, a traditional lumpectomy often leads to deformity of the breast; this is why combining lumpectomy with a plastic surgery technique has potential benefit for patients. The goal of oncoplastic breast surgery is to improve aesthetic outcomes without compromising the resection and treatment of breast cancer.

In general, ideal candidates for breast conservation are those who have a small tumor relative to total breast size. Oncoplastic breast surgery can be integrated with any lumpectomy procedure, but patients with large breasts or breasts with a fair degree of ptosis (or “droop”) are the optimal candidates. In these cases, the tumor can be safely removed using standard breast reduction or breast lift techniques while also improving the overall appearance of the breast. A balancing breast lift or reduction of the other breast is typically performed simultaneously for symmetry purposes.

Oncoplastic breast surgery can also be a good strategy for women who are wanting mastectomies and reconstruction but also would require post-mastectomy radiation (usually for an advanced cancer or cancer in the lymph nodes). In order to prevent radiating a total breast reconstruction, oncoplastic surgery is followed by radiation. Completion mastectomies and total breast reconstruction can then be performed at a later time after the patient has recovered from radiation therapy.

The Advantages of Having a Mastectomy | Breast Reconstruction Associates | Dallas Forth Worth

The Advantages of Having a Mastectomy

Written by Breast Reconstruction Associates on . Posted in Breast Reconstruction.

Breast cancer is one of the most common types of cancer among American women — nearly one in eight women develop it in the course of their lifetime. Treatment of breast cancer involves a multidisciplinary approach and therapies are selected based on biology, size, and location of the tumor. In most cases, surgical intervention is recommended, and patients are faced with the decision to undergo lumpectomy followed by radiation (known as breast conservation therapy) or mastectomy.

A mastectomy is the complete surgical removal of breast tissue. This surgical approach is appropriate for patients with breast cancer that does not meet the criteria for breast conservation therapy, patients who prefer mastectomy over BCT, or for prevention of breast cancer in high risk patients.

Historically, mastectomies included the removal of the overlying breast skin. Strategies to preserve the breast skin have now been developed that have significantly improved the cosmetic outcome of immediate breast reconstruction following a mastectomy. Patients who have a mastectomy followed by breast reconstruction can now have equivalent or superior cosmetic outcomes compared to breast conservation therapy.

There are other advantages of having a mastectomy over breast conservation. By choosing a mastectomy, patients have the potential to avoid the need for radiation therapy. This allows women to forgo the skin changes and other effects caused by radiation. Patients also no longer require regular mammograms following a mastectomy. And lastly, while research has demonstrated equivalent survival outcomes between mastectomy and breast conservation therapy, the risk of local recurrence is lower in patients who undergo mastectomy.

The decision to choose a mastectomy over other surgical treatment approaches is difficult and includes many variables. To determine the best plan for you, talk to your breast surgeon in Fort Worth.

Breast Reconstruction Associates – North Austin Area

Breast Reconstruction Associates – Austin TX

I’ve Had a Lumpectomy and Radiation Previously but Now I Need a Mastectomy. What Should I Know? | DIEP Flap Texas

I’ve Had a Lumpectomy and Radiation Previously but Now I Need a Mastectomy. What Should I Know?

Written by Breast Reconstruction Associates on . Posted in Mastectomy Radiation.

Lumpectomy and radiation, also known as Breast Conservation Therapy (BCT), is an increasingly common way to treat breast cancer, especially in women with larger breasts and smaller tumors. Although BCT has similar survival rates compared to women who undergo mastectomy and reconstruction (usually without radiation), there is a higher local recurrence rate for breast cancer in the same breast after BCT.

For women who have had BCT previously but now have a new breast cancer in the same breast, another lumpectomy with radiation is not possible. For this reason, women are best counseled to treat their new cancer with mastectomy. Although hormornal or chemotherapy may be indicated, radiation is usually not able to be given a second time.

For women undergoing mastectomy in this scenario, reconstruction with an expander or implant has a much higher rate of infection and reconstruction failure compared to women who undergo microsurgical breast reconstruction using their own tissues. For this reason, we strongly counsel women to consider free flap breast reconstruction. Depending on the previous scars present and the tissue quality, skin sparing mastectomy might still be possible.