A mastectomy is a vital cancer-fighting surgical procedure, but it can leave a woman feeling incomplete. It leaves many breast cancer survivors searching for a way to feel confident and hopeful during their recovery from the hardships of treatment.
Following a mastectomy, breast reconstruction can be an important step in the healing process. Board-certified plastic surgeon Dr. Michael Howard specializes in reconstruction techniques that restore symmetry, shape, and volume to the breasts, helping patients regain comfort within their own bodies. Whether through implant-based or autologous tissue reconstruction, our goal is to create natural-looking results that help restore your well-being.
As a board-certified plastic surgeon, teacher, and researcher practicing at Northwestern Medicine, Dr. Howard carefully considers every individual’s unique body shape and personal preferences before forming a customized treatment plan. At his offices in Lake Forest, IL, Chicago, IL, and Glenview, IL, you can rest assured that your needs and desires will be heard and met with the expertise you deserve.
Contact him today by calling (224) 271-4250 to reach one of the locations closest to you.
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Breast Reconstruction Options
Before patients undergo a partial or double mastectomy, they have the option to choose between an immediate reconstruction or a delayed reconstruction. The advantage of an immediate reconstruction is that the aesthetics of the breasts are taken into consideration at the time of the initial surgery. Surgeons often use skin-sparing techniques that will make breast restoration much easier to perform.
With the delayed option, women have more time to decide which approach they want to take and gain more time for healing. Some patients must opt for a delayed surgery if they still need to undergo radiation therapy. Regardless of when it takes place, they are always performed in stages to prepare the breast tissue for further modification. If you are considering a reconstruction and have already undergone a mastectomy, Dr. Howard can help you achieve amazing results with highly advanced delayed reconstruction techniques.
Implant Reconstruction
For an implant reconstruction, Dr. Howard will first prepare the remaining breast tissue for implants to be placed. He accomplishes this by using a tissue expander, a device placed under the skin that is slowly filled at follow-up appointments. This creates a pocket for each breast that will properly accommodate the implants. Ideal candidates for tissue expanders are women who have had a full mastectomy since the results will be much more symmetrical. These patients should also be on the slimmer side since too much subcutaneous fat can interfere with the definition of the implants. (1)
After the breast tissue is properly prepared with tissue expanders, the second surgery is completed around 6 months later. (2) This will involve the actual placement of the implants and any necessary reconstruction of the nipple-areola complex. At the time of your consultation with Dr. Howard, he will outline your implant options and the unique benefits of each type/feature. He offers his patients:
- Silicone and saline implants
- Round and teardrop shapes
- Textured and smooth
- Implants of various projections and sizes
Dr. Howard will closely evaluate if the implants should be placed prepectorally (above the pectoral muscles) or subpectorally (under the pectoral muscles) in order to produce the best cosmetic results.
DIEP Flap Reconstruction
Dr. Howard specializes in DIEP (deep inferior epigastric perforator) flap reconstruction, a form of autologous tissue surgery- and a type of surgery that utilizes your own body’s tissues. Though this method of reconstruction takes 6 to 8 hours, you can achieve soft, natural-feeling breasts that don’t require a follow-up procedure years later. For this surgery, Dr. Howard makes an elliptical incision in the abdominal area and resects an area of fat, skin, veins, and arteries. This separated abdominal tissue is called a “skin island”. If you only had a partial mastectomy, the abdominal incision would be about half the size. He then makes inframammary incisions- incisions along the bottom crease of where the breasts will be. Using these incisions, he will attach the veins and arteries of the abdominal tissue to the chest. Once the skin island is properly vascularized, he will form a new breast. He will suture the abdomen so that the incision line is situated right above the pubic area, allowing for a discreet scar placement. He will also be sure to reposition the naval to a natural placement.
Personal Consultation
A personal consultation with Dr. Howard is an essential first step in addressing your concerns regarding breast reconstruction. As a physician with decades of experience, he understands the emotional and physical challenges that come with breast cancer and is dedicated to providing compassionate care throughout your journey. He takes the time to employ surgical techniques that align with your aesthetic goals. Dial (224) 271-4250 to reach his offices in Lake Forest, IL, Glenview, IL, and Chicago, IL, and his staff will readily assist you in scheduling your consultation.
Benefits of Implants
Implants are a popular method of breast augmentation for both mastectomy patients and those seeking cosmetic enhancement for many reasons. In general:
- They come in a wide variety of shapes, sizes, and materials.
- They provide excellent symmetry between each breast.
- It only requires about 1 week of downtime.
- They can provide natural-looking results.
- Dr. Howard takes about 1 to 2 hours to complete the procedure.
- The results last 10 to 20 years before a replacement is required.
Benefits of the DIEP Flap
As one of the most intricate and state-of-the-art breast reconstruction procedures available, the DIEP flap offers extraordinary benefits:
- It contours the abdomen similarly to a tummy tuck.
- The abdominal incision can be hidden under a bathing suit
- It utilizes your own biocompatible tissue.
- You will not require any additional surgery and results last a lifetime.
- The results look and feel incredibly natural.
- The strength and integrity of the abdominal muscles are preserved. (3)
- Dr. Howard checks for proper circulation flow within the “skin island” prior to reconstruction, effectively preventing vascularization complications.
Candidates for Breast Reconstruction
Ideal candidates for implant-based reconstruction or DIEP are non-smoking women who have had mastectomies and have completed their cancer treatments and/or radiation therapy. Women who are seeking a DIEP flap procedure should be within the normal BMI range or above since it requires additional abdominal fat. Those who have already had previous abdominal surgery and those within the obese weight range will not qualify. Dr. Howard will evaluate the quality of your abdominal vascularization with a CT scan in order to determine if you can safely undergo a DIEP flap.
Preparation
About 2 weeks before your surgery, you should refrain from taking blood thinners and hormone medications. Dr. Howard will provide you with further guidance on which ones to avoid. Both surgeries will limit your range of motion for some time, so please arrange your home so that items are easily accessible. You may want to plan for a friend or family member to help you with everyday errands and chores for the first few days of recovery.
Dr. Howard advises his patients to stock up on food and other necessary items so that they will be able to focus on healing. If you are a smoker, he will perform your reconstruction if you commit to quitting for at least a few weeks prior to surgery and during recovery.
Recovery and Results
The recovery processes for breast implant reconstruction and DIEP flap reconstruction are a bit different. Since both procedures require general anesthesia, you will need someone to take you home once your surgical team says it is safe to do so. Your surgical team will administer IV fluids and oxygen and closely monitor you as you recover from the general anesthesia. After a breast implant procedure, you will be able to go home the same day, but for a DIEP flap, you may need to stay in the hospital for 2 to 5 days. After this period, it’s important that you take your prescription medications to ease your recovery and prevent infection.
Dr. Howard will prescribe a compression bra to protect the new contours of your breasts and reduce swelling. After receiving implants, you will be able to return to work after 1 week, but DIEP flap procedures usually take 2 weeks of downtime. For both procedures, patients can usually return to their workout routine after 6 to 8 weeks, but it’s important to consult Dr. Howard at a follow-up appointment. He will prescribe an enhanced recovery program (ERP) that has been proven to lead to improved cosmetic results and shorten the recovery period in the hospital. (4)
Cost of Breast Reconstruction in Chicago
When discussing the cost of breast reconstruction, it’s essential to consider various components. These include the surgeon’s fee, anesthesia fees, hospital or surgical facility fees, pre-operative tests, post-surgical garments, and any necessary medications. During your consultation with Dr. Howard, you will have an understanding of his recommended treatment plan for you and the total cost involved. Luckily, breast reconstructions are usually covered by insurance, so they are highly accessible for many patients.
Call to reach our Glenview, Chicago, or Lake Forest, IL practice at (224) 271-4250 to see if one of Dr. Howard’s life-changing procedures is suitable for you.
References
- Regan JP, Schaffner AD. Breast Reconstruction Expander Implant. PubMed. Published 2023. Accessed November 14, 2023. https://www.ncbi.nlm.nih.gov/books/NBK431062/
- Bellini E, Pesce M, Santi P, Raposio E. Two-Stage Tissue-Expander Breast Reconstruction: A Focus on the Surgical Technique. BioMed Research International. 2017;2017:1-8. doi:https://doi.org/10.1155/2017/1791546
- Hyun Jun Cho, Hyo Jeong Kwon, Moon SH, Young Joon Jun, Jong Won Rhie, Deuk Young Oh. One-stage nipple and breast reconstruction using a deep inferior epigastric perforator flap after a skin-sparing mastectomy. Archives of Plastic Surgery. 2020;47(01):26-32. doi:https://doi.org/10.5999/aps.2019.00598
- Linder S, Walle L, Loucas M, Loucas R, Frerichs O, Fansa H. Enhanced Recovery after Surgery (ERAS) in DIEP-Flap Breast Reconstructions—A Comparison of Two Reconstructive Centers with and without ERAS-Protocol. Journal of Personalized Medicine. 2022;12(3):347. doi:https://doi.org/10.3390/jpm12030347