Breast Reconstruction – Richmond, VA
If you have had a mastectomy, breast reconstruction can restore your breasts so that you feel whole and normal again. Dr. Steven Montante is experienced in the most advanced breast reconstruction techniques, and he will work with your oncologist to ensure that your surgery is integrates with your overall cancer care.
Breast reconstruction is typically not a single operation, but rather a process that typically involves several procedures. The reconstructive journey frequently begins at the time of your mastectomy. There are many potential methods based on the amount of tissue that remains after tumor removal. The reconstructive plan is determined by the nature of the breast cancer, any planned additional therapies, and the goals of the patient.
Dr. Montante has performed numerous successful breast reconstructions for his patients in Richmond, Virginia, and he is sensitive to the stress that his patients are under as a result of having endured breast cancer.
The surgery can often begin right after tumor removal, but in some cases, a recovery period may be necessary before reconstruction. The procedure does not interfere with chemotherapy, but it should be postponed until after any radiation therapy has finished.
Before & After
View a selection of Before & After photos of procedures performed by Dr. Montante and the skilled team at Montante Plastic Surgery & Aesthetics. These photos provide actual results achieved to get a better sense of the possible outcomes following your procedure.
If you have any questions about any of our treatments, please give us a call or contact us today!
What can Breast Reconstruction do for you?
Breast reconstruction can:
- Restore breast contours
- Make your breasts more symmetrical
- Help you feel more like yourself again and put cancer behind you
Your Consultation for Breast Reconstruction
Dr. Montante will spend time with you during your initial consultation to hear your concerns and goals, as well as answer your questions. He will review your medical history, followed by an examination of your body. This will allow him to recommend a surgical plan tailored specifically for you.
Dr. Montante will advise you of all preparations to take prior to your operation.
What should you expect from Breast Reconstruction?
This surgery is performed using general anesthesia and often requires a hospital stay of a few days. The length of each procedure varies from patient to patient. Below are the two most common breast reconstruction techniques:
This process involves first inserting a tissue expander under the mastectomy flaps. Tissue expanders are temporary implants which remains in place for a few weeks or months. In the past, the expanders have been placed under the chest (pectoralis) muscle to hold it in proper position. More recently, the expander can be placed above the muscle (or prepectoral) position. Dr. Montante has significant experience in this new technique. By performing Prepectoral expander reconstruction, Dr. Montante finds that he can provide very symmetric, natural appearing results with much less pain and faster recovery. He is proud to offer state-of-the art implant-based breast reconstructions. Once the expander is in place, fluid is gradually inserted into the expander in order to stretch the muscle and skin so that they can cover a breast implant. Once the tissue has expanded sufficiently, the expanders are removed and replaced with permanent implants, much like a breast augmentation. (Read more about breast augmentation and the type of implants available.)
In this technique, a flap of skin, fat, and muscle from your own tissue is used to reconstruct the breast(s). An implant may or may not also be used. The tissue is usually taken from the abdomen or the back. TRAM refers to a flap of abdominal tissue, which is tunneled under the skin so that it can stay attached to the abdomen’s blood supply. Alternatively, a DIEP flap involves transferring abdominal tissue to the chest and establishing a blood supply to recipient vessels through microsurgical techniques.
When tissue from the back is used, it’s called a Latissimus Dorsi Flap. In this procedure, a segment of skin and the underlying latissimus flap is elevated and transferred to the chest to recreate a breast. In many cases, a tissue expander or implant is also placed to provide additional volume. Dr. Montante has performed numerous latissimus flap reconstructions with excellent results. Through this technique, he has been able to complete reconstructions to many patients who failed other reconstructive techniques. The latissimus flap is particularly useful in patients who are poor candidates for other techniques due to previous radiation therapy.
Recovering from Breast Reconstruction
If you are receiving an expander, you should be able to return to work 3-4 weeks after the expander has been inserted. You must avoid strenuous activity and lifting for about 8 weeks.
After exchange of the expanders to permanent implants have been inserted, you should be able to go home the same day and return to work within a week. At the time of exchange to permanent implants, Dr. Montante typically will also perform fat grafting to the breasts to help restore additional volume and to improve the overall breast contour. In this procedure, fat is harvested through liposuction, typically of the hip areas, flanks, and abdomen. The fat is purified and then transferred to the breast. Dr. Montante has been performing fat grafting to the breast as a routine part of his reconstructions for many years. He also frequently incorporates fat grafting into his procedures for facial rejuvenation.
Flap reconstruction usually requires a 3-4-day stay in the hospital. Recovery takes 6-8 weeks. Drainage tubes are usually placed within the incisions after breast reconstruction. These collect post-surgical fluids and will be removed during one of your follow-up visits in our office, perhaps a week or two after your surgery.
Expect to feel some post-operative discomfort, but this can be managed with oral pain medication and antibiotics. Bruising and swelling are also normal after each procedure. Swelling will take the longest to resolve, so you won’t be able to see the final results of your surgery until all of the swelling has resolved. This could take a few months.
You should sleep on your back for up to 8 weeks.
There are visible scars after breast reconstruction, but they will become flatter, smoother, lighter, and less prominent over time.
Dr. Montante will monitor your progress carefully in follow-up examinations.
Breast reconstruction in Richmond can help you feel more like yourself again after a mastectomy. Call us today at (804) 325-4795 to schedule a consultation to find out more about breast reconstruction surgery.
Dr. Steven J. Montante
Dr. Steven J. Montante has many years of experience in the field and is board certified by the American Board of Plastic Surgery. He received his medical degree at the University of Pittsburgh School of Medicine and completed his plastic surgery residency at Medical College of Virginia at Virginia Commonwealth University.