Breast reconstruction is a surgical procedure that aims to restore the shape, size, and appearance of the breasts after mastectomy. Plastic surgeons will often take a varied approach to reconstruction, considering cancer treatments, chemoradiation, timeline, methodology, and more, while also listening to the patient’s overall goals to achieve an optimal outcome in reconstruction.
Dr. Michael A. Howard has proven his success in this field, having worked with patients throughout their journey from diagnosis to mastectomy to reconstruction and recovery. As one of the area’s leading microsurgeons and an AOA Medical Honor Society member, Dr. Howard has made significant advances in the field of DIEP (deep inferior epigastric perforator) flap reconstruction, and can offer expert insights for your reconstructive journey. Submit an online contact form today to schedule an appointment with Dr. Howard, or call one of our offices at (224) 271-4250 for more information.
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About Breast Reconstruction
When a doctor delivers a breast cancer diagnosis, discovers a genetic predisposition toward it, or detects current or future cellular mutations, they will often recommend that the patient undergo a procedure to remove their breast tissue, known as a mastectomy. While there have been significant advances in breast cancer treatment like early detection, endocrine therapy, and breast preservation procedures, the condition is still the second leading cause of cancer death in women and the most common cancer worldwide. (1) Despite advancements, many doctors will still recommend a mastectomy to remove the tissue entirely to prevent further complications.
Modern breast augmentation often operates on one of two methods: implant-based (silicone implants are used to reshape the breast) or autologous-based (using the patient’s own tissue to reshape the breast). DIEP Flap breast reconstruction, Dr. Howard’s specialty, is an autologous reconstructive procedure that preserves the existing muscle tissue, nerves, and blood vessels to achieve a quick recovery and maintain natural blood flow and sensation in the breast.
An added benefit of DIEP Flap reconstruction is that it makes your midsection flatter and tighter. (2) Dr. Howard’s experience in reconstruction and microsurgery has benefited many patients, meaning you can achieve the reconstructive results you are looking for. Contact our office at (224) 271-4250 or schedule your consultation online to begin your reconstruction process with Dr. Howard.
Benefits of Breast Reconstruction
Breast reconstruction offers women the ability to reclaim their sense of womanhood following their breast cancer treatment and/or mastectomy. Reconstructing and reshaping the breasts can improve a patient’s body image and increase their self esteem. In doing so, this psychological boost further aids the healing process. The option of autologous reconstruction eliminates the need for prosthetics and implants, which can not only be uncomfortable, but have complications in the long term. Patients also report increased comfort in clothing like bras, swimsuits, shirts, and dresses. (1)
Candidates
DIEP flap reconstruction procedures from Dr. Howard are available to patients who require breast reconstruction. This can include breast cancer survivors, mastectomy or lumpectomy patients, severe chest trauma patients, among others. For patients who still require a mastectomy or lumpectomy, the planning of your reconstruction will be incorporated into the planning of these procedures.
The best way to learn about your candidacy and available options is to schedule a consultation with Dr. Howard.
Personal Consultation
Understanding the plan for your procedure and the desired goals and enabling clear communication between you and Dr. Howard is one of the most important ways to ensure a successful outcome. Dr. Howard listens to and appreciates every need of each patient, and provides expertise and insight based on the most up-to-date information available in the field. Scheduling a personalized, confidential, comprehensive consultation with Dr. Howard to discuss your breast reconstruction options means meeting with one of the most decorated surgeons in the greater Chicago area. In addition to being an AOA Medical Honor Society member, Dr. Howard is on the Medical Expert Panel for Bright Pink, a non-profit supporting women with raised potential for breast cancer. He has also taught courses on nipple preservation in mastectomies for the American Society of Plastic Surgeons and received specialized breast augmentation and microsurgery instruction from some of the country’s most renowned breast surgeons. Dr. Howard is passionate about his work and his patient care, so schedule your consultation to plan your procedure.
Preparation
Breast reconstruction, and especially DIEP Flap reconstruction, can take up to eight hours to complete. The most effective anesthesia for breast reconstruction has recently been found to be an epidural block, where local anesthetic agents will block the pain receptors in your spinal cord and brain. During your consultation with Dr. Howard, you will receive all of the necessary preparatory information for your specific procedure.
Procedure
Dr. Howard often refers to reconstruction as more of a process than a one-and-done procedure. From initial planning to undergoing your procedure and then follow-up appointments, Dr. Howard pays special attention to each of his patients to ensure an effective reconstruction and swift recovery. While DIEP Flap reconstruction is Dr. Howard’s specialty, he may incorporate methods from other procedures like the ones below.
Tissue Expansion and Delayed vs. Instant Reconstruction
Depending on the amount of muscle tissue and available grafting fat on the patient, Dr. Howard may need to delay reconstruction to allow expansion of the breast before conducting the breast reconstruction surgery. This is achieved by inserting an implant to expand the breast, sometimes increasing its size if necessary. When the surrounding tissue has expanded enough, Dr. Howard will remove the implants and then use grafted body fat to fill and shape the breast, reattaching blood cells and nerves with microsurgical techniques. If the patient qualifies for instant reconstruction, the process of temporary implanting will be bypassed entirely. (1)
TRAM Flap Reconstruction
Transverse Rectus Abdominis Musculocutaneous (TRAM) Flap Reconstruction is the most widely utilized method of breast reconstruction. Patients qualifying for this method have enough (but not excessive) abdominal fat and average muscular build, i.e., the average person. TRAM Flap Reconstruction takes a selected piece of skin and fat, and some of the abdominal muscle (the “six pack”) and relocates it to the mastectomy site where it is then reconstructed into a breast.
DIEP Flap Reconstruction: Dr. Howard’s Specialty
Deep Inferior Epigastric Perforator (DIEP) Flap Reconstruction operates similarly to TRAM Flap Reconstruction, utilizing the same skin and fat from the abdomen. However, DIEP does not remove any muscle from the area, preserving the integrity and muscle strength. (3) Once the filler tissue is added and the breast is sculpted, Dr. Howard utilizes microsurgery to connect the borrowed blood vessels and nerves to those surrounding the breast, creating regular blood flow and sensation to the breast and nipple. Because DIEP does not remove any muscle from the abdomen, complications like hernias, muscular defects, or muscular atrophy are significantly less likely. DIEP is often the primary choice for breast reconstruction patients although it is more selective in its candidacy; requiring sufficient grafting tissue and comfortability with some scarring.(4)
Recovery
Each patient recovers from breast reconstruction at a different rate based on their immune system strength, lifestyle, and the scale of their procedure. All variables aside, most patients see a reduction in bruising and swelling in six to eight weeks, and any soreness or tenderness is likely to fade in a fraction of that time. Complete and total healing may take up to two years, and in this time Dr. Howard highly recommends regular follow-up appointments to address concerns you may have and co-monitor your healing. Habits like smoking can significantly delay the healing process and increase the likelihood of complications, so it is recommended to stop prior to the procedure and not resume throughout the recovery period.
Results
The results of your breast reconstruction will vary based on your recovery period and the scale of your procedure, but you will emerge with a new breast and the increased happiness and confidence that comes with it. Dr. Howard recommends and supports potential patients speaking with his former patients to hear their results. Overall, breast reconstruction has shown to boost happiness, confidence, and overall quality of life in patients who undergo the procedure.
Cost of Breast Reconstruction in Chicago
The cost of your breast reconstruction procedure will depend entirely on the scale of your operation and your outcome goals. To learn more about your procedural costs and your available options, schedule a consultation with Dr. Howard or call the office at (224) 271-4250 to speak with a staff member.
References
- Regan JP, Casaubon JT. Breast Reconstruction. PubMed. Published 2022. https://www.ncbi.nlm.nih.gov/books/NBK470317/
- DIEP Flap. www.breastcancer.org. https://www.breastcancer.org/treatment/surgery/breast-reconstruction/types/autologous-flap/diep
- de la Parra M, Camacho M, de la Garza J. DIEP Flap for Breast Reconstruction Using Epidural Anesthesia with the Patient Awake. Plastic and Reconstructive Surgery – Global Open. 2016;4(5):e724. doi:https://doi.org/10.1097/gox.0000000000000737
- Ben Aziz M, Rose J. Breast Reconstruction Perforator Flaps. PubMed. Published 2022. https://www.ncbi.nlm.nih.gov/books/NBK565866/