A: For patients newly diagnosed with breast cancer it’s helpful to make a binder and find a method for you to keep the wealth of information organized. Often patients have been referred from a breast surgeon, who will work with you on determining the right surgery to remove the involved tissue. The options you will review are lumpectomy with radiation versus a single or double mastectomy with the possibility of preserving the nipple. Once you have committed to the idea of restoring the breast, call, and set up your plastic surgery consultation to begin reviewing your options. The decision about how to move forward will be a combined decision between you, us and the breast surgeon. Don’t have a breast surgeon? No worries, we will refer you to surgeons we trust that we have worked closely with to achieve the natural results we are looking for.
A: The initial consultation begins with a conversation about your medical history and preferences for reconstruction. This follows with a physical exam and measurements to look to see what options you are even a candidate for. Many women come in for a second opinion after being told they are not a good candidate for tissue reconstruction. Please understand, microsurgical breast reconstruction using one’s own tissue is a very technically sophisticated procedure that requires specialized training. Often a surgeon who is not facile performing DIEP flap surgery will discourage a prospective patient from pursuing this and only promote an implant reconstruction option. Even in thinner patients, DIEP flap surgery is possible. Only after getting the information can you weigh the options and feel comfortable making an informed decision about any tradeoffs.
A: Secondary revision surgery is a large part of our practice. Whether an initial reconstruction was never done or was performed with an implant or your own tissues it may need some further attention to achieve the best result possible for you. Over time changes may occur that could benefit from revision surgery. Some procedures can be done in an outpatient fashion with minimal downtime. These include exchange or implant size changes or the additional use of fat grafting to smooth surface irregularities. For some patients, improving the current implant result will be suboptimal and a recommendation may be to forego the implant and pursue a tissue-based reconstruction. This involves a longer procedure with a short hospital stay, but the lifelong permanent benefit of switching to your own tissues may outweigh the short-term inconvenience.
A: For decades, breast implants were placed partially below the pectoral muscle to both protect the implant and help in achieving a smooth contour to the upper breast. More recently, because of changes in mastectomy technique as well as the availability of tissue grafts and newer form stable implants, reconstruction are frequently being performed above the muscle. The technique is called ‘pre-pectoral’ breast reconstruction and has some benefits in the right patients. Avoiding the use of the pectoral muscle may allow for a subjective decrease in pain during the recovery. For some breast shapes (not all!), it may also make creating a natural contour to the breast more achievable. The primary benefit is the avoidance of a visual moving of the breast that occurs when the pectoral muscle overlying the implant is strongly flexed. The drawbacks for some are the thinner amount of tissue covering the implant which may accentuate rippling and feeling the implant more.
A: Yes! We fell in love with plastic surgery because of the enjoyment in performing cosmetic and reconstructive surgeries throughout the body. While 50% of our practice is dedicated to breast reconstruction because there is a tremendous need for talented surgeons to take care of these women, the remaining 50% of our practice spans male/female surgery both reconstructive and cosmetic of the face, breast and body.
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Mehul Kamdar MD
261 James Street, Suite 1B
Morristown, NJ 07960
973.577.6050
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