Breast Reconstruction

Breast reconstruction surgery is a procedure designed to rebuild or replace breast tissue lost to injury or surgical revision. Often performed in conjunction with or following breast cancer removal, breast reconstruction can be accomplished using the patient’s own tissues or a prosthetic inserted beneath the skin.

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LENGTH Stage 1: Tissue Expander Placement, 2 to 4 hours including mastectomy. Stage 2: Tissue expander exchange to final implant with fat grafting, 1.5 to 2 hours. Stage 3: Nipple reconstruction with additional fat grafting, 1.5 hours.

ANESTHESIA General.

IN/OUTPATIENT Stage 1: 1 to 2 day hospital stay; Stage 2 and 3: Outpatient.

RECOVERY Daily living may be resumed immediately. Return to non-strenuous work, with lifting limited to 10-lbs. or less, may be resumed in 2-4 weeks. No forceful pushing, pulling, or repetitive upper body movements for 3 weeks. Visible reduction in scarring should be obvious in 6 to 24 months. Bruising to the affected area should last no more than 2 to 4 weeks. Moderate to significant swelling may be apparent for up to 4 weeks, with subtle to mild swelling possible for 2 to 3 months, depending upon the extent of the procedure.

DURATION OF RESULTS Tissue expander will be replaced by permanent prosthesis in 3 to 6 months. Implants may require replacement or removal at some point in the future. Results of the procedure are intended to last years/decades.

Side Effects & Risks

SIDE EFFECTS Temporary soreness, swelling, bruising, numbness, burning sensation.

RISKS A few risks include infection, asymmetry, permanent decrease in sensitivity in nipples and breast skin. Tightening and hardening of breast tissue surrounding prosthetic implant or rupture of implant may also occur, requiring additional surgical intervention to release scar tissue or replace the implant.

Reconstruction After Skin Cancer Removal

A skin cancer lesion that is particularly large, is being removed with frozen sections or is likely to cause disfigurement may require reconstruction. The general principle of closure is to borrow extra, unnecessary tissue from other similar or nearby locations. All layers of the defect and all tissue types that are removed must be replaced. Skin grafts and cartilage grafts harvested from other regions of the head and neck, or body are often necessary. For defects of the nose, multiple surgeries may be necessary to provide optimal results.

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LENGTH The size and location of the defect will dictate the recommended closure and repair. The procedure length varies from 15 min. to 3 hrs. depending on the exact defect.

ANESTHESIA Generally, the closure can be done under local anesthesia or conscious sedation.

IN/OUTPATIENT Outpatient

RECOVERY You should be able to return to normal function the day of the procedure. Incision sites may be sore, red or drain small amounts of fluid following surgery. An occlusive dressing may be placed after the surgery. Keep incision sites clean and well protected from potential injury. Try to limit movement that may stress your wound and your sutures. Sutures are removed within 7 days of the procedure.

DURATION OF RESULTS Healing will continue for many weeks or months as incision lines continue to improve. It may take a year or more following a given procedure for incision lines to refine and fade to some degree. In some cases, secondary procedures may be required to complete or refine your reconstruction.

Side Effects & Risks

SIDE EFFECTS The side effects are similar for both skin graft and skin flap surgeries and include nerve pain, swelling, bleeding, infection, scarring, wound separation, graft failure and in rare situations, flap necrosis.

RISKS Skin grafts and flaps used to cover surgical areas may not fully survive, requiring additional repair.

Abdominal Wall Reconstruction

Abdominal Wall Reconstruction is a complex surgery typically used to correct abdominal weaknesses caused by recurring hernias, or open wounds that are not easily resolved by other specialties. It is usually performed as a last line of defense once other surgeries have failed.

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LENGTH 2 to 7 hours, depending on the patient and their condition.

ANESTHESIA General

IN/OUTPATIENT Inpatient with a 72 hour stay & up to a week.

RECOVERY You will likely be given an abdominal binder to wear at all times post-operatively. You will likely stay in the hospital for several days. The recovery following hernia repair takes two to four weeks. During this time, patients must refrain from heavy lifting and strenuous exercise.

DURATION OF RESULTS Permanent.

Side Effects & Risks

SIDE EFFECTS Moderate to severe pain is common immediately after the surgery and continues for a few days.

RISKS There is the risk of significant scarring and long wound healing. Complications are generally rare but may include bleeding, infection, hematoma and seroma.