Plastic Surgery 101

Breast reconstruction surgery can be done after a mastectomy

Q. I had breast cancer approximately four years ago. At the time, I decided to have a mastectomy and no reconstruction. Is it possible to do reconstruction now that I feel much better and am ready to get on with my life?

A. You are not alone; many patients feel the same way as you do. Breast reconstruction can be done at the time of surgery or anytime thereafter, assuming you’re healthy enough and there is no contraindication to the surgery.

There are many types of reconstructive procedures. The most common and least invasive is the implant procedure. Implants may be put in at the time of the original surgery, or after the surgery. There are many types of implants. Silicone implants have had a new resurgence; many like them because of their natural feel and look. Sometimes, if your skin has contracted or because you had radiation, you may need to put in a tissue expander, which is an implant filled with saline so it can expand your skin. This procedure may take several weeks.

Another type of breast reconstruction is a flap reconstruction, which involves transferring tissue from one part of the body to another — either directly connected or using a free flap. A free flap is reconnected with an artery and a vein. The primary flaps include the TRAM flap (transverse rectus abdominis muscle) and the DIEP (deep inferior epigastric perforator flap). Each flap has its advantages and disadvantages. Discuss with your plastic surgeon.

Dr. Carlos Wolf is a partner in Miami Plastic Surgery and is board certified. Email your questions to him at