Joshua Cooper, MD, FACS

Breast Reconstruction


Breast Reconstruction

In addition to helping restore a woman's appearance after total or partial mastectomy, breast reconstruction can benefit women emotionally as well. Many women find that breast reconstruction is an important final step in the healing process during their battle with breast cancer. By offering compassionate care and detailed options, Dr. Cooper can help you determine which method of breast reconstruction is right for you.

Tissue expander/Implants

One of the most common methods for breast reconstruction is through the use of tissue expanders followed by the placement of implants, either silicone or saline, underneath the skin. Depending on the amount and quality of skin and soft tissue left behind after a mastectomy, tissue expanders may be placed at the time of mastectomy or months to years later. This method helps expand your remaining skin to allow the subsequent placement of the correct sized implant and to eventually restore your lost breast shape and volume.

Additionally, Dr. Cooper will use Alloderm along with your tissue expanders if you are undergoing immediate placment of tissue expanders at the time of mastectomy.  Alloderm is a specially processed cadaveric dermis which helps support the tissue expander, protect the tissue expander, and better define the breast pocket and inframammary fold. 

Using saline injections, Dr. Cooper fills the tissue expander at weekly office visits. This process typically takes one to two months to complete. After the filling of the expander is complete, the tissue expanders will stay in place for another couple months to allow the breast pocket to mature. During a second operation the tissue expander is removed and a silicone or saline implant is placed.

Autologous Reconstruction

Some women may not be candidates for tissue expansion. This is largely dependent on your unique anatomy and the quality of your remaining skin and soft tissue after radiation therapy. Additionally, some women prefer to have a breast constructed from their own soft tissues rather than have implants placed. For these women, autologous (using your own body) reconstruction may be an appropriate option.

T.R.A.M. (transverse rectus abdominus myocutaneous) Flap

The TRAM flap procedure involves using muscle, fat, and skin from your abdomen to recreate a breast. A low abdominal incision is made and a portion of your abdominal musculature and soft tissues are transferred to your chest wall, creating a new breast. This technique is can also be used to reconstruct a partial mastectomy defect.

Latissimus Dorsi Flap

The latissimus dorsi flap technique involves transferring a portion of your back muscle, skin and fat in order to recreate a breast. Sometimes, in order to add more volume, a tissue expander or implant is placed as well. The latissimus flap can also be used to help reconstruct partial mastectomy defects.

Nipple and Areolar Reconstruction

The creation of a nipple and areola is the final component of your breast reconstruction. Using your own breast skin and soft tissue, Dr. Cooper will use local skin flaps to recreate a nipple. This operation is performed in an office procedure room using a local anesthetic. Once the nipple reconstruction has had ample time to heal, Dr. Cooper will then perform tattooing in order to give your nipple and the surrounding skin a more natural appearance.

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