About Breast Reconstruction
Breast reconstruction surgery can be performed to restore one or both of the breasts to an attractive size, shape, and appearance following a lumpectomy or mastectomy. It's also used to repair the chest if it has been damaged by a birth defect or trauma. Advanced options in reconstructive surgery make it easier for breast cancer patients to feel whole again and have breasts that look natural after removal or damage. This surgery generally involves several procedures and different stages that may be done at the beginning of your breast cancer treatment or delayed until the treatment is complete. Board-certified and fellowship-trained plastic surgeon Dr. Derek Lou creates a personalized surgical plan with compassion as we help you and your cancer team to restore your physical appearance and confidence at Lou Plastic Surgery in Houston, TX.
"Dr. Lou was great! He completely put me at ease. I had something done that I thought would be more complicated. He explained the procedure and said it could be done in his office in a 30 minute time span. So easy! Now I regret waiting so long."- A. / Healthgrades / Jan 10, 2019
"Dr. Lou and Erica are simply amazing! Dr. Lou is not only a very talented surgeon he is a very patient, nice, and comforting Dr. Him and Erica never made me feel rushed or like I was asking too many questions and made me feel completely comfortable, I love them and am forever grateful to them for changing my life. Allie has been wonderful with post op treatments as well, could not ask for a better team than Lou Plastic Surgery!"- S.H. / Google / Oct 16, 2019
"Dr. Lou and his team are absolutely phenomenal and were God sent. I'd previously considered another surgeon for my procedure but didn't feel quite comfortable with him. So, I searched my insurance portal, and found Dr. Lou. I respect how he believes in knowing exactly what he's going into before a surgical procedure. Therefore, I was scheduled to have several CAT scans done before cutting into the unknown. He was very attentive during my healing process, and even came to my aid on Christmas day to check on me. His right hand person/office manager, Erica is more kind than I can express! She assured me that everything would go as planned, and ALWAYS greeted me with a smile....she even took out time to listen to me speak about my past moments of depression due to my displeasure with my body. What more can I say? Dr. Lou is an absolutely AMAZING and extremely CARING surgeon!! I'd choose this practice all over again if need be."- C.Y. / Google / Oct 12, 2019
"I saw Dr. Lou for a second opinion after an incident involving my thumb. There's a long story behind how the injury got so bad, but finding Dr. Lou was the best thing that ever happened to me. I only wish I had known him at the onset of this ordeal. The day before I met Dr. Lou, another doctor (at a clinic) was trying to convince me to go into emergency surgery to open my thumb up for what they said was infected very badly. Turns out, there was no infection at all, which was exactly what Dr. Lou confirmed before the results even came back. Dr. Lou is the best in my opinion. A doctor has to be able to listen (and there was a lot of background to give him), have compassion for the patient (which I was totally convinced he cared about me, what I was going through and my fears) and still provide the best solution for the problem. He had to clean up (cut) my thumb pretty good (and by good - it wasn't pretty, but I felt nothing b/c I was numb), but I immediately started the down road to recovery which no other doctor (I had seen 3 already) could get me to. It's because of Dr. Lou and his staff that I write this long review. I haven't experienced anything this traumatic in my adult life! Some people would say "it's just a thumb"...but you don't realize how much you need a thumb until it's almost gone! I'm almost 100% healed and Dr. Lou and his nurses have guided me every step of the way. They make you feel like family and you just don't get better than that these days! Thank you for everything Dr. Lou, Erika and Allie!"- K.M. / Google / Oct 11, 2019
"I wanted to write a review to thank Erika for helping me arranged my appointment with Dr. Lou to get some injections done. She helped me iron out some questions I had about the injectable products. I've been going to Dr. Lou for over a year now and his work is superior and he really provides excellent patient care. I definitely recommend Dr. Lou for all cosmetic needs whether it's small or large. Remember to ask for Erika when you call to book your appointment."- A.H. / Yelp / Oct 03, 2019
Reconstruction of the breast(s) is an extremely individualized surgery. Each patient will be required to have an in-depth consultation appointment with Dr. Lou to determine their surgical plan from their concerns, needs, and available techniques. If you are considering reconstruction, it's important that you understand realistic expectations for results. While Dr. Lou aims to give you an attractive, natural appearance, your reconstructed breast(s) may not have the same sensations, look, or feel like your original breast(s). You should be cleared by your oncology team to undergo reconstruction surgery and talk to Dr. Lou regarding other medical conditions that may impair your recovery.
There are many surgical techniques available to reconstruct the breast. There are also multiple factors that Dr. Lou will consider when deciding on the technique that will give you your best results. A few of these factors include your specific cancer diagnosis, when the reconstruction is performed, whether you will use implants or natural tissue, and if nipple reconstruction or nipple-sparing is a part of the treatment plan. To recreate the breast, you must have enough tissue to fully cover the breast mound. Flap techniques accomplish this by using your own fat, muscle, and skin to build and cover the breast. The most frequent flap techniques are:
- TRAM Flap
This technique takes muscle, skin, and fat from your abdomen to rebuild the breast. The tissue selected to build the new breast may be removed from the stomach or the tissue may stay connected to the donor location, maintaining the original blood supply.
- DIEP Flap
Similar to a TRAM Flap, the DIEP Flap uses skin, fat, and blood vessels from the lower abdominal area; however, it does not use the muscle. The DIEP (deep inferior epigastric perforator) flap moves skin and fat from the stomach to build the new breast, then uses microsurgery to reattach the transferred blood vessels to the chest wall.
- Latissimus Dorsi Flap
This technique uses muscle, fat, and skin from your back. During this technique, tissue is transferred from the back to the breast(s) via a surgically created path so it stays attached to the donor location, which keeps the original blood supply in place.
- PAP Flap
Another flap is the profunda artery perforator (PAP). This method uses fat, skin, and muscle tissue from your inner thigh to reconstruct your breast(s).
- LTP Flap
Although the TRAM flap is one of the most common techniques used for breast reconstruction, sometimes there isn't enough muscle, fat, and skin that can be taken from the abdominal area. In this case, the LTP flap technique may be performed, which uses tissue from the outer thigh.
- Composite Flap
Also called a composite stacked flap, this technique takes flaps from various sections of your body for breast reconstruction.
Although flap procedures are a common and highly successful method for breast reconstruction surgery, you may want to reconstruct your breast(s) with the tissue expansion method. This technique places a tissue expander below the breast wall and then gradually fills it with a saline solution over 4 – 6 months to stretch the skin naturally. After you choose the flap method or tissue expansion, you may then decide whether you would prefer to use breast implants or a fat transfer to create the shape and volume of the breast(s). After your reconstruction mammoplasty, you can further improve the look by having areola and nipple reconstruction. There are several procedures to restore the nipple and areola so that it appears natural.
What to Expect
Surgical breast reconstruction is done in several steps. In some phases (like the flap creation, tissue expansion, or implant placement), general anesthesia may be used. Some patients may need to stay overnight, but this is based on the actual treatment phase. When the last stage is completed for your breast reconstruction, you should wear a medical support bra and you may be prescribed medication by Dr. Lou to help control discomfort, bleeding, and swelling. In time, the reconstructed breast(s) should appear more normal so you can feel more comfortable. Regular checkups with breast exams and mammograms are essential and highly recommended for your ongoing health.
Frequently Asked Questions
How much does breast reconstruction surgery cost?
Breast reconstruction surgery can be complicated so to get your best results, you should focus on finding a doctor who has years of training and experience, like Dr. Lou, over the cheapest price. During your initial consultation, Dr. Lou will take time to understand your concerns and cosmetic goals before developing your unique treatment plan. Then, our team will go over costs, options for payment, and where to find low-interest medical financing.
Does insurance cover my surgery?
The Women's Health and Cancer Rights Act (WHCRA) of 1998 requires health insurance policies that cover breast cancer surgery (mastectomy) to cover reconstruction surgery as well. If you have health insurance, a team member at Lou Plastic Surgery will help explain your policy and benefits. We can also assist you with getting any needed information to your insurance carrier.
Which technique should I choose?
With so many options, there is no single reconstruction technique that works for every patient. The recommended method for you will be based on your concerns, goals, and physique. At your initial consultation, Dr. Lou will explain your choices, including both flaps and implants, so you can understand the advantages and drawbacks of each before deciding which is best for you. Whether you choose a flap or implants, Dr. Lou will do his best to make your results look natural.
What about nipple reconstruction?
Nipple and areola reconstruction are typically done using 3D cosmetic tattooing. If you're interested in this, you should talk to Dr. Lou during your initial consultation. He will explain your options to help you decide whether you'd like nipple and areola reconstruction to be included in your surgical plan.
Should I have reconstruction with my mastectomy or wait?
The timing of your breast reconstruction is a personal decision. Some patients decide to get their breast(s) reconstructed along with their mastectomy, while others decide to defer reconstruction surgery. Dr. Lou suggests you make an appointment for a consultation following a diagnosis of breast cancer so you can start thinking about your choices, including when you want to have breast reconstruction surgery. If you want to undergo reconstruction in conjunction with your breast cancer treatment, Dr. Lou will collaborate with your oncology team to plan your care.
Reclaim Your Self-Confidence
Although the process of breast reconstruction can take time, it's probably one of the top beneficial surgeries for our Houston, TX patients at Lou Plastic Surgery. It may help improve the physical and emotional impact of breast cancer treatment while also allowing you to reclaim your figure and self-confidence. If you have breast cancer, have had an injury to the chest, or have a congenital defect that affects the appearance of your breasts, we encourage you to contact our Houston, TX office and make an appointment with Dr. Derek Lou.