Breast Reconstruction Surgery – TRAM – Breast Restoration Post-Mastectomy – Newport Beach, CA*

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About Breast Reconstruction

Having breast cancer is a long journey on its own, and when you add in the decision to have breast reconstructive surgery, it can be overwhelming. Our compassionate and caring plastic surgeon, Dr. Karen Leong, would be honored to help guide you through this time in your life with breast cancer. Surgical breast reconstruction is performed to reconstruct the breast after mastectomy has disfigured the shape and size of the breast mound. Some women have nipple-sparing mastectomies, but most women have all of it removed because of cancer and for preventing it in the future.

No matter where you are along the path of recovery from breast cancer, know that you can discuss your breast aesthetics and health with Dr. Leong in her Newport Beach, CA practice. She consults with women newly diagnosed with breast cancer, who need a breast reconstruction revision surgery, or who want to finally have the breast reconstruction surgery years after the mastectomy. We want you to know you have a choice at each of our Newport Beach locations. If you would like to discuss your options with Dr. Leong at any point in your life with breast cancer, she is a phone call away. It is important for you to look and feel feminine and natural for your well-being. You may choose to have as little done as possible or choose to delay the surgery until your cancer treatments are over. Dr. Leong will be flexible in structuring your treatment timeline. She will also work with your other doctors and surgeons to give you the wraparound care you deserve.

Ideal Candidates

While not every woman is an ideal candidate for a breast reconstruction, we will do our best to accommodate your surgeries. There are certain aspects of this journey that can really take its toll on your physical and mental health. During a consultation with Dr. Leong, she will listen to how you would like to proceed and offer suggestions on how she can support your goals for realistic outcomes. She will also discuss with you how your breasts would look and feel after a reconstruction because it is a change you will have to come to terms with during your recovery. Dr. Leong will create your newly reconstructed breasts to look as natural as possible. Also, she may request to exchange medical information with your team of doctors to discuss if a reconstruction is appropriate at this stage of your treatment.

Surgical Technique

There are a variety of techniques available today for breast reconstruction. There are also many factors that Dr. Leong considers when determining the technique that will produce your best results. Some of these factors include cancer diagnosis, reconstruction timing, whether you will use natural tissue or implants, and if nipple-sparing or nipple reconstruction is a part of the process. Most women opt for the implant-based reconstruction. In order to rebuild the breast out of your own tissue, there must be enough tissue to adequately cover the breast mound. Flap procedures accomplish this by using your own skin, muscle, and fat to create, cover, and build the breast mound. The most common flap techniques are:

  • TRAM Flap
    The transverse rectus abdominis myocutaneous (TRAM) flap uses skin, fat, and muscle from your abdomen to create the breast. All of the upper ab muscles may need to be harvested to rebuild the breast.
  • Latissimus Dorsi Flap
    The latissimus dorsi flap (LDF) uses muscle, skin, and fat from your back. During this procedure, fat, tissue, and muscle are moved from the back to the mastectomy site through a surgically created tunnel and remains attached to the donor location, which leaves the original blood supply intact.
  • DIEP Flap
    Like a TRAM flap, a DIEP (deep inferior epigastric perforator) flap removes fat, skin, and blood vessels from the abdomen, but it doesn't take the muscle. The DIEP flap removes fat and skin from the belly to form the breast mound. Dr. Leong would then attach the blood vessels to the chest via microsurgery.
  • PAP Flap
    Another flap alternative is the PAP (profunda artery perforator). This technique takes skin, fat, and muscle tissue from your inner thigh to create your breast(s).
  • LTP Flap
    While the TRAM flap tends to be one of the more common methods used during reconstruction, sometimes there is not enough muscle, skin, and fat that can be taken from the abdominal area. In these situations, the LTP flap may be used, which takes tissue from the lateral thigh area.
  • Composite Flap
    Also known as a composite stacked flap, this method combines flaps from different areas on your body to reconstruct the breast.

Additional Considerations

While flap procedures are usually successful and a common method used in breast reconstruction, you may be able to rebuild your breast(s) with tissue expansion. This involves placing a tissue expander under the breast wall and then slowly filling it with saline over the course of 4 – 6 months until the skin is properly stretched. After a flap has been created or the skin is stretched through an expander, you can then decide whether you want to use a natural fat transfer or breast implants to create the volume and shape of the breast(s). After your breast reconstruction surgery, you may want to improve the appearance with nipple and areola reconstruction. There are numerous methods to restore the nipple-areola complex so that it looks more attractive.

What to Expect

Breast reconstruction surgery is performed in various stages. During certain phases (such as creating a flap, inserting an expander, or placing implants), general anesthesia is often used. Some patients will require an overnight stay — this is dependent on the current phase of treatment. Once the final step has been completed in the breast reconstruction process, you will wear a compression bra for the chest and you will be given medication by Dr. Leong to control swelling, bleeding, and discomfort. Ongoing monitoring with mammograms and breast exams are important and recommended for long-term health.

Frequently Asked Questions

How much does breast reconstruction surgery cost?
Since breast reconstruction is a complex surgery, to get great results you should concentrate on choosing a plastic surgeon with experience and training, like Dr. Leong, over who bids the lowest price. In your consultation, Dr. Leong will listen to your needs and goals before crafting your custom reconstruction plan. Once this is done, she can talk to you about cost estimates, payment methods, and low-interest financing.

Does insurance cover my surgery?
The WHCRA (Women's Health and Cancer Rights Act) of 1998 requires insurance plans that cover mastectomies to also cover breast reconstruction surgery. If you have insurance, we will help you submit needed information and paperwork to your provider.

Which technique should I choose?
There is no single technique that is right for everyone. The best technique for you will depend on your needs, goals, and body. During your consultation, Dr. Leong can go over your options, including both implants and flaps, so you understand the benefits and challenges of both before you decide on your treatment plan. Whether you decide on implants or a flap for reconstruction, Dr. Leong will do her best to give you natural-looking results.

Should I have reconstruction with my mastectomy or wait?
When you choose to have breast reconstruction, it is based on several factors. Some patients choose to have their reconstruction performed at the same time as their mastectomy, while other patients prefer to wait. If you decide to have reconstruction at the same time as your mastectomy, Dr. Leong can work with your general surgeon to plan your surgery.

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Reclaim Your Self-Confidence

While the breast reconstruction process can be lengthy, it is considered one of the most worthwhile cosmetic surgeries. It can help decrease the emotional and physical impact of a mastectomy while also allowing you to boost your self-confidence and figure. If you have been diagnosed with breast cancer, have had trauma to the chest, or were born with a defect that affects the shape of your breasts, we invite you to call our Newport Beach, CA office and schedule your consultation with Dr. Leong.

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*Individual results are not guaranteed and may vary from person to person. Images may contain models.