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Breast reconstruction

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. 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

What can breast reconstruction correct

Absent breast after mastectomy

When breast removal surgery (also known as mastectomy) is necessary, the patient is left with no breast gland tissue. This leads to a flattened appearance to the chest due to gland removal. Breast reconstruction surgery replaces this lost breast tissue with an implant or the patient’s own tissue.

Absent nipple after mastectomy

In most patients, mastectomy surgery requires removal of the nipple and areola. Breast reconstruction surgery makes a new nipple from the patient’s own tissue. Although the new nipple is not functional, it appears like a normal nipple and permits the woman to feel more confident without underwear.

Breast changes after radiation

Patient’s who require radiation to treat their cancer may develop tightness and pain of their native breast skin. Breast reconstruction surgery can replace this affected skin by skin from other areas of the body.

Absent nipple after mastectomy

In most patients, mastectomy surgery requires removal of the nipple and areola. Breast reconstruction surgery makes a new nipple from the patient’s own tissue. Although the new nipple is not functional, it appears like a normal nipple and permits the woman to feel more confident without underwear.

Breast changes after radiation

Patient’s who require radiation to treat their cancer may develop tightness and pain of their native breast skin. Breast reconstruction surgery can replace this affected skin by skin from other areas of the body.

What can breast reconstruction correct

Absent breast after mastectomy

When breast removal surgery (also known as mastectomy) is necessary, the patient is left with no breast gland tissue. This leads to a flattened appearance to the chest due to gland removal. Breast reconstruction surgery replaces this lost breast tissue with an implant or the patient’s own tissue.

Absent nipple after mastectomy

In most patients, mastectomy surgery requires removal of the nipple and areola. Breast reconstruction surgery makes a new nipple from the patient’s own tissue. Although the new nipple is not functional, it appears like a normal nipple and permits the woman to feel more confident without underwear.

Breast changes after radiation

Patient’s who require radiation to treat their cancer may develop tightness and pain of their native breast skin. Breast reconstruction surgery can replace this affected skin by skin from other areas of the body.

Absent nipple after mastectomy

In most patients, mastectomy surgery requires removal of the nipple and areola. Breast reconstruction surgery makes a new nipple from the patient’s own tissue. Although the new nipple is not functional, it appears like a normal nipple and permits the woman to feel more confident without underwear.

Breast changes after radiation

Patient’s who require radiation to treat their cancer may develop tightness and pain of their native breast skin. Breast reconstruction surgery can replace this affected skin by skin from other areas of the body.

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.

Incisions

The same incision used by the cancer surgeon to remove the breast, no new incisions are made.

Ideal Candidates

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.

Incisions

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.

Ideal Candidates

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.

Incisions

Made and hidden in the upper back such that the bra can cover it.

Ideal Candidates

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.

Implant Reconstruction

-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.

Autologous Reconstruction

-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.

RECOVERY AND DOWNTIME

Implant Reconstruction: Typically requires one overnight stay in the hospital but may be an outpatient procedure. There is tightness, swelling and bruising for 2 weeks after surgery. Drains are used. Usually a bandage is placed and removed in 48 hours. Drains are used. A sports bra is worn for a total of 2 weeks.
Autologous Reconstruction: Typically requires 2-3 day hospital stay. There is tightness, swellin, and bruising for 2 weeks following surgery. Drains are used in the breast and donor sites. Bandages are placed and removed in 48 hours.

Implant Reconstruction: Most patients generally return to work in 1-2 weeks. Exercise is not allowed until 4 weeks after the surgery.
Autologous Reconstruction: Most patients generally return to work in 3-6 weeks. Exercise is not allowed until 8 weeks after the surgery.

The cost of a breast reconstruction varies from patient to patient depending on the type of technique needed, anesthesia time, and surgical time. At Precision, we make sure we provide you with an accurate personalized price that will cover all costs needed for you to obtain a fantastic result.

A WORD ON MASTECTOMY

Mastectomy surgery is done by a breast cancer surgeon or surgical oncologist. Removal of the breast, also known as mastectomy, is a procedure where the breast gland is removed. Dr. Rueda does not perform mastectomy surgery, but performs breast reconstruction to rebuild a new breast after mastectomy. There are different kinds of mastectomy breast surgery; some of the most common are skin sparing mastectomy and nipple sparing mastectomy.

Skin Sparing Mastectomy 

Skin sparing mastectomy is a procedure where the breast gland, nipple, and some breast skin are removed; it is called skin sparing because it tries to save as much skin as possible in the native breast. These patient’s are candidates for reconstruction of their absent breast gland and nipple.

Nipple Sparing Mastectomy 

Nipple sparing mastectomy is a procedure where the breast gland and some skin are removed while the nipple is preserved. There are strict criteria to make sure a patient is a candidate for this procedure; it is only offered to patients who do not increase the risk of cancer recurrence by keeping the nipple.

Why choose precision plastic surgery for your breast reconstruction

Dr. Rueda, a Cleveland Clinic trained surgeon who has 7 years and 2,000 procedures of experience in Plastic Surgery will be your safe and best choice for breast reconstruction surgery. Successful results in this procedure require a surgeon that is experienced, artistic, and detailed oriented. Dr. Rueda has published articles on breast reconstruction in expert peer reviewed journals, and his work has been presented in several national plastic surgery conferences. Dr. Rueda’s passion for patient education and custom centered approach will guarantee you feel comfortable every step of the way. Dr. Rueda also believes in treating his patients as if he was treating his own family; you can trust you will enter a trusting long-term relationship and have the best breast reconstruction Palm Beach can offer.

Use your own tissue

Use your own tissue

Dr. Rueda is one of the few plastic surgery specialists in Palm Beach who offers breast reconstruction with your own tissue (autologous reconstruction). These techniques have been shown to lead to improved patient satisfaction in the long-term for some woman.

Minimize the amount of surgeries

Minimize the amount of surgeries

Dr. Rueda also specializes in direct to implant breast reconstruction. In patient’s who are good candidates, Dr. Rueda can perform implant reconstruction that usually takes two surgeries in one single procedure. This is important for the patient as it reduces the time to healing and also allows for earlier return to cancer treatment if needed.

Reduce your pain

Reduce your pain

Dr. Rueda uses a special technique with injectable long acting medication that reduces the postoperative discomfort after surgery. In some patients Dr. Rueda has noticed up to 40% reduced discomfort after breast reconstruction surgery.

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.

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