Breast Reconstruction is a type of surgery for women who have had a breast removed (mastectomy). The surgery involves rebuilding the breast to restore size and shape. There are a wide variety of options for breast reconstruction. Dr. Ploplys can work with your breast cancer surgeon at the time of a mastectomy or help you after you have recovered from your cancer treatments. Please call to schedule an appointment. We give patients with a new diagnosis of breast cancer priority and can usually see you within a week of your call.

Nipple Sparing Mastectomy

A subset of women diagnosed with very early breast cancer or breast pre-cancer may be candidates for nipple sparing mastectomy. What kind of mastectomy you have is decided by your general surgeon based on your cancer type. This type of reconstruction works best in women with smaller, non-sagging breasts.

Skin Sparing Mastectomy

Modern mastectomy techniques can spare the breast skin to aid in reconstruction. This is possible as long as the skin is not involved in the cancer. Nipples are removed. We work with your choice of general surgeons to provide immediate reconstruction so that you wake up from surgery with a breast form.

Delayed Reconstruction

Reconstruction does not have to be immediate. Some patients decide to undergo all of their cancer therapy before reconstruction, and some decide to pursue reconstruction later for personal reasons. We are happy to help you decide which reconstructive path is right for you.

Matching Procedures

The opposite breast can undergo a variety of treatments to match the reconstructed breast. This includes lift, reduction, augmentation or fat grafting and is covered by insurance.

Nipple Reconstruction

If a patient desires a prominent nipple, and they have thick enough skin to create one, a nipple can be folded from the skin on the breast. This procedure is done in the office.

Tattooing

A tattoo can be completed in the office to finish off the look of a reconstruction. This can add pigment to the nipple areola or create a 3D effect to simulate a projecting nipple where there is none.

Fat grafting

Fat grafting uses the fat liposuctioned from stubborn areas to fill in areas of the breast deformed by lumpectomy and radiation and/or release tight tissue under arms or on breasts. This is a commonly used adjunct to improve the look and feel of a breast reconstruction.

Surgery is a painful process. Breast reconstruction sometimes involves lifting the chest muscles, which adds to postoperative pain. We offer a nerve block during surgery with Exparel to ease this pain and aid in recovery.
The reconstructive process is very rarely “immediate.” Even when a final implant can be placed at the time of surgery, a so called direct to implant reconstruction, there is often nipple reconstruction to be done. We recommend waiting 3 months between stages of reconstruction to allow the body to heal. Depending on chemotherapy and radiation needs as well as method of reconstruction, the process can take up to a year.
Implant based reconstruction where silicone implants are placed require MRI screening of the implants every 2-3 years. This checks the integrity of the implant but does not serve as a complete cancer screening test. Your oncologist will usually recommend breast self exam to check for any new lesions in the remaining breast skin. Mammograms will usually not be needed after mastectomy and implant reconstruction.
Insurance is required by the Women’s Health and Cancer Rights Act of 1998 to cover reconstruction. The required coverage includes all stages of reconstruction of the breast on which the mastectomy was performed, surgery and reconstruction of the other breast to produce a symmetrical appearance, prostheses and treatment of physical complications of the mastectomy, including lymphedema.
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