Dr. Steven Rueda is one of the most sought after breast reconstruction surgeons in Palm Beach. His attention to detail and methodical technique create beautiful and natural results in cosmetic breast surgery. Breast reconstruction is offered to woman who undergo removal of their breast after a diagnosis of cancer, or as a prophylactic method in patients at high risk. Dr. Rueda specializes in breast reconstruction with implants and flaps. Breast reconstruction with flaps is commonly known as reconstruction with the patient’s own tissue or autologous reconstruction.
There are known advantages to reconstructing a woman’s breast proven in all the scientific studies: Restoration of cosmetic breast shape and contour, enhanced confidence and perception of self, enhanced quality of life, restoration of physical and emotional balance
BREAST RECONSTRUCTION PROCEDURE
AUTOLOGOUS VS IMPLANT RECONSTRUCTION
Both methods of breast reconstruction, implant or your own tissue (autologous reconstruction), are excellent and time proven procedures. The decision of which type of reconstruction to choose is largely dependent on patient desires and expected time to recovery.
RECONSTRUCTION WITH IMPLANTS
This type of reconstruction uses a breast implant to rebuild the new breast. The traditional method places an implant called a “tissue expander”; this implant is placed in an initial surgery. The expander functions as an internal balloon that is gradually filled with fluid from the outside until its filled to the desired volume. After this is complete, a second surgery is done about 4-8 weeks later to replace this expander by a traditional silicone implant. In patients that are good candidates, Dr. Rueda is specializes in doing the reconstruction in a single procedure where the definitive implant is placed instead of a tissue expander, this is called “direct to implant” reconstruction.
RECONSTRUCTION WITH FLAPS
This type of reconstruction uses tissue from somewhere else in the body to rebuild a new breast. The most common areas of the body used as donors of tissue are the abdomen and the back. If these areas have had prior surgery, it is likely the tissue has been injured and it may not be used for reconstruction. These procedures generally require a single but longer operation to complete the initial reconstruction. In patient’s who are good candidates, Dr. Rueda prefers TRAM flap reconstruction using tissue from the abdomen; for other patient’s he uses Latissimus Dorsi flap reconstruction using tissue from the back.
The same incision used by the cancer surgeon to remove the breast, no new incisions are made.
Patients who need a fast recovery and return to work. Those who lack sufficient tissue or have a contraindication to use donor tissue form the abdomen or back.
Made and hidden in the lower aspect of the abdomen slightly higher or incorporating the c-section scar; this allows it to be hidden by underwear.
Patients who do not desire implant reconstruction and are able to have a prolonged recovery. These patients also need to have excess abdominal tissue available and no contraindication to its use.
Made and hidden in the upper back such that the bra can cover it.
Patients who do not desire implant reconstruction and are able to have a prolonged recovery. These patients also need to have excess back tissue available and no contraindication to its use.
Pluses: Fast recovery, no need of surgery in other parts of the body
Minuses: Patient needs to feel comfortable having implants, risks associated with implants.
Pluses: No implants or their risks, the tissue grows and looses weight with the patient, long-term satisfaction is higher
Minuses: Prolonged recovery, surgery in unaffected areas of the body.
Frequently Asked Questions (FAQ)
Dr. Rueda thinks the best results are obtained when the reconstruction is done at the same time as the breast removal. This allows the tissue to remain pliable so that a best breast contour is achieved. Some times it is safer for the patient to stage the reconstruction, like in the case of possible use of radiation therapy.
Implant reconstruction may take 1-1.5 hour per breast depending on the degree of complexity. Reconstruction with your own tissue may take 2-4 hours.
Breast reconstruction surgery is typically performed with general anesthesia for patient’s comfort. This requires that the patient has a friend or family member that can drive them to and from the hospital where the surgery is performed.
Your breast reconstruction surgery will be performed at a local hospital or ambulatory surgery center in Palm Beach.
We do not recommend having other procedure done at the same time of cancer reconstruction due to the potential risk of contamination. However, matching procedures of the contralateral breast are frequently performed in an attempt minimize the number of procedures for the patient.