Richard V. Dowden, M.D., C.M., F.A.C.S.
Certified by the American Board of Plastic Surgery
Cosmetic and Plastic Surgery, Inc.
6770 Mayfield Road, Suite 410
(Mayfield Heights)
Cleveland, Ohio 44124
(440) 449-7470
What are the techniques of breast reconstruction?
When is the best time to do breast reconstruction?
Does insurance help with the cost of breast reconstruction?
Where are the scars located after breast reconstruction?
Can breast cancers come back after breast reconstruction?
Is breast reconstruction surgery painful?
What is the recovery period after breast reconstruction?
Finding a Surgeon Near You.
Answers to Frequently Asked Questions about abdominoplasty:
There are two main categories of breast reconstruction, implant methods, and non-implant methods.
The implant methods are chosen when there is a sufficient amount of healthy skin to stretch to accommodate the implant. Very often, an adjustable implant is chosen, which is not fully filled when it is first put into position, but then can be gradually inflated with salt-water in the office, a little each week, until the correct size is reached, or even temporarily a little larger than final desired size. Then at a later operation, that expander is either converted into a long-term implant, or is replaced by a long-term implant.
The non-implant methods are chosen when there is too little skin remaining after the mastectomy, or the skin is too tight, too thin, or damaged by radiation. Then healthy tissues have to be transferred from other areas of the body, usually the abdomen, or the back, or the buttock region. These transfers may require more than one operation to accomplish. Occasionally an implant is also added.
There is no one "best" time for every patient, because the timing depends upon many factors that are different for each individual woman. But in general, a good time to do reconstruction is right at the same time as the mastectomy, or within a few days later. In contrast, the first few months beyond those opportunities are not as favorable, because of the healing that is going on. And then, after at least six months have passed, the timing becomes optimal again, and stays so for years, unless there has been radiation therapy. Radiation therapy greatly complicates reconstruction to a degree that increases as the years go by. If there is to be radiation, most plastic surgeons will try to accomplish the reconstruction as early as possible.
Yes, because of federal legislation requiring insurance companies to recognize that reconstruction is not cosmetic surgery. The actual fees will reflect several key attributes. One can find surgeons offering low fees for this surgery, and although lower fees do not necessarily mean that the surgeon is not experienced, there are several questions to which prospective patients must learn the answers:
- Is the surgeon certified by The American Board of Plastic Surgery?
- Does the surgeon have considerable experience with the surgery?
- Is the surgical facility fully accredited for general anesthesia?
- Will there be an M.D. Anesthesiologist present?
- Will the surgeon be doing the surgery himself/herself?
- Can you be sure the surgeon is not just supervising trainees?
You want to be certain the answer is yes to all of these before deciding.
There will always be the scar from the mastectomy itself, although that may be moved or shifted slightly. If an implant-only reconstruction was chosen, then that will likely be the only scar. If tissues are transferred from elsewhere, then there will be scars from the donor site, as well as additional scars on the breast itself very often.
It is always possible that breast cancers can return, even after many years, and that possibility is not changed by having had reconstruction. Modern techniques are able to detect such recurrent cancers just as early and as well as without reconstruction.
Yes, moderately so, because of the operation upon the muscles that is almost always involved. All the patients are given strong narcotic pills to take at home, and limit their activities accordingly.
Recovery time depends on the individual, but usually follows a general pattern. For the first five to seven days, the patients take fairly strong pain medicine, usually a mild narcotic. During this time they generally stay at home, and they cannot drive a car or operate machinery. Near the one-week mark, when they are on milder medicine, they can start light exercise, such as walking, treadmill, stationary bike, but not impact exercises like running or aerobics. The second week, weights or exercise machines can be added, and then after three weeks, running and aerobics can be done. The point at which work can be resumed depends upon how the work activities fit into the progression described above, and this is individualized. Dr. Dowden often recommends that an elastic binder be worn for varying lengths of time.
If you are interested in abdominoplasty and want to find a board-certified Plastic Surgeon in your area who is qualified to do it, call the referral service of the American Society of Plastic Surgeons at (800)-635-0635, or check http://www.plasticsurgery.org. Alternatively, one can ask the local plastic surgery society, or the plastic surgery department of the nearest medical school. To find out if a surgeon whose name you have been given is truly a Board-Certified Plastic Surgeon, put the name into the search engine at http://www.abms.org to find out.
This page Copyright © R.V. Dowden, MD, 1995, 1996, 1997, 1998, 1999, 2000, 2001, 2002, 2003, 2004, 2005, 2006, 2007, 2008.
This information may not be reproduced or distributed electronically or in print without permission from Dr. Dowden.
Note that while the information given by Dr. Dowden during a consultation is completely current and up-to-date, the information of this website is only as current as the date of last update, and therefore may become out-of-date.
Cosmetic and Plastic Surgery
6770 Mayfield Road, Suite 410
(Mayfield Heights) Cleveland, Ohio 44124
(440) 449-7470
Note: To ensure privacy for our patients, all of our outgoing phone lines have their caller ID permanently blocked; if your phone does not accept blocked ID calls you will not be able to receive any calls back from our office.
Last Update: 5:44 PM on 06/01/2008
URL of this page:
http://dr-dowden.com/main/recofaqs.html
URL of breast reconstruction page:
http://dr-dowden.com/main/brrecons.html
URL of Dr Dowden's home page: http://dr-dowden.com/index.html