More Information, FAQ, and Timeframes on Breast Cancer Reconstruction

When diagnosed with breast cancer you can easily find yourself overwhelmed with information. Rather you will be having a lumpectomy/partial mastectomy, or a total mastectomy (nipple sparing/skin sparing), there are several options to consider and you should discuss all the pros and cons with your plastic surgeon. Dr. Theunissen is a board certified plastic surgeon in Baton Rouge, LA that specializes in all forms of reconstruction such as autologous flap, implant, or a combination of both. Dr. Theunissen understands how important it is to not limit patients to just one type of reconstruction because not all patients are the same. One type of breast reconstruction in Baton Rouge or any other city might be perfect for you and your lifestyle, but another patient might require or want something different. Dr. Theunissen’s goal is to be able to openly discuss all options, listen closely to your goals, and help you decide what option(s) are best for you.

Lumpectomy Vs Partial Mastectomy

Very often people do not know the difference between a lumpectomy and a partial mastectomy. A lumpectomy is also known as breast-conserving surgery where the cancer can be removed by a wide local excision leaving behind the majority of the healthy breast tissue. A partial mastectomy is very similar to a lumpectomy but unlike a lumpectomy, it involves taking significantly more breast tissue with the removal of the cancer.

Your board certified plastic surgeon should recommend a few different options depending on your current breast size, the amount of tissue that will be removed, and what your goals are for the outcome you hope to achieve.
In women with much larger breast, Dr. Theunissen usually performs an oncoplastic reduction/lift which involves reshaping the existing healthy breast tissue into a more aesthetic breast to fill in the deficit left behind by the lumpectomy/partial mastectomy. Along with an oncoplastic reduction/lift, Dr. Theunissen will perform a contralateral procedure to your other breast to improve symmetry by reducing/lifting it. Both of these can be done through the same incisions as a traditional breast reduction/lift.
Women that have smaller breasts and will be receiving a lumpectomy/partial mastectomy, they often have to have added volume in the form of an implant or tissue to fill in the deficit left by the removal of the tumor. Dr. Theunissen can use tissue in the form of fat grafting or a TDAP (thoracodorsal artery perforator) flap to reconstruct the breast. Fat grafting is where Dr. Theunissen will perform liposuction to harvest fat from one or multiple areas of your body and inject it into the breast deficit where the tumor once was. A TDAP flap is a muscle sparing, rotational flap of tissue that comes from the bra line/area along your back. Dr. Theunissen will harvest the TDAP flap of tissue and rotate it under the skin to the front to fill in the deficit left after the removal of the tumor. In some cases Dr. Theunissen will use an implant should you be a good candidate and would need significant volume. Even then Dr. Theunissen commonly will add tissue via fat grafting to help smooth out contours/irregularities in the breast.

• Procedure is performed on average 2-3 hours and will be done at the same time as your lumpectomy/partial mastectomy.
• It is performed in an outpatient setting where you will get to go home the same day.
• Most patients will have to have drain tubes for on average 10 days.
• Recovery time is about 1-2 weeks.
• Reconstruction is usually done in one surgery at the same time as your lumpectomy/partial mastectomy.

Mastectomy (Skin or Nipple sparing)

A mastectomy is the removal of all breast tissue. The choice of whether you will have a nipple sparing or skin sparing mastectomy is made depending on your cancer type/location/size, and that choice is made between you and your oncology breast surgeon. Autologous muscle sparing breast reconstruction (the use of your own tissue without sacrificing the muscle), implant reconstruction, or a combination of both, are all options you should look into when thinking about your reconstruction. Autologous reconstruction is considered the gold standard in reconstruction. It is extremely important that you do your homework and go to a board certified plastic surgeon that specializes and performs this type of reconstruction often and with a high success rate. Autologous reconstruction requires the skill, training, and knowledge of microvascular surgery. Dr. Theunissen performs on average 150-200 breast reconstruction flaps every year with a success rate of 98%. Autologous reconstruction can involve taking tissue from the abdomen, thighs, back, hips/buttocks area and transplanting it in the place where your breast tissue once was. Should you choose autologous reconstruction, Dr. Theunissen will discuss with you which area would be best and everything that would be involved. In women that are thinner will often need a combination of tissue from multiple areas and an implant. Using a combination of your own tissue with an implant gives for a more natural looking breast. Using your own tissue is definitely more of a recovery and investment of time on the front end but once fully completed, you never have to worry about having to have another surgery in the future, like you would with implants. To see all the different options of autologous reconstruction, switch over to our reconstruction page where all types are listed in detail including recovery.

• Autologous reconstruction is performed at the same time as your mastectomy and depending on the type it takes on average 4 hours for a bilateral and 3 hours for a unilateral.
• It is performed as an inpatient surgery where patients stay on average 2-3 nights in the hospital.
• It does require drains that stay on average 10 days.
• Recovery is on average 3-4 weeks.
• It involves 2 stages/surgeries.

Implant reconstruction is an older/traditional way to reconstruct the breast. It is important to make sure you are going to a board certified plastic surgeon that is familiar with implant based reconstruction. Rare and uncommonly patients that have an extremely low BMI (body mass index), are not a good candidate for autologous reconstruction. In those cases Dr. Theunissen will discuss with you all the options involved with implant reconstruction such as implant type, placement, and size. Dr. Theunissen almost always uses fat grafting (liposuction fat from multiple areas to inject in the breast), in conjunction with implant reconstruction to help give the breast a more natural appearance and smooth out any contour irregularities. One negative aspect of implant based reconstruction is that you will have to have future surgeries to exchange/replace your implants. It could be as soon as 5 years or as long as 10 years when you will need to exchange them. Switch over to our implant reconstruction page to get all of the details on implant reconstruction including recovery.

• Implant reconstruction is performed at the same time as your mastectomy and on average takes about 2 hours.
• It is performed as an outpatient procedure.
• It requires drains that usually stay in place 10-14 days.
• The recovery is on average 2-3 weeks.
• On average it involves 2 stages/surgeries.

Conclusion

When deciding what type of reconstruction that is best for you, be sure to know all of your options and discuss them openly with your board certified plastic surgeon. Dr. Theunissen is there for his patients every step of the way and is constantly striving to push past the standard in breast reconstruction. Reconstructive surgery can be complex and require advanced skills. With 10+ years in practice, you can trust Dr. Theunissen has the experience, confidence, skill, and compassion to help you make the best decision to achieve the goals you have for yourself.