Breast Reconstruction After Mastectomy Surgery Options

Breast Reconstruction is a surgical procedure I use to reconstruct the breast mound after a mastectomy. I employ a variety of surgical techniques for breast reconstruction. Some of these breast reconstruction procedures include TRAM Flap, Tissue Expander with implant, and Latissimus Muscle Flap.

Breast reconstruction can be a very rewarding procedure for a woman who has lost her breast due to cancer. It is important that you feel emotionally ready to undergo reconstruction and to understand and accept the limitations and results. While the creation of a new breast can help you feel better about yourself in clothing, the reconstructed breast will never feel or look like your original breast.

Consultation, outpatient clinic, and in-patient surgical services accessible to patients in the Springield, MA or Hartford, CT areas.

Pioneer Valley Plastic Surgery provides consultation and outpatient clinical services for reconstructive surgery patients at our offices in Longmeadow, MA. We also provide inpatient and outpatient surgical services at three locations in Massachusetts within convenient driving distance from Hartford, CT including Baystate Medical Center in Springfield, MA, Mercy Medical Center in Springfield, MA, and Baystate Wing Hospital in Palmer, MA. For directions and maps, please see our surgical affiliations.

See our breast reconstruction FAQs below, and our breast reconstruction before and after photo gallery


Breast Reconstruction consultation in the Springfield, MA area

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Breast reconstruction is a physically and emotionally rewarding procedure for a woman who has lost a breast due to cancer or other conditions.

Breast Reconstruction FAQs

How should I prepare for my breast reconstruction consultation?

If you have friends or family who have had breast reconstruction, ask them about their experience. View the informatiove Breast Reconstruction Video
on our Youtube channel. Researching breast reconstruction surgery on reputable internet sites such as the American Society of Plastic Surgeons and the American Cancer Society can provide an informative overview. The best information for your personal case, however, will be obtained by making an appointment and speaking with your surgeon. It may also be helpful to view before and after photos of patients that have had the procedure. It's best to view photos of women with a similar body type as yours. Remember to write down any questions or concerns you have so they can be addressed at your consultation. Know what your surgical expectations are so your surgeon can discuss them with you. If you are a smoker we recommend you quit to help reduce the risk of wound healing. We also recommend a healthy lifestyle to help your recovery process.

Will I be seen by the surgeon?

Yes. Dr. Johnson will meet with you and she will discuss all your surgical options. You may also see a Physician Assistant first. Together they will provide you with the necessary information so that you feel confident and comfortable with your surgical decision.

Will I be charged for an initial consultation?

No. Your initial consultation will be billed through your insurance carrier. After your consultation, if all criteria is met, we will attempt to obtain authorization through your insurance carrier to cover the surgery.

Is the plastic surgeon board certified?

Yes. Dr. Johnson is board certified by the American Board of Plastic Surgery, is a fellow of the American College of Surgeons, and is a proud member of the American Society of Plastic Surgeons. Additionally, she is a member of the American Society for Aesthetic Plastic Surgery, which recognizes surgeons who specialize in cosmetic plastic surgery.

Are there different types of breast reconstruction procedures?

Yes. Dr. Johnson performs many different types of reconstruction procedures utilizing a number of techniques, including TRAM flap, Latissimus muscle flap, and tissue expander reconstruction.

Where will my breast lift surgery be performed?

Dr. Johnson has privileges at Baystate Medical Center and Mercy Medical Center. Both are accredited by the Joint Commission and have been awarded the Gold Seal of Approval, and both are conveniently located in Springfield, MA.

What is the TRAM flap technique of breast reconstruction?

This technique involves the use of the abdominal muscle flap made from the rectus abdominus muscle. The muscle and a portion of lower abdominal skin and fat are tunneled up through the chest wall and repositioned to reconstruct a breast mound. The TRAM flap may be created at the time of your mastectomy or it may be delayed as a separate stage. During a TRAM an incision is made at the lower abdominal fold and the muscle, fat and skin are tunneled up through the chest wall and repositioned on the chest wall to recreate a breast. On the breast you will have an ellipse shaped incision around the flap skin. You will have two drains in the abdominal area and one or two at the chest site.

What can I expect after TRAM flap surgery?

The surgery is performed at a hospital. During surgery you will receive general anesthesia and an epidural catheter is recommended for post-operative comfort. The surgery will take between 4-5 hours. Once you are awake you are taken to the recovery room for another 1-2 hours and then you are taken to your hospital room where you will spend 3-5 days in the hospital. During your hospital stay we will slowly advance your activity level and transition you to pain meds by mouth.

Am I a good candidate for TRAM flap breast reconstruction?

During your consultation, Dr. Johnson will provide you with her expert opinion as to whether a TRAM flap is a good option for you. A TRAM flap is an appropriate procedure for you if you have an adequate amount of abdominal tissue to recreate a breast and if you do not have any medical conditions that will inhibit the success of the flap. The risks and benefits and possible complications of surgery will all be discussed. Once you are fully informed, you will be able to determine whether having a TRAM flap is for you.

Are there risks involved with a TRAM flap?

Yes, there are risks with any surgical procedure. The most common risks with a TRAM flap are pain, infection, hematoma/seroma, loss of the flap (complete or partial), sensation changes to the abdomen and breast, the need for another operation due to asymmetry, unsatisfactory scarring or results, fat necrosis.

What is the recovery process?

The first couple of weeks you may feel pain/discomfort in the abdominal area and the chest region. You will notice that the discomfort decreases with each passing day. You are sent home on pain medications which will decrease your discomfort. We will recommend that you do no strenuous exercise or any heavy lifting for at least one month following surgery.

What is the Latissimus Muscle Flap technique of breast reconstruction?

This technique involves the use of the latissimus muscle from the back. The muscle and a portion of the back skin and fat are tunneled to the mastectomy site to reconstruct the breast mound. In some instances, the muscle flap is sufficient enough to recreate the breast, however, often an implant is needed to augment the size of the breast. The latissimus flap may be created at the time of your mastectomy or it may be delayed as a separate stage. During a latissimus flap an incision is made at the upper back just above the latissimus muscle and the muscle, fat and skin are tunneled through to the mastectomy site. In some instances a tissue expander or implant are also placed to augment the size of the new breast mound. On the breast you will have an ellipse shaped incision around the flap skin. You will have two drains in the back area and one or two at the chest site.

What can I expect after Latissimus Muscle Flap surgery?

The surgery is performed at a hospital. During surgery you will receive general anesthesia and an epidural catheter is recommended for post-operative comfort. The surgery will take between 4-5 hours. Once you are awake you are taken to the recovery room for another 1-2 hours and then you are taken to your hospital room where you will spend 3-5 days in the hospital. During your hospital stay we will slowly advance your activity level and transition you to pain meds by mouth.

Are there risks involved with a latissimus flap?

Yes, there are risks with any surgical procedure. The most common risks with a latissimus flap are pain, infection, hematoma/seroma, loss of the flap (complete or partial), sensation changes to the back and breast, the need for another operation due to asymmetry, unsatisfactory scarring or results, fat necrosis.

Am I a good candidate for Latissimus Muscle Flap breast reconstruction?

During your consultation, Dr. Johnson will provide you with her expert opinion as to whether a latissimus flap is a good option for you. A latissimus flap is an appropriate procedure for you if you do not have any medical conditions that will inhibit the success of the flap. The risks and benefits and possible complications of surgery will all be discussed. Once you are fully informed, you will be able to determine whether having a latissimus flap is for you.

What is the recovery process after a latissimus flap breast reconstruction procedure?

The first couple of weeks you may feel pain/discomfort in the back and chest area. You will notice that the discomfort decreases with each passing day. You are sent home on pain medications which will decrease your discomfort. We will recommend that you do no strenuous exercise or any heavy lifting for at least one month following surgery.

What is Tissue Expander breast reconstruction?

This technique is a multi-stage process. It first involves placing a silicone balloon-like tissue expander that is inserted beneath the skin and chest muscle. Saline is gradually injected into the tissue expander to fill it over a period of weeks or months. In most cases, once the skin has been stretched enough, the expander is surgically removed and replaced with a permanent implant.

What is the Tissue Expander breast reconstruction surgical procedure?

The tissue expander may be placed at the time of your mastectomy or it may be delayed as a separate procedure. During the tissue expander procedure the mastectomy incision is used to place the expander under the skin and the chest muscle. With an immediate tissue expander placement, a piece of acellular dermal matrix is used to help provide more coverage to the expander and to help create a more natural breast appearance. The mastectomy incision is closed and one to two drains are placed to help prevent seroma formation. Slowly over the next few weeks to months the expander is filled with saline in our office. Once the skin is stretched adequately a second surgery is needed to exchange the expander to the permanent implant.

What can I expect after Tissue Expander breast surgery?

The surgery is performed at a hospital. During surgery you will receive general anesthesia. The tissue expander portion of the surgery will take between 1-2 hours. Once you are awake you are taken to the recovery room for another 1-2 hours and then you are taken to your hospital room where you will spend one night in the hospital. You are discharged home the next morning with the drains.

What is the recovery process?

The first couple of days/weeks you may feel pain/pressure in the chest area. You will notice that the pain decreases with each passing day. You are sent home on pain medications which will decrease your discomfort. We will recommend that you do no strenuous exercise or any heavy lifting for at least one month following surgery. We will recommend that you wear a breast binder or sports bra for support.

Are there risks involved with a tissue expander/implant reconstruction?

Yes, there are risks with any surgical procedure. The most common risks with a tissue expander/implant reconstruction are pain, infection, hematoma/seroma, sensation changes to the chest skin, rupture of the expander/implant, capsular contracture (scarring around the implant), the need for another operation due to asymmetry, unsatisfactory scarring or results.

What is Nipple Reconstruction?

This technique involves the restoration of the nipple-areolar complex lost due to injury, breast cancer, or other conditions. A variety of different techniques exist for reconstruction of the nipple and its surrounding areolar tissue. These include the use of skin grafts taken from other regions of the body, local flaps of breast skin that are re-shaped into a nipple, or the sharing of tissue from the opposite nipple-areolar region. Additional techniques such as tattooing may be used to add color to the tissue if needed.

What is the Nipple Reconstruction surgical process?

The surgery is performed at a hospital. During surgery you will receive local anesthesia vs. IV sedation. The surgery will take about 1 hour. If you receive anesthesia you are taken to the recovery room for another 1-2 hours and then you are discharged home. You will have a bulky dressing on that will remain in place until your follow up visit in the office.

What is the Nipple Reconstruction recovery process

Most patients have no pain from this procedure. If you have any discomfort is it very mild. You are sent home on pain medications which will ease the discomfort. We will recommend that you do no strenuous exercise or any heavy lifting for at least one month following surgery.

Are there risks involved with a nipple reconstruction?

Yes, there are risks with any surgical procedure. The most common risks with a nipple reconstruction are pain, infection, loss of the nipple (complete/partial), loss of projection, sensation changes to the skin, the need for another operation due to asymmetry, unsatisfactory scarring or results.

What are Post-Operative Instructions for Breast Reconstruction Patients? (Download printable PDF)

There may be information here that contradicts information on the general Post-Operative Instructions sheet. Any time this occurs, follow these procedure specific instructions. If you have any questions, please call the office at (413) 731-7877.

  • Minimal activities for the first 4 days after surgery.
  • Sleep on back for first 2 weeks.
  • While drains are in you may sponge bath only.
  • You may change the gauze dressings as needed. You can use ABD pads, maxi pads, or nursing pads.
  • Leave the binder in place until your first post-operative visit. The dressings will be changed at your first visit.
  • Do not raise arms above shoulders.
  • NO heavy lifting (greater than 15 pounds), pushing or pulling for 4 weeks after surgery.
  • NO driving or working while on pain medications.
  • You may take Tylenol for pain or Benadryl for itching if needed.
  • Avoid Advil, Motrin, or Ibuprofen for the first week after surgery but you may take them any time after the 1st week.

You can expect:

  • Sutures to be removed between 10-14 days after surgery if they are not dissolvable.
  • Drains will be in for 1-2 weeks after surgery.
  • To return to non-strenuous work within 3-7 days.
  • Moderate discomfort which should be relieved with pain medications.
  • Moderate swelling of chest and abdomen.
  • Bruising around chest.
  • Some bloody or clear drainage on dressings for the first week after surgery. Wear pad to keep clothes clean.

Call the office if you experience:

  • Severe pain not relieved by pain medications.
  • Increased swelling or firmness.
  • Excessive drainage on dressings that is increasing.
  • Incisions that appear to be opening.
  • Any red, hot, or pus containing areas.
  • A fever greater than 101.5
  • Call the office at any time with questions.

As time goes by and you are healing, the following apply:

  • Most swelling, bruising and soreness resolves within 6-8 weeks.
  • Return to strenuous activities in about 8 weeks.
  • The scar will continue to fade for up to 2 years.

Some supplies that may be helpful to purchase prior to surgery:

  • 1 box of gauze pads, maxi pads, or nursing pads for dressing changes
  • 1 bottle of antibacterial soap
  • 1 roll of paper tape
  • 1 tube of bacitracin ointment

We require 48 hours for prescription refills. Please call in advance.