Understanding the Basics of Breast Reconstruction Surgery

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Breast Reconstruction Surgery 101

Breast reconstruction surgery is a surgical procedure that is used to rebuild the shape and size of the breast(s) after a surgical removal of the breast or “mastectomy”.

At AMAE Plastic Surgery in the West Bloomfield area our entire team understands that undergoing the surgical removal of one or both breasts can be an extremely physically and emotionally challenging experience. Many people may experience a range of emotions, including sadness, grief, anxiety, and fear, both before and after the surgery. It is important to understand that these emotions are normal and that it is okay to feel them.

Patients may feel a sense of loss after a mastectomy, particularly if they have had to undergo the procedure due to breast cancer. Losing a breast can be a significant change, and it can be difficult to adjust to the physical and emotional changes that come with it.

Some women may feel self-conscious about their appearance after a mastectomy, which can affect their self-esteem, their feelings of femininity, or their body image. And many women just want to feel “whole again”. Breast reconstruction in the hands of a skilled and experienced plastic surgeon can help women put their lives back together after breast removal surgery by restoring the natural appearance and symmetry of the breast(s).

Breast Reconstruction Techniques

Breast reconstruction surgery can be performed using a variety of techniques, and the appropriate technique will depend on the individual patient’s needs and goals, the extent of the previous surgery, the availability of tissue, and other factors.

Breasts can be reconstructed using breast implants, using the patient’s own tissue (autologous reconstruction), or a combination of both. The appropriate technique will depend on the individual patient’s needs and goals. These different methods of breast reconstruction are called “pathways”.

Autologous breast reconstruction: This pathway involves using the patient’s own tissue, such as skin, fat, and muscle, to reconstruct the breast. Autologous reconstruction can be performed using a variety of techniques, including the TRAM flap, the DIEP flap, the SIEA flap, and the latissimus dorsi flap. These techniques involve transferring tissue from one part of the body to the chest area to reconstruct the breast.

Breast implant reconstruction: This pathway involves using breast implants to reconstruct the breast. Breast implants can be made of silicone or saline and are available in a range of sizes and shapes to suit the individual needs of patients. Breast implant reconstruction can be performed using a variety of techniques, including the two-stage approach and the direct-to-implant approach.

Hybrid breast reconstruction: This pathway involves using a combination of the patient’s own tissue and breast implants to reconstruct the breast. Hybrid reconstruction can be a good option for patients who do not have enough tissue available for autologous reconstruction or who prefer the look and feel of breast implants.

It’s important to note that every patient is different and the appropriate pathway to breast reconstruction will depend on the individual woman’s body, needs and goals. Renowned plastic surgeon Dr. Ali at AMAE Plastic Surgery in the West Bloomfield area will discuss the available options with you to help you make the decision that is best for you.

AMAE Plastic Surgery is also among the first and only surgical practices in the West Bloomfield area to offer state-of-the-art Vectra 3D imaging for breast reconstruction patents. This revolutionary imaging system provides a three-dimensional computerized image of the patient’s breasts from any and every angle – so that Dr. Ali can show you your options and expected outcomes before your breast reconstruction surgery!

Timing of Breast Reconstruction Surgery

Breast reconstruction surgery can be performed at the same time as the mastectomy (immediate reconstruction) or at a later date (delayed reconstruction). The timing of the surgery will depend on the individual patient’s needs and goals, as well as other factors such as the availability of tissue and the patient’s overall health.

Recovery from breast reconstruction surgery will depend on the individual patient’s healing process and the extent of the procedure. Most patients are able to return to work and other normal activities within a few weeks of the surgery, although it’s important to follow the surgeon’s instructions and avoid strenuous activities or heavy lifting for at least the first few weeks to allow for proper healing.

Choosing a Breast Reconstruction Surgeon

Breast reconstruction surgery is a complex procedure that requires the skill and expertise of a qualified and highly experienced plastic surgeon. Here are a few tips to help you choose a plastic surgeon for your breast reconstruction surgery.

Look for a board-certified plastic surgeon like Dr. Ali. (Not a ‘cosmetic surgeon’ which means they have far less training). It is important to choose a plastic surgeon Like Sr. Ali who is certified by the American Board of Plastic Surgery (ABPS). This certification indicates that the surgeon has received specialized training and has passed rigorous exams in the field of plastic surgery. You can also check your plastic surgeon’s credentials with the state medical board and look for any disciplinary actions or complaints.

Consider the plastic surgeon’s experience and expertise. Choose a plastic surgeon who has years of experience performing hundreds of breast reconstruction surgery, like Dr. Ali. Do not be afraid to ask the plastic surgeon about their training, the number of breast reconstruction surgeries they have performed, and their success rate. Ask to see pictures of actual patients showing the results of their breast reconstruction surgery.

And always look for a surgeon who is a good fit for you. It is important to feel comfortable with your plastic surgeon and to be able to communicate openly with them.

Top West Bloomfield Area Breast Reconstruction Surgery

Dr. Ali is caring and compassionate West Bloomfield area board certified plastic surgeon who has helped countless women reclaim their bodies after cancer with breast reconstruction surgery. He will offer you a consultation to answer your questions and offer you understanding advice about your breast reconstruction surgery options.

If you are battling – or have battled – breast cancer, you are not alone. We are here to help you determine what you want to do, so you can move forward with your best life.

West Bloomfield Area Breast Reconstruction Surgery: 248-335-7200

The Steps of Breast Implant Removal Surgery

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What is Involved in Breast Implant Removal Surgery

While breast implant surgery removal is uncommon, there are certain circumstances when a woman wants or needs to remove previous breast implants. In some cases, this may be simply an aesthetic or a lifestyle choice. In other cases there may be medical reason necessitating implant removal.

Whatever, the reason, it is important to have the procedure performed by a board-certified plastic surgeon with years of experience in breast implant removal, to avoid complications and achieve the most beautiful and natural looking reconstruction of the breast.

Why Patients Have Breast Implants Removed

In a rare number of cases, a woman may no longer wish to have the larger breasts that she desired when she was younger for strictly personal aesthetic reasons. We have seen women who find that they “went too big” when they were younger and that the breast implants are now in the way or a little too ostentatious.

More common are women who desire breast implant removal because a less-than-skilled surgeon previously did not do a good job with their breast augmentation surgery. At AMAE Plastic Surgery in Birmingham, MI we have seen breast implants by other (unskilled) doctors that were uneven, placed too high, asymmetrical, oddly shaped, dropped or otherwise malformed.

New generations of implants are very unlikely to “pop” or “leak.” But some women may need to have older breast implants removed due to leaking or deflation. Other women may be experiencing pain, discomfort or breast hardening due to breast capsule (capsular contraction), which is the scar tissue that forms after the placement of a breast implant.

Breast implant removal surgery may involve replacement with more attractive implants – but can also involve natural reconstruction of the breasts without implants. In either case, the key to successful results is going to a skilled and experienced plastic surgeon like Dr. Ali in Birmingham, MI.

Breast Implant Removal Step 1 – Anesthesia

Medications, intravenous sedation, and general anesthesia (putting the patient to sleep) are all administered for patient comfort during breast implant removal surgery. The selection of anesthetic will be discussed with you by Dr. Ali during your initial arm lift consultation.

Breast Implant Removal Step 2 – Incision

Typically a breast implant removal involves an incision to be placed along the lower fold of the breast (“inframammary fold”) or an incision around or below the areola.

Dr. Ali will select the best incision placement for optimal results with the least visible scar.

Breast Implant Removal Step 3 – Removal

The removal technique will depend on each patient’s unique needs. In cases of capsular contracture, scar tissue will need to be carefully removed and adhesions that hold tissue together released.

Breast Implant Removal Step 4 – Reconstruction

If the patient has chosen new implants, the breast augmentation procedure will begin. In other patients, Dr. Ali may be able to use their own tissue for breast reconstruction or reshaping of the area – to ensure a nature texture and appearance.

Breast Implant Removal Step 5 – Closing the Incisions

Sutures (stitches), skin adhesives, tapes and/or clips may be used to close the skin incisions. Gauze dressings or bandages will be applied – and thin drains may temporarily be inserted to remove excess blood and fluid in some cases. A support bra, surgical garment, or compression garment may be used to minimize swelling following breast implant removal surgery.

Dr. Ali will provide you with detailed instructions on caring for the incision, removal of the stitches (and drain if applicable), and medications to take for post-operative discomfort and to avoid infection.

It is extremely important that the incisions are not subjected to force, swelling, abrasion or excessive motion during the recovery – and Dr. Ali will explain what you can and can’t do and when you can return to your normal activities.

Most patients can resume work, school and less strenuous normal activities within two weeks. And by six weeks, the majority of patients are able to return to a completely normal activity level.

Remember: the fastest recovery, least pain and least visible scars all depend on following your plastic surgeon’s instructions after your arm lift surgery! Healing will continue for several weeks as swelling decreases – and it may take several months to see full results when all swelling has subsided. And, of course, continue to follow your plastic surgeon’s instructions and attend follow-up visits as scheduled.

Breast Implant Removal Surgery | Birmingham, MI

Top Birmingham board-certified plastic surgeon Dr. Ali has provided breast revision surgery for hundreds of women across Oakland County and the greater Detroit area, including: Birmingham, Bloomfield Hills, West Bloomfield, Troy, Southfield, and more.

Because of his expertise, high standard of care, and exceptional results in even the most difficult cases, he is the surgeon that other physicians refer their patients to for breast implant removal and breast revision surgery. With his years of expertise, caring demeanor and modern techniques, Dr. Ali can fix almost any breast implant problem, including: implant rupture, asymmetry, capsular contracture, implant size change, and more.

No matter what problems or issues you are having with your breast implants, board certified breast revision surgeon Dr. Ali will listen to your concerns and help you find the solution.

Breast Implant Removal Surgery | Birmingham, MI:  248-335-7200

Nipple Reconstruction Surgery FAQs

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Nipple Reconstruction Surgery Frequently Asked Questions– 

Dr. Ali is a prominent board certified plastic surgeon in the greater Birmingham, MI area, with decades of experience and thousands of satisfied patients. With over 20 years in practice and extensive training, Dr. Ali is a Fellow in the American College of Surgeons, and has been rated Top Doc by Hour Detroit Magazine multiple years in a row. In this article, Dr. Ali discusses nipple reconstruction surgery, and answers some frequently asked questions about the nipple reconstruction procedure.

How is Nipple Reconstruction Surgery Performed?

Most often, the nipple is constructed from a flap of skin on the top of the breast, such as what is called the C-V and skate flaps. These procedures can be performed as an outpatient. The scar-based modified C-V flap can be performed for nipple reconstruction and scar revision at the same time.

Reconstruction of the areola is performed using a full-thickness circular skin graft from a different location on the patient’s body, for instance, the bra roll, a C-section scar, or even sometimes the inner thigh. Using a skin graft allows the areola to maintain a distinct topography from the rest of the breast, and it also enables the physician to hide some of the scars left by the mastectomy.

Does Nipple Reconstruction Surgery Require Hospitalization?

Nipple reconstruction surgery is almost always performed on an outpatient basis, meaning that a hospital stay is not necessary.

What Type of Anesthesia is Used for Nipple Reconstruction Surgery?

Generally, nipple reconstruction surgery is performed using a local anesthetic. Dr. Ali will inject a medication that numbs the area where the reconstructed nipple will be located. Under a local anesthetic, you will be awake during the procedure, although you will likely be given a medication to allow you to relax.

In the event Dr. Ali feels that a general anesthesia would be preferable, you will be given an IV (intravenous infusion), which would be inserted into a vein in your hand or arm and taped securely in place. Along with the anesthesia, a medication to relax you is inserted through the IV line. With this type of anesthesia, you will be asleep during the procedure.

Can I have Nipple Reconstruction Surgery During Chemotherapy?

Usually, nipple reconstruction surgery is the final stage of breast reconstruction. Chemotherapy is usually completed before breast reconstruction is commenced. Most doctors want the patient to be fully recovered from their mastectomy and effects of chemotherapy before beginning the reconstruction process.

Are There Non-Surgical Alternatives to Nipple Reconstruction?

Nipple tattoos are becoming an increasingly popular option for women who have undergone breast reconstruction surgery after cancer. Techniques have improved to the point where it is difficult to tell the difference.  Dr. Ali can refer you to a specialized nipple tattoo expert who can create extremely natural-looking 3D tattoos using medical tattooing.

How Long is Recovery from Nipple Reconstruction Surgery?

Recovery time depends upon the technique selected. If you decide upon a tattoo, you can return to work the very next day.

The surgical flap technique is a little bit more involved, and the length of recovery depends upon the location of where the skin graft is taken. Generally, the area around the newly-constructed nipple and areola are for the most part insensate, so most patients report minimal discomfort.

When the flap technique is used, patients normally take a few days for the initial healing and then can return to work. However, you should wait from two to four weeks before intense exercise is resumed, in order for the surgical scars to heal properly. In the meantime, gentle exercise such as walking is encouraged, and you can begin to walk as soon as the evening of the procedure if you feel up to it.

Is Nipple Reconstruction Surgery Permanent?

While nipple reconstruction surgery is considered to be permanent, the newly created nipples may flatten a bit after a length of time, and tattoos can fade somewhat. Additional procedures down the road to maintain the projection or color are not unusual, and are happily performed by our Birmingham surgical team – to keep your breast and nipples looking beautiful and natural.

Will My Insurance Cover Nipple Reconstruction Surgery?

If you are having reconstruction done post-mastectomy, both surgical and non-surgical options for nipple and/or areola reconstruction are generally covered by insurance companies.

While this article answers many questions you may have, if you are considering surgery to reconstruct your nipples, no doubt you have more. It is important that you select a surgeon in whom you have confidence, who will take the time needed to explain all of your options and put you at ease, and with whom you feel completely comfortable. If you live in or near the greater Birmingham, MI area and are considering nipple reconstruction surgery, schedule a consultation with Dr. Ali to discuss your unique situation and the best options available to you.

Typically nipple tattoo experts do not take insurance, but do provide information to the patient so that they can submit to their insurance for reimbursement.

Nipple Reconstruction Surgery – Birmingham, MI

Dr. Ali is a board certified Macomb County area plastic surgeon who has helped countless women get the breast appearance they love after breast reconstruction with nipple reconstruction surgery. He will offer you a consultation to answer your questions and offer you understanding advice about your nipple reconstruction options.

If you are a warrior who has undergone a mastectomy after battling breast cancer, we are here to help you improve your nipples’ appearance. Live your best life, feeling attractive and confident in your appearance, with beautiful nipples.

Birmingham, MI Nipple Reconstruction Surgery Consultation: 248-335-7200

Nipple Reconstruction After Breast Reconstruction Surgery

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Nipple Reconstruction After Mastectomy & Breast Reconstruction– 

After a mastectomy, most women choose to have nipple reconstruction surgery to completely finish reconstruction of their breast.

No matter how skilled the plastic surgeon, surgically created nipples will never react like or have the same sensation as do natural nipples. However, the appearance of recreated nipples look very much like natural ones, and that can give women who have undergone breast cancer reconstruction procedures a sense of “completeness.”

Dr. Azhar Ali is a prominent board certified plastic surgeon in the Macomb County, Michigan area, with decades of experience and a host of satisfied patients. Dr. Ali has extensive experience reconstructing breasts and nipples for women who have had mastectomies, and employs the latest cutting-edge techniques to achieve the most natural appearance possible. In this article, Dr. Ali discusses the basic elements of nipple reconstruction.

Nipple Reconstruction Surgery Techniques

Breast reconstruction is usually performed in multiple stages. Nipple reconstruction involves recreating a nipple, and usually the areola (the pigmented tissue surrounding the nipple) at the apex of the breast mound. There are both surgical and non-surgical options for the nipple reconstruction, depending on the patient’s goals.

Most often, the nipple is constructed from a flap of skin on the top of the breast, such as what is called the C-V and skate flaps. These procedures can be performed as an outpatient. The scar-based modified C-V flap can be performed for nipple reconstruction and scar revision at the same time.

Reconstruction of the areola is performed using a full-thickness circular skin graft from a different location on the patient’s body, for instance, the bra roll, a C-section scar, or even sometimes the inner thigh. Using a skin graft allows the areola to maintain a distinct topography from the rest of the breast, and it also enables the physician to hide some of the scars left by the mastectomy.

Reattachment during Nipple Reconstruction Surgery

Many women ask whether their own nipples can be reattached to their reconstructed breasts. In some cases, the answer is yes. In others, it is not possible. The decision must be made prior to the mastectomy, since once it is removed, the nipple cannot be reattached months later. That being said, there are a number of techniques available that allow for the nipple to be reattached at the time of the mastectomy.

The Best Time for Nipple Reconstruction Surgery

Nipple and areola reconstructions most commonly occur as the final phase of breast reconstruction, usually about 3-4 months post-surgery, allowing the new breast time to heal. Surgery to reconstruct the nipple and areola is a separate surgery, and can be done as an outpatient procedure.

Complete mastectomies are only one reason for breast reconstruction and subsequent nipple and areola reconstruction. These procedures may also be appropriate following a central lumpectomy, where the breast itself is preserved, but the nipple and/or areola are compromised. Similarly, nipple/areola reconstruction may occur following oncoplastic reductions (where the tumor actually involves the nipple) or even non-cancer operations where the areola and/or the nipple have been altered.

Nipple Reconstruction is Not Mandatory

As with each aspect of breast reconstruction, whether or not to restore the nipple is a personal choice. While it can be done as soon as three months after the initial breast reconstruction, there is no time limit determining when nipple or areola reconstruction procedures can be safely or effectively performed. Many women want to have the procedure done as soon as is possible, but some wait a considerable amount of time – even five to ten years – to undergo the procedure. And, some women elect to forego the reconstruction altogether.

Alternatives to Nipple Reconstruction Surgery

Nipple tattoos are becoming an increasingly popular option for women who have undergone breast reconstruction surgery after cancer. Techniques have improved to the point where it is difficult to tell the difference. Dr. Ali can refer you to a specialized nipple tattoo expert who can create extremely natural-looking 3D tattoos using medical tattooing.

The decision to have nipple reconstruction surgery is extremely personal. There are many options available, and it is important for you to be completely comfortable with the procedure itself, and more importantly, with the surgeon who will perform it.

Dr. Ali has the experience, artistic skill and technical expertise necessary to enhance your appearance and accomplish your goals, as he has done with a host of satisfied patients. If you live in or near the Macomb County, Michigan area and are considering nipple reconstruction surgery, give us a call to schedule an appointment with Dr. Ali to discuss what options may be available to you.

Best Macomb County Nipple Reconstruction Surgery

Dr. Ali is a board certified Macomb County area plastic surgeon who has helped countless women get the breast appearance they love after breast reconstruction with nipple reconstruction surgery. He will offer you a consultation to answer your questions and offer you understanding advice about your nipple reconstruction options.

If you are a warrior who has undergone a mastectomy after battling breast cancer, we are here to help you improve your nipples’ appearance. Live your best life, feeling attractive and confident in your appearance, with beautiful nipples.

Macomb County Nipple Reconstruction Surgery Consultation: 248-335-7200

Protecting Your Breast Implants After Reconstruction

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Protecting Your Breast Implants After Reconstruction

If you have survived breast cancer and a mastectomy, and have undergone breast reconstruction surgery, you have already been through so much! You are a warrior! So, of course, you want to do everything possible to protect your new breasts – and ensure that you do not have to undergo any further breast revision surgery.

In December, a new clinical study published in the Journal of the American College of Surgeons reported that two huge risk factors –  smoking and obesity – can dramatically increase the odds of early implant loss after breast reconstruction with implants following a mastectomy.

The study was conducted at the Perelman School of Medicine at the Hospital of the University of Pennsylvania, Philadelphia.The stated goal of the study was figure out which patients are at greatest risk for complications within the first 30 days after breast reconstruction.

In order to determine which risk factors were associated with 30-day breast implant loss for any reason data from the American College of Surgeons National Surgical Quality Improvement Program was analyzed. The study included more than 14,500 women between the ages of 40 and 60 who had undergone immediate breast reconstruction with implants after a mastectomy.

The results of the study were starling:

Smoking was shown to increase woman’s risk of early implant loss by three times!

And obesity as shown to increase woman’s risk of early implant loss by three times! Additionally, the more severe the state of obesity, the higher the patient’s risk of losing the implant was.

Other Risk Factors for Breast Implant Loss

Other lesser factors that were associated with a greater chance of complications included age, with women over age 55 being at slightly greater risk for implant failure. Additionally, direct-to-implant reconstruction – undergoing mastectomy and implants in a single procedure –  also increased the risk of implant failure within the first 30 days after breast reconstruction surgery.

Less than one percent of all patients in this study of 14,583 women (so about 14) experienced complication involving implant loss in 30 days or less.  Patients in to lower risk groups only had a, failure rate of .39% . But patients in the high risk group – due to smoking or obesity – had a failure rate of  3.86%.

This is actually quite a substantial difference – because it means that one in 25 patients in the high-risk group will lose a breast implant within the first 30 days.

The takeaway from this is that while smoking and obesity have a variety of negative health consequences, their impact on breast reconstruction surgery can be dire. We understand that losing weight or quitting smoking is a difficult uphill battle. But in order to ensure that your reconstruction surgery is a success, we urge you to find the support that you need so that you can give up cigarettes or lose some of the extra weight.

Top Troy, MI Area Breast Reconstruction Surgeon

Dr. Ali is a Troy, Mi area caring and compassionate board certified plastic surgeon who has helped countless women reclaim their bodies after cancer with breast reconstruction surgery. He will offer you a consultation to answer your questions and offer you understanding advice about your breast reconstruction surgery options.

If you are battling – or have battled – breast cancer, you are not alone. We are here to help you determine what you want to do, so you can move forward with your best life.

Troy, MI Area Breast Reconstruction Surgery Consultation: 248-335-7200