Breast Reconstruction in Baltimore, MD
Losing one or both breasts to cancer is a traumatic experience for any woman. Fellowship-trained Baltimore plastic surgeon Dr. Steven J. Rottman, double board certified and fellowship trained plastic surgeon, specializes in breast reconstruction to help you overcome the physical and emotional scars of breast removal.
What Is Breast Reconstruction?
Breast reconstruction provides physical and emotional support for women who have lost one or both breasts as a result of cancer or other conditions. The ability to create a relatively natural-looking breast allows women to regain self-confidence and improve their quality of life. Although the goal of breast reconstruction is to restore your breasts to as close to their natural shape, appearance, and size as possible, patients should have realistic expectations about reconstructed breasts. A reconstructed breast doesn’t look, feel, or have the same sensation as the breast that has been removed. Additionally, incision lines will be present on the breast and the donor site, if utilized.
Benefits of Breast Reconstruction Surgery
Breast reconstruction has emotional and physical benefits. After a mastectomy, a woman may feel less feminine. Dr. Rottman uses several techniques to restore your breasts to a more natural and feminine shape and size.
Breast reconstruction is a type of surgery for women who have had a breast removed. Our before and after pictures of some of our breast reconstruction patients show you how well Dr. Rottman can reconstruct your breasts.
How Is Breast Reconstruction Performed?
Breast reconstruction is a highly personalized treatment that typically involves several procedures performed in multiple stages. It can either be done immediately following a mastectomy or be delayed until you have recovered from your mastectomy and have completed any additional cancer treatments as necessary. There are several different techniques Dr. Rottman may recommend, including prosthetic implants, pedicled flaps, and free flaps. Most reconstruction procedures use breast implants to rebuild the breast, typically involving either a flap technique or tissue expansion.
Flap techniques reposition a woman’s own muscle, fat, and skin to create or cover the breast mound. Two basic types of tissue flaps are used: pedicle flap, which retains an attachment to the original blood supply, and free flap, which does not and often involves microsurgery to create a new blood supply.
- A TRAM (Transverse Rectus Abdominus Myocutaneous) flap uses donor tissue from the abdomen. The flap may either remain attached to the original blood supply and tunneled up through the chest wall or be completely detached. Candidates for TRAM flap include patients who either want or need to have their breasts reconstructed with their own tissues.
- A DIEP (Deep Inferior Epigastric Perforator) flap transports fat and skin from the abdomen and does not require implants or any movement of muscle tissue. The soft tissues of the abdomen are transferred to the chest wall, along with blood vessels, which are grafted to the new site with microsurgical techniques.
- A SGAP (Superior Gluteal Artery Perforator) flap transports fat and skin from the buttock and hip area. Using microsurgery, blood vessels from the perforator flap are connected to the internal mammary vessels on the chest. The SGAP procedure is often recommended for patients who exhibit defects resulting from previous breast surgery.
- A Latissimus dorsi flap uses donor tissue from the back that is tunneled to the mastectomy site and remains attached to its donor site, leaving the blood supply intact. On occasion, the flap can reconstruct a complete breast; however, it is most often used to provide the muscle and tissue necessary to cover and support an implant.
Tissue expansion is the most common method of breast reconstruction method in the United States and offers an easier recovery than flap procedures. However, the process is longer and requires regular office visits over a 4-6 month period. Tissue expansion stretches healthy skin at the breast site to leave room for a breast implant. The device is gradually filled through an internal valve and, once ready, a second surgical procedure is necessary to replace the expander with an implant.
AlloDerm®, also known as Acellular Dermal Matrix, is a biologic material that acts a skin substitute during breast reconstruction. The material closely resembles normal skin and integrates well with existing tissue. Typically used in expander-based implant reconstruction, AlloDerm® supports the tissue and provides necessary coverage of the breast implant.
Breast Reconstruction with Direct Implant Placement
In some instances, a saline or silicone implant can be placed immediately following a mastectomy to create a breast mound.
Nipple Areola Reconstruction
After the implant is in place, Dr. Rottman will use skin grafting or other specialized techniques to recreate the nipple and areola.
Fat Grafting for Breast Deformities
Fat grafting can improve the cosmetic result of breast reconstruction. During this procedure, fat is taken from elsewhere in the body using a low-pressure liposuction method. The fat is washed gently with saline and then injected into contour depressions along the margins of reconstructed breasts. The technique has limitations and risks, but overall it is a safe alternative to more complicated procedures that achieve similar results.
For patients with smaller breast cancers, a nipple sparring mastectomy preserves the breast skin, nipple, and areola for breast reconstruction. The breast reconstruction technique allows for effective cancer treatment yet helps with a natural reconstruction after a mastectomy.
Preparing for Breast Reconstruction
Breast reconstruction may occur during your mastectomy or after the removal of your breast. Dr. Rottman is available to meet with you at any point during your treatment for breast cancer. He may wish to review your medical record, including oncology reports. He also works with you to schedule your breast reconstruction when appropriate after your mastectomy.
Recovery from Breast Reconstruction
After breast reconstruction, you may be given bandages or a support bra to help reduce swelling and to support your new breast(s). You will be able to see the results of your breast reconstruction immediately and as the swelling and bruising subside, you will be able to enjoy your new breast(s) even more. During the months following your procedure, the incision marks will gradually fade and become less noticeable.
How Much Does Breast Reconstruction Cost?
Breast reconstruction may be covered by your medical insurance. You may be responsible for a co-payment, deductible, or co-insurance. If the procedure is not covered by insurance, you are responsible for the entire cost. We work closely with CareCredit®, a healthcare financing company that offers convenient monthly payments that fit your budget. To learn more, please visit our financing page.
Is Breast Reconstruction Right for Me?
Breast reconstruction is typically appropriate for women who have undergone a surgical removal of one or both breasts. The best way to find out if breast reconstruction is right for you is to meet with Dr. Rottman for a personal consultation.
Why Choose Dr. Steven J. Rottman for Breast Reconstruction?
Dr. Rottman has an extensive background in reconstructive surgery, including breast reconstruction. He specializes in providing compassionate and personalized care to women who have undergone mastectomies.
What to Expect During Your Breast Reconstruction Consultation
During your consultation for breast reconstruction, Dr. Rottman examines your breasts. The examination allows him to determine how much breast tissue, scar tissue, and skin are present. This information is used as a basis for his recommendation of a specific technique. He also helps you communicate your personal desires for breast reconstruction and gives you realistic expectations of the procedure.
Dr. Steven J. Rottman is a cosmetic and reconstructive plastic surgery expert who serves the men and women of Baltimore and surrounding areas. Dr. Rottman is recognized for his approach to plastic and reconstructive surgery that gives his patients exceptional natural-looking results. Because each patient is unique, Dr. Rottman uses both traditional and advanced techniques for his procedures. Please contact us today to schedule your personal consultation with Dr. Rottman.