Frank Agullo, MDBoard Certified Plastic Surgeon

Breast Reconstruction

Breast Reconstruction

Women who have beaten breast cancer are especially courageous. It takes a special kind of person to go through that type of treatment and make it through the other side, sometimes losing one or both breasts in the process. For women who have undergone a mastectomy, the feelings can be like a roller coaster. One part is thankful for the second chance to live, while the other feels disappointed by having to lose a part of their femininity. Losing a breast can really feel like a loss, but a breast reconstruction is an ideal solution.

A breast reconstruction surgery must be done by an accredited plastic surgeon. It begins by rebuilding the mound on top of a woman’s chest. Dr. Agullo uses pictures of the patient and the information learned in the consultation to determine the size, shape and placement of the breast for the individual.

Is breast reconstructive surgery for me?

Most often breast reconstruction El Paso and Albuquerque is associated with women who lose one or both breasts to breast cancer. The doctor has to fully remove them from her body in order to keep the cancer from spreading. Although a mastectomy is often used only as a last resort to other treatments, there are still thousands of women who will need a breast reconstruction as the only alternative.

The choice to get a breast reconstruction is not an easy one, but by getting all the facts up front it can lead to the best decision that is right for you.

Autologous vs. Implant Breast Reconstructions

There is more than one solution to reconstructing a breast. The most common is a breast implant, but you can also opt for using your own tissue from another part of your body, such as your waistline, back, or even a combination of both procedures.

Depending on which method the patient decides to use for breast reconstruction, there may be pros and cons associated with each. Dr. Agullo is a caring expert surgeon who can guide women throughout Juarez, Chihuahua, Alamogordo and the entire El Paso area with a solution that is based on individual health and preferences. Here are the two considerations:

    Autologous Tissue Flap

    Uses tissue from the patient’s abdomen or back to create new breast(s). It is a lengthy operation but the main benefits include a more natural breast shape and feel, and less likeliness of the body rejecting it. It does require more recovery time than traditional breast implants. Most patients with a history of radiation to the breast or axilla will require a form of autologous tissue flap breast reconstruction. Although there are more choices developing as the technology changes, these are the two most commonly applied tissue flap reconstructive breast surgeries:

  • TRAM Flap – TRAM stands for transverse rectus abdominus myocutaneous flap. Some women like the added benefit of a “tummy tuck” by using tissue from the abdomen to recreate the breast.
  • Latissimus Dorsi Flap – Muscle and skin from the upper back is funneled underneath the skin to the chest area, creating a pocket for a breast implant. This can give a women added fullness in the breast area, although very rarely some women report a decrease in shoulder strength afterward.
  • When performing autologous tissue flaps, Dr. Agullo uses the latest technologies available to ensure best outcomes. Dr. Agullo currently employs the SPY system by Lifecell Corporation to ensure healthy blood flow to the flaps, decreasing the risks of fatty necrosis or flap loss.

    Implant Reconstruction

    Uses a silicone breast implant to recreate the breast mound. Many patients prefer this method as it does not weaken the abdominal wall and is a shorter surgery with fewer risks. The only major drawback of implants is that they are not meant to last a lifetime. They can also rupture, causing pain or infection. Previous radiation is sometimes a contraindication to implant reconstruction.

    The two types of implant breast reconstruction surgery are as follows:

  • One stage immediate breast reconstruction: Often done in conjunction with the mastectomy, the surgeon will remove the breast and then a plastic surgeon comes in to replace the breast with an implant and a special mesh (Alloderm).
  • Two-stage breast reconstruction: Can be done in conjunction with the mastectomy or after the chest and skin are healed. An implanted tissue expander is placed under the chest muscle and skin. This allows the surgeon to apply a water and salt solution over a two to three month period, enabling the skin over the breast region to stretch. A second surgery is used to remove the expander and position a permanent breast implant.

With any type of implant reconstruction, Dr. Agullo prefers to use Alloderm mesh, as it allows for better breast contour and shape, as well as less pain suffered by the patients than in previous total muscle coverage procedures.

Getting breast reconstruction surgery

Whether you have had a mastectomy or you have been diagnosed with breast cancer and will have a mastectomy, Dr. Agullo can help. Even though you’ve already gone through a lot of pain and recovery with the breast cancer, it’s really never too early to consider breast reconstruction. It’s something you can talk about with your doctor from the moment you know you have breast cancer, because your doctor can work together with Dr. Agullo to create a plan of action and make you feel as comfortable as possible. Our office has one of the highest volumes of breast reconstructive surgeries in El Paso. Therefore, we are knowledgeable on many types of scenarios and have a wealth of experience to present you with.

Unlike other types of breast surgeries, breast reconstruction surgery typically requires more than one operation. Stage one creates the breast mound, usually at the same time as the mastectomy. Subsequent surgeries may entail revisions for better results, exchange of expanders to permanent implants, symmetry procedures if you only had reconstruction on one side, and lastly, nipple reconstruction and areola tattoo.

General anesthesia is most often used for the first part of your breast surgery. The drugs administered may make you feel sleepy, however you will not experience any pain during your procedure. The follow-up surgeries can be done either through IV conscious sedation or general anesthesia. In either case, most patients do not remember any of the experience.

Before any procedure requiring anesthesia, remember DO NOT:

  • Eat or drink after midnight on the night before surgery
  • Drive a car or operate any equipment on the day of or for a few days thereafter
  • Forget to pack an overnight bag in case you need to spend the night
  • Use any lotions or crème on your skin, particularly in the chest area
  • Smoke tobacco for at least 2 weeks prior to surgery or 2 weeks following (make this a great time to quit!)

Are there risks?

There are always risks associated with any type of breast reconstruction:

  • Extreme fatigue
  • Scar tissue growth
  • Infection
  • Implants leaking or rupturing
  • Loss of sensation
  • Problems such as swelling, fluid build-up or pain at the donor site
  • Blood clots or capsular contracture
  • Need for additional surgery if problems occur
  • Flap failure
  • Weakness of the abdominal wall

Recovery from breast augmentation surgery

Getting back to your normal self may take six to eight weeks of healing, although healing time of implants without flaps tend to require more expedient recovery times. You may feel sore, tired and uncomfortable, which will go away with proper rest. It will probably be at least one to six days before you can return home from the hospital, since this is the most complex of all types of breast enhancing surgeries.

When undergoing implant reconstruction, you will be given a special bra to wear that will keep your breasts safe and help them heal properly. Wear it day and night until further instructed and do not use any type of underwire or traditional bras. When undergoing flap reconstruction, Dr. Agullo will advice not to use any type of bras to allow for the tissues to heal.

Express any changes in your health after surgery, such as abnormal pain or bleeding, rapid heartbeats, dizziness, spins, chest pain or shortness of breath. To avoid the potential for blood clots, don’t smoke. Make sure you move around enough to keep the circulation flowing properly, yet without harming your breast or chest area.

Dr. Agullo will monitor you closely and will make your recovery as comfortable as possible. Avoid lifting heavy objects for at least six weeks and thereafter. You may have some emotional adjustments due to the loss of your breast(s), so finding a supportive group of friends or other women who have suffered from breast cancer may be able to give you some advice and support over any anxieties you face.

Cost of breast reconstruction

In nearly all cases, health insurance covers the cost of breast reconstruction in El Paso and the surrounding area. They should not deny you the breast reconstructive surgery because it is essential to the recovery process after breast cancer. In fact, there are federal laws in place to require breast reconstruction in most cases of mastectomies. Dr. Agullo’s team will make sure that your surgeries are approved beforehand.
After it’s all said and done, you will begin to feel better again and embrace the way you look, knowing that you beat breast cancer! It may be a good time to reach out to other women to offer your support and to share your experience. You are lucky to be alive and this is the best time to seize your second chance at becoming the healthiest “you” that you can be!
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