Discovering that you have breast cancer may be one of the most traumatic experiences of your life. Undergoing a mastectomy, double mastectomy, or lumpectomy is often an important part of breast cancer treatment, but it also alters your appearance. For many women, breast reconstruction is an important component of the healing process, allowing you to restore a sense of femininity and wholeness with the help of a board-certified reconstructive surgeon.

Am I a Candidate?

Breast reconstruction may be an option for any woman who has undergone surgical treatment for breast cancer, including:

  • Mastectomy
  • Double mastectomy
  • Lumpectomy and radiation

It is also an option for women who have had prophylactic mastectomies due to their family history or positive genetic testing. It is best to work closely with both your reconstructive surgeon and oncologist to determine your best options.

When is the Right Time for Breast Reconstruction?

It is important to understand your breast reconstruction options before undergoing a mastectomy. By speaking with Dr. Ali and Dr. Tamir in the early stages of the process, you can integrate your breast reconstruction plans with your oncologist’s treatment plans. You have two options regarding the timing of your breast reconstruction:

  • Immediate breast reconstruction, which is performed at the same time as your mastectomy
  • Delayed breast reconstruction, which is performed after your mastectomy is completed

Dr. Ali and Dr. Tamir generally recommend undergoing breast reconstruction at the same time as your mastectomy procedure since it expedites the process of restoring a sense of wholeness and femininity following your cancer treatment. In addition, immediate breast reconstruction allows Dr. Ali and Dr. Tamir to spare more of your skin and achieve a shorter scar.

However, there are some instances where it may be more beneficial to delay your breast reconstruction until a later date. It is important to understand that both options can deliver beautiful results. In addition, there is no time limit if you choose the delayed reconstruction option. You may undergo the procedure even if you received breast cancer treatment many years ago.

Types of Breast Reconstruction

There are generally two types of breast reconstruction that Dr. Ali and Dr. Tamir perform. You will discuss the right option for you during a consultation.

Implant-Based Breast Reconstruction

The first phase of this technique typically involves placing a tissue expander into the breast. Tissue expanders are temporary, adjustable volume implants that are used to create the new breast mound. Saline solution is gradually inserted into the expander over time to achieve the desired result. Dr. Ali and Dr. Tamir generally perform these expansions in 1-2-week intervals, and multiple expansions are usually required to achieve the desired outcome. The use of tissue expanders allows you to have greater input regarding the final breast size.

At the end of the expansion phase, Dr. Ali and Dr. Tamir will replace the tissue expander with a breast implant. In most instances, this will occur approximately 3 months after your mastectomy and initial placement of the expander. However, if chemotherapy is necessary, Dr. Ali and Dr. Tamir will generally wait to replace the expander with an implant until at least one month after the completion of your chemotherapy treatments. If radiation therapy is required, you may need to wait up to 6 months before beginning the implant phase of your procedure.

In some instances, Dr. Ali and Dr. Tamir may recommend performing breast augmentation or a breast lift on the other breast during the implant phase of reconstruction. This often helps improve breast symmetry, creating a more complete outcome.

If the nipple was removed during your mastectomy, Dr. Ali and Dr. Tamir will perform nipple reconstruction about two months after your implant is inserted. In most cases, tissue from the chest wall will be used to create the new nipple and areola. Once you have healed following the nipple reconstruction procedure, you can have medical tattooing performed to conceal the scars and achieve a more natural-looking appearance.

Flap-Based Breast Reconstruction

Flap-based breast reconstruction is a more extensive procedure and will result in the creation of a scar in the donor site as well as in the breast region. However, the final result typically looks and feels more natural than implant-based reconstruction procedures.

During a flap-based reconstruction procedure, Dr. Ali and Dr. Tamir will remove tissue from the donor site and use it to rebuild your breast mound. As a result, the procedure is more permanent than an implant-based reconstruction and will require less maintenance down the road.

There are several different techniques which can be used for a flap-based breast reconstruction:

  • Muscle-sparing microvascular free TRAM flap: This spares more muscle than the traditional TRAM flap technique.
  • Traditional TRAM flap: This technique requires the tunneling of fat, skin, and muscle from the abdominal wall in order to rebuild the breast.

All these techniques achieve beautiful results, and the right option for you will depend on your unique individual needs. During your consultation, Dr. Ali and Dr. Tamir will discuss these options with you in detail before making individualized recommendations for your treatment plan.

Combination Procedure

In some instances, flap-based reconstruction can be performed in conjunction with implant-based reconstruction to provide more durable, long-lasting results than can be achieved with an implant alone. Dr. Ali and Dr. Tamir will use fat, skin, and muscle from the back to cover the breast implant. This tissue provides additional support for the breast implant while also providing a more natural-looking and -feeling appearance.

Whenever possible, Dr. Ali and Dr. Tamir will place the incision on the back in a location that will conceal the scar beneath the bra line. The positioning of this scar is usually discrete enough to be concealed when you wear lower-cut clothing.

This procedure is more involved than an implant-based reconstruction and will add some time to your hospital stay and recovery period. In most cases, you should be able to resume normal activities within 4-6 weeks.

“My whole experience was wonderful. Everyone was very accommodating and kind.”- A.W.

“The staff is pleasant and caring. The facility is clean and bright.”- J. C.

The staff is awesome!! Every question I asked Dr. Ali was answered. He is so patient and kind. I have already started to refer others to Mosharrafa Plastic Surgery. From making the inital appointment, through surgery and follow up, I have been so impressed with everyone associted with my process.
-D.B.

Why Choose Mosharrafa Plastic Surgery?

Dr. Ali and Dr. Tamir are both board-certified plastic surgeons who are highly regarded within the medical community. They have received the “Top Doctor” award from Phoenix Magazine every year since 1998, a testament to their commitment to delivering the exceptional care you deserve.

Our reconstructive surgeons have extensive experience performing breast reconstruction procedures, and they consider it an honor and a privilege to help you complete your recovery after breast cancer. They will provide compassionate care throughout every step of the process, explaining all your options to ensure you are fully comfortable with your treatment plan before moving forward.

Please contact Mosharrafa Plastic Surgery using our online form or calling our Phoenix office to schedule your breast reconstruction consultation. We serve patients in Phoenix, Scottsdale, Paradise Valley and throughout Arizona.

Frequently Asked Questions

Can I sleep on my side after breast reconstruction?

Yes. Depending on the type of reconstruction, you may be able to sleep on your side soon after surgery. Check with your surgeon.

Can you have reconstruction after breast radiation?

Yes. Radiation, particularly external beam radiation, can have long term effects on the soft tissues of the chest wall. However, several options exist for successful breast reconstruction following radiation. This may or may not involve the use of a tissue flap.

Do I need to wear a bra after breast reconstruction?

This depends on the type of reconstruction. Please ask your surgeon.

Does breast reconstruction look natural?

Yes. With more conservative, yet effective, techniques for mastectomies, including nipple-sparing mastectomies, as well as refined techniques in reconstruction, very natural and beautiful results can be achieved.

How long after breast reconstruction can I exercise?

Typically non-upper body exercises can be resumed at 2-4 weeks and upper body workouts can begin at 6-8 weeks.

How long does a mastectomy scar take to heal?

Scars heal very quickly (days to weeks), but can take 12 months or so to fully mature.

How long does DIEP flap surgery take?

DIEP (deep inferior epigastric perforator) surgery takes approximately 2-4 hours per side.

How long does it take to recover from reconstructive breast surgery?

For most procedures, light activity such as walking can be resumed right away. Activities that elevate heart rate or cause sweating should be avoided for 2 weeks. Upper body exercises, including lifting over 10 lbs and yoga should be avoided for the first 6 weeks. Please check with your surgeon before resuming any activities.

Is a mastectomy considered major surgery?

A mastectomy is a surgery performed under general anesthesia. It can be done as an outpatient or in some cases with an overnight stay.

Is breast reconstruction surgery inpatient or outpatient?

Most implant-based reconstruction procedures and some tissue flaps can be done as an outpatient. Longer surgeries, such as DIEP flaps typically require at least one overnight stay.

Is it OK to wear a sports bra after breast reduction?

This depends on the type of reconstruction performed. Please check with your surgeon regarding any clothing restrictions following surgery.

Is there an alternative to breast implants?

Yes. A patient’s own tissues can be used for reconstruction. Most common is abdominal tissue (DIEP or TRAM flap). Other options include tissue from the back, thighs or buttocks. In some cases fat grafting can be used as well.

What is the difference between Diep and TRAM flap?

Both utilize the same areas of skin and fatty tissue from the lower abdomen to provide volume and shape to the reconstructed breast(s). A DIEP (Deep Inferior Epigastric Perforator) flap is a micro vascular procedure in which blood vessels in the groin area are detached and reattached under a microscope to vessels in the chest to restore blood flow to the tissues. A TRAM (Transverse Rectus Abdominus Myocutaneous) flap utilizes the same lower abdominal tissue, but bases its circulation on vessels that come from above, and therefore the tissues can be rotated in to the chest without dividing the blood supply. It does not involve a micro vascular reconnection, but unlike a DIEP flap, which preserves the abdominal muscle(s), a TRAM flap takes the rectus abdominus muscle(s) with the flap.

What kind of bra should I wear after breast surgery?

This depends on the type of surgery. Please clarify with your surgeon.

What should I wear after breast reconstruction?

Loose, comfortable button up tops are usually best. Avoid garments that need to be pulled on over your head.

What should I wear after breast surgery?

Loose, comfortable button up tops are usually best. Avoid garments that need to be pulled on over your head.

When can I wear a bra after a mastectomy?

This depends on the type of surgery. Please clarify with your surgeon.

When can I wear a normal bra after breast reconstruction?

This depends on the type of surgery. Please clarify with your surgeon.

How difficult is the recovery from DIEP flap surgery?

DIEP flap surgery typically requires a day or two of inpatient recovery. Because the abdominal muscles are spared, the recovery is typically easier than a TRAM flap.

How do you lift your breast with surgery?

A mastopexy is a procedure to lift the breast and give it better shape. There are forms of reconstruction that incorporate a breast lift so that a woman with droopy breasts can have reconstructed breasts that are lifted and have a better shape than her natural breasts did.

How do you massage your breasts after breast augmentation?

Massage is meant to move the implant within the pocket created at surgery so that the capsule of scar tissue that forms around the implant maintains the same boundaries as the original surgical pocket. Your surgeon will instruct you on how and when to do implant massage.

How do you shower after breast reduction surgery?

Regular showers can be resumed 2-7 days after breast reconstruction. If drains are still in place, there are products you can wear around your neck to manage the drains while showering.

How long is hospital stay after breast reconstruction?

Many are outpatient. Some require 1-2 days stay in an outpatient recovery care center or a hospital.

How long is surgery for double mastectomy and reconstruction?

Depending on the type of reconstruction, this can range from 3 hours to 8 hours.

How painful is a breast lift?

Although there is some incisional pain associated with a breast lift, it is not a particularly painful operation.

How soon after mastectomy can I wear a bra?

This depends on the type of surgery. Please clarify with your surgeon.

Should you wear a bra to bed?

This depends on the type of surgery. Please clarify with your surgeon.

What can I do after breast reconstruction surgery?

Eventually, you will be able to resume essentially all of your normal activities. Your surgeon will guide you in advancing your activities appropriately.

What is a DIEP flap breast reconstruction?

A DIEP (Deep Inferior Epigastric Perforator) flap is a micro vascular procedure in which tissue from the lower abdomen is transferred to the chest to reconstruct the breast(s). Blood vessels in the groin area are detached and reattached under a microscope to vessels in the chest to restore blood flow to the tissues.

What is breast reconstruction surgery?

Breast reconstruction surgery consists of a procedure to restore all or a portion of the breast following mastectomy or lumpectomy.

What should I wear immediately after a mastectomy?

This depends on the type of surgery. Please clarify with your surgeon.

What type of bra do you wear after breast reconstruction?

This depends on the type of surgery. Please clarify with your surgeon.

When can I stop wearing surgical bra?

This depends on the type of surgery. Please clarify with your surgeon.

When can I sleep on side after breast lift?

Check with your surgeon. In some cases, you may be able to resume sleeping on your side soon after a breast lift.