Breast Reconstruction in Baltimore, MD

Commonly, women look to breast reconstruction surgery to restore their bodies and experience a new beginning if one or both breasts have been lost to cancer. Breast reconstruction after mastectomy is known to be both physically and emotionally rewarding. With extensive experience in advanced reconstruction techniques, Dr. Woodyard offers Baltimore patients several options in breast restoration. At the time of cancer diagnosis, the discussion of breast restoration will begin. Our team will work with the cancer surgeon so that a mutual goal can be set, and the best outcome can be attained.

During the first consultation to discuss breast reconstruction surgery, it is important for patients to disclose where they are in the treatment process and which cancer surgeon provided treatment. Our office will require patients to provide any necessary pathology reports. The reconstruction process may take place in multiple steps if the breast tissue needs to be stretched to make room for implants. This discovery phase will help guide the reconstruction process so patients end up with a new breast that is the size, shape and look they want.

Each reconstruction technique will be tailored according to the patient’s physical health, aesthetic goals, and personal preferences. There are many factors playing into the approach that will be taken. The ultimate goal is to ensure the patient is healthy and happy with their final breast results.

There are two primary categories of breast reconstruction techniques:

• Procedures that involve using a breast implant

• Procedures that are autologous (use the patient’s own body’s tissue to reconstruct and recreate the breast)

Breast reconstruction using silicone or saline implants is a common approach that generally starts with the use of a tissue expander to help form a suitable pocket for an implant.  The expander may be inserted after the mastectomy procedure or during the same operative session. Over the course of several weeks to months, the expander will slowly be enlarged using a sterile saline solution injected through a port residing under the skin. During the scheduled reconstruction surgery, the expanders are removed and replaced with permanent implants.

In some cases, the breast may be totally or partially (combined with an implant) reconstructed using tissue from another part of the body. The most common tissues used are from the abdomen or upper back. This is an autologous approach to breast reconstruction. The TRAM flap (transverse rectus abdominis myocutaneous flap) technique involves taking skin and fat from the abdomen and relocating it to the breast.The latissimus dorsi flap is another common method using tissue from the patient’s back.

During a mastectomy, the nipple and areola often are removed. The loss of one’s nipple and areola can be as upsetting as the removal of the breast itself. However, reconstruction techniques have advanced greatly, allowing plastic surgeons the opportunity to recreate these areas of the breast to give a natural, aesthetically appealing appearance. In a separate procedure, the nipple is created using existing breast skin or from the abdominal or latissimus flap. The areolar color is usually restored by tattooing techniques, or less frequently by skin grafting.

Breast reconstruction surgery is performed under general anesthesia at an accredited surgical facility. Some patients may be required to stay in the hospital to be monitored for complications. Patients who have had reconstruction using a flap technique will usually be required to stay in the hospital for 2-3 days. The recovery process can be somewhat lengthy, but many view it as the final step in their cancer journey thus the experience can be very rewarding.  Most women are thankful to have had the opportunity to restore their breasts and are satisfied with their results. 

The Women’s Health and Cancer Rights Act of 1997 has made it possible for many women to undergo breast reconstruction surgery without the burden of a heavy financial cost. The act states that insurance companies and managed care organizations are required to pay for all  stages of breast reconstruction for women undergoing mastectomy. It supports all phases of the cancer treatment and reconstruction process which includes surgery to the opposite breast for the creation of symmetry. Our insurance and billing office will work with the provider to understand exactly what the coverage will be.

With so many options, no single reconstruction technique is right for every patient. The recommended technique for you will depend on your needs, goals, and physique. In your consultation, Dr. Woodyard will discuss your choices, including both implants and flaps, so you can understand the advantages and drawbacks of each before you decide on your treatment plan. Whether you decide on a flap or implants, Dr. Woodyard will do Her best to give you natural-looking results.

Reconstruction of the nipple-areola complex is usually performed using 3D cosmetic tattooing. If you're interested in this, you should tell Dr. Woodyard during your consultation. She will discuss your options so you can decide if you want cosmetic tattooing of your nipple-areola complex to be included in your surgical plan.

A reconstructed breast will not have the same sensation as the breast did before the mastectomy. However, over time, some of these sensations will return to normal. This will depend on the extent of the reconstruction process and will vary by patient.