Breast reconstruction is surgery usually to rebuild your breasts after a mastectomy or lumpectomy, although it’s performed for other reasons as well. Board-certified surgeon Dr. Mohamed Soliman Ahmed Elfar and highly regarded plastic surgeon Dr. David Shokrian at New York Breast Surgery Center restore your breast mound, rebuild your silhouette and reconstruct your nipple and areola.
“As experienced breast cancer reconstruction specialists, we apply the same surgical precision to every procedure, whether it’s for reconstructive breast surgery after cancer or for breast augmentation. We rebuild your breasts to restore your body image.” — Dr. Shokrian
If you’ve undergone the physical and emotional weight of breast cancer treatments, reconstructive breast surgery after cancer can close that chapter of your life, allowing you to move forward with renewed self-confidence. You’ve beaten cancer; you want to return, as much as possible, to your life before the diagnosis, a result that holds up every single day. Your reconstruction plan is built around your goals, your anatomy, your life. Nothing about this process is generic.
Immediate breast reconstruction after mastectomy for cancer happens in the same hospital operating room as your mastectomy, immediately after that procedure, while you’re still under general anesthesia. The timing ensures your safety and comfort, whether you’ve had a single or double breast removal. Why undergo two surgical procedures when you can get everything done at the same time?
This timing matters. Your plastic surgeon is able to preserve your natural breast skin, the fold beneath your breast and the shape of your chest wall when they’re most intact. This timing often produces the best aesthetic results. When you awake after the surgery, your reconstruction is already underway, which makes an enormous emotional difference for most women.
Dr. Shokrian confirms that “the best plastic surgeon works closely with your oncologist closely to design a sequence that both ensures your cancer recovery and protects your reconstructive result.”
If post-mastectomy radiation is part of your treatment plan, the researchers at the non-profit advocacy group Breastcancer.org support delayed breast reconstruction. The experts at New York Breast Surgery Center agree that immediate implant breast reconstruction isn’t the right approach in these cases. Radiation dramatically increases complication risks with implants.
Delayed breast reconstruction refers to a separate surgery sometime after your mastectomy. Some women wait weeks. Some wait years. Your cancer treatment sometimes determines the decision. When post-mastectomy radiation is part of your treatment plan, most doctors agree that you should wait before undergoing breast reconstruction.
Delayed breast reconstruction with implants in a radiated chest wall carries real risks. Furthermore, the New York Breast Surgery Center experts recommend autologous reconstruction — using tissue from another part of your body — in this situation because it produces a safer and longer-lasting outcome, especially when your existing breast tissue has been altered by radiation.
“We commonly delay double mastectomy breast reconstruction surgery. Waiting doesn’t hurt the results. In fact, it provides every bit as strong a result as immediate reconstruction. Delayed breast reconstruction after double mastectomy is one of the most frequent procedures we perform.” — Dr. Shokrian
Most women who have a mastectomy are candidates for breast reconstruction surgery. Age isn’t a barrier. The evaluation is specific to your body, your health and your cancer treatment plan. Strong candidates for breast cancer reconstruction at New York Breast Surgery Center at either location include:
During your consultation, your plastic surgeon discusses implant-based reconstruction. If you decide to proceed, you’ll learn about associated risks, such as breast implant illness (BII) and patient safety. For a breast imbalance or prior breast surgeries, you may consider additional procedures like a breast asymmetry correction or breast revision surgery as part of your treatment plan.
Dr. Shokrian adds, “You get straight answers about what’s best for you based on our years of experience. Expect a clear, honest assessment of what your options are and why.”
The board-certified plastic surgeons at New York Breast Surgery Center in Midtown Manhattan and Great Neck, Long Island offer a full range of breast reconstruction techniques. These experts understand anatomy well enough to foresee most situations and prevent most complications. They build your treatment plan with the technique that produces the best outcome for you specifically. The two primary breast reconstruction techniques include:
Implant-based reconstruction uses a tissue expander, followed by permanent gummy bear breast implants or Motiva breast implants to rebuild your breast mound. This two-stage process is the most commonly performed breast reconstruction technique at New York Breast Surgery Center.
Autologous reconstruction uses your own body to do the rebuilding, but it does require harvesting the tissue from another part of your body, so it too is a two-stage process. Your plastic surgeon determines your breast cancer reconstruction options by considering your overall health. Your procedure involves three steps:
Every implant-based breast reconstruction includes the acellular dermis technique, not because it’s trendy, but because leaving it out produces an inferior result. This technique also lowers the risk of complications, including capsular contracture, which causes scar tissue to form, tightening around the implant over time. Once you’re affected, you require capsular contracture treatment to correct the problem.
AlloDerm is the type of acellular dermal matrix that your expert New York City plastic surgeons use. It’s derived from donated human skin with all cells removed, which leaves a collagen scaffold that your body integrates over time. During your first reconstruction surgery, AlloDerm is positioned along the lower portion of your breast as a structural sling. That sling performs four things all at once, including:
“If your surgeon gets this foundation wrong, nothing will look right,” says Dr. Shokrian. “I’ve completed thousands of breast procedures, so I know what to look for and how to do things correctly. Plus, I have skilled eyes for sculpting a woman’s body. I know that women who have implant reconstruction with AlloDerm get softer, more natural-looking, better-defined results.”
Flap reconstruction uses your own tissue to rebuild your breast. Skin, fat, blood vessels and in some techniques, muscles are transferred from a donor site on your body — like your abdomen — to your chest, where your surgeon shapes it into a new breast mound.
If you had radiation, then your doctor may recommend flap reconstruction. Radiated tissue isn’t healthy enough to support an implant. Flap reconstruction sidesteps this issue entirely by using tissue your body already has. And because it’s your own tissue, it ages with you naturally, without ever looking unnatural.
The DIEP flap, for deep inferior epigastric perforator, is the most advanced technique. This fat transfer breast augmentation takes skin and fat from your lower abdomen without sacrificing any muscle. Your abdominal wall stays completely intact, so your core strength isn’t compromised. Other flap options include:
To create an LD flap, your surgeon takes tissue and muscle from your upper back to rebuild your breast mound. The track record for this procedure is lengthy, and the successful outcomes are consistently high.
Your NYC plastic surgeon tunnels the latissimus dorsi muscle, along with an attached segment of skin and fat from your back, around to your chest. Unlike the free flap techniques, the tissue in an LD flap stays connected to its original blood supply. That continuity eliminates the risk of complications from interrupted circulation that accompanies most free-flap microsurgeries.
“The LD flap is the right choice, says Dr. Shokrian, “when you have limited chest wall skin, when radiation has compromised your chest tissue or when other donor sites aren’t viable. I position the scar on your back to fall under your bra strap line. The functional loss from your back muscle is minimal and doesn’t affect everyday activities.”
Nipple reconstruction and correction is the final stage of breast reconstruction surgery, completing your results. If your mastectomy preserved your nipple and areola, you don’t need nipple reconstruction. But during a total mastectomy, the oncological surgeon removes your nipple. Your plastic surgeon then has to rebuild it using skin already on your breast, working directly from the mastectomy scar. Usually your surgeon doesn’t need to make any new incisions on your breast.
Four to six weeks after shaping the nipple, a medical tattoo artist creates the areola. Its color, size and placement match your reconstructed breast and your other breast. If done properly, most people can’t tell the difference.
“Women who’ve been through this process say consistently that this final step is what made them feel complete. The mirror finally showed them what they’d been expecting to see.” — Dr. Shokrian
This was absolutely the best decision i have ever made! The staff and Dr Shokrian were absolutely amazing, and my results couldn’t be better. It took me 3 years but i finally chose millennial and I am so happy that i did! Thank you thank you thank you!
Brittanii BThe duration of your breast reconstruction surgery depends on your chosen procedure and technique. Implant-based reconstruction takes two-to-four hours. Flap procedures take longer because of the microsurgery involved. The experienced reconstructive surgeons at New York Breast Surgery Center are usually able to give you a specific estimate for your procedure during your consultation.
Breast reconstruction surgery delivers you to the other side of breast cancer with your body intact and your confidence restored. The center is a trusted practice due to the expertise of plastic surgeon David Shokrian, MD and board-certified surgeon Mohamed Soliman Ahmed Elfar, MD, MS, FACS. Their care doesn’t waver from your first consultation to your final stage.
Don’t find the answer? We can help
That decision belongs to you. Some women want their body back after beating cancer. Others simply want to move forward in their lives, leaving surgery behind them. There is no wrong answer. At your consultation, your plastic surgeon provides a clear picture without pressure, so you can make the choice that fits your life.
Nobody needs breast reconstruction. Some women go flat. Some use a prosthesis. Some come back for reconstruction two years later when they’re ready. The plastic surgery experts at New York Breast Surgery Center support your decision.
The Women’s Health and Cancer Rights Act of 1998 requires any insurance plan that covers mastectomy to also cover breast reconstruction completely. Your insurer cannot charge you more for reconstruction than for any other surgical procedure. The team at New York Breast Surgery Center works with you and your insurance carrier to keep your treatment affordable, although the center is not in network with your plan. If you don’t have insurance, you can get financing and other payment options.
The cost of your breast reconstruction depends on the technique you choose, how many stages you need and what your insurance covers. Because federal law requires most plans to cover reconstruction after mastectomy, you may have the bulk of your costs covered. You learn the cost for your procedure before you schedule it.
During surgery, you’re under general anesthesia. After your procedure, as the anesthesia wears off, you can expect some pain, which your care team at New York Breast Surgery Center manages with medication and care instructions.
If your nipple was removed during the mastectomy, your plastic surgeon rebuilds it using skin already on the breast. A few weeks later, a medical tattoo artist creates the areola. Women who had nipple-sparing mastectomies keep their original nipple throughout.
Breast reconstruction doesn’t raise your risk of the cancer coming back. Your oncology team continues monitoring you with regular follow-ups and imaging, whether you had reconstruction or not.
You can expect some scarring, although the visibility of the scars varies from person to person, depending on your healing and skin response. The surgeons at New York Breast Surgery Center use advanced surgical techniques are used to keep them as minimal and discreet as possible.
Most breast reconstruction cases are completed in stages, rather than in a single operation. Immediate breast reconstruction vs. delayed reconstruction means that you can start the reconstruction at the time of your mastectomy, but additional procedures are still required to refine your breast’s shape, place permanent implants, or complete nipple reconstruction.
Recovery from reconstructive breast surgery after cancer is a multi-stage process. Each stage is shorter and easier to manage than the one before it. The stages include:
Most women are back to full activity within seven-to-ten days after Stage Four. Your team at New York Breast Surgery Center tracks your progress closely and provides detailed instructions to address your questions and concerns. Schedule your consultation for breast cancer reconstruction in Midtown Manhattan or in Great Neck, Long Island today.
Facility Safety Note: All surgical procedures are performed at our JCAHO-accredited flagship surgical center in Bryant Park, Manhattan (HCO ID: 676295). Consultations, minimally invasive procedures and pre/post-operative care are available at our Bronx and Great Neck locations.
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