Breast Reconstruction Surgery
SERVING SCOTTSDALE AND PHOENIX, ARIZONA
Dr. Parson has been specializing in Breast Reconstruction since he began his practice and has one of the largest experiences with this type of surgery in the Southwestern U.S. In addition to breast reconstruction for cancer, Dr. Parson specializes in all types of chest wall reconstruction secondary to all variety of reasons. Dr. Parson finds tremendous reward and satisfaction in reconstructing breasts and chest wall deformities. The field of breast reconstruction has been steadily expanding to newer methods and techniques. These techniques now allow board certified plastic surgeon’s like Dr. Parson, to create breasts that are very close and shape and appearance to that of the non-affected breast. Breast reconstruction can be performed as either an immediate or delayed procedure. Immediate breast reconstruction is performed at the same time as the mastectomy and serves to decrease a woman’s total number of times in the operating room. Newer advances in this arena can allow Dr. Parson to perform a single stage procedure and at times even preserve the patient’s own nipple and areola.
Dr. Parson will thoughtfully listen to your concerns and goals and the two of you will construct a “game plan” that is unique to each patient. Breast reconstruction can be an overwhelming undertaking in terms of understanding the various methods and techniques that are best for your specific set of circumstances. Dr. Parson and his team will make every effort to help lead you through this process with all the respect and compassion that you deserve.
Breast Reconstruction Patient Photos
Click the thumbnails below to see the before and after photos in sequence. Please note that all photos are actual patients of Dr. Parson.
The Pre-Operative Breast Reconstruction Period
Most patients who require a mastectomy are also healthy enough to undergo breast reconstruction surgery. However, some patients may be better candidates for a delayed breast reconstruction. This can be secondary to either medical versus personal factors. Some woman may have underlying health issues in the way of a past smoking history or diabetes for example. These medical issues may lead Dr. Parson to suggest that the mastectomy be performed first and that a period of recovery transpire prior to undertaking any type of breast reconstruction surgery. Some woman may also find it hard to cope with the stress placed by being diagnosed with breast cancer. This may also be a situation where it’s advisable to undergo the mastectomy first and then focus on subsequent breast reconstructive surgery. Dr. Parson will make every effort to help guide you through this process so that things make sense and are specific to your personal situation.
Either way Dr. Parson and his staff will be able to work closely with all other health care providers to ensure that you have a “team” approach to your care. He will work closely with your breast surgeon as well as your oncologist to devise an individual treatment plan.
The Pre-Operative Period
It is important that plastic surgery patients take certain measures in the pre-operative period to decrease chances for potential complications. All of your medications will be reviewed prior to this period. Any medications that may cause surgical complications will be discontinued at least 2 weeks prior to operation. Any infections that arise prior to operation, however seemingly trivial, should be reported to our office. Even an otherwise innocent infection can result in a surgical wound infection, and must be treated prior to any breast surgery. Dr. Parson will also be in close communication will all other physicians involved in your care. He will make sure that everyone is on the “same page” when it comes time for your surgery.
Appropriate prescription medications will be written well prior to your procedure. This will allow you to have your medication when you return home from the operation.
Pre-operative photographs are taken at this appointment. These photos will be recorded in the TouchMD system so that you will also have access to them from home. These photos will serve as a marker for you to see the improvement from your breast reconstruction surgery afterwards. You will be asked to sign a surgical consent. The consent explains the potential risks of the procedure in detail. Some of these risks have been explained here, but more discussion will occur at the consultation.
Dr. Parson will recommended one of two types of breast reconstruction; either breast implant reconstruction or breast reconstruction using a tissue flap. When breast implants are used for the final reconstruction device then it is often necessary to use an expander device to enlarge the tissue pocket so that the final implant can be comfortably placed. This type of surgery may require a second surgery that typically is scheduled three months after the initial procedure. At this second surgery the final implants are placed and the nipple and areola are also reconstructed. However, newer advances in breast reconstruction now allow Dr. Parson to often finish the entire reconstructive process at the same time as the mastectomy. Dr. Parson will be able to discuss with you in detail whether you are a candidate for this type of surgical procedure. He will also discuss the various types of breast implants and find one that is right for you.
When a tissue flap is used for your breast reconstruction Dr. Parson will borrow tissue from some other location (typically your stomach or your back) and use this tissue to reconstruct a new breast. This type of surgery carries different risks and recovery compared to reconstruction with an implant. However, when this type of surgery is employed, patients will wake up from their mastectomy with a new breast in place. Dr. Parson will be able to recommend which type of procedure is best for your specific situation.
You will need to arrange for someone to drive you to and from the surgery center. It is mandatory to have someone stay with you for at least 24 hours after surgery for your comfort and safety. If you don’t have help available Dr. Parson’s office will be able to assist you.
The Day of Your Breast Reconstruction
Breast reconstruction surgery usually involves more than one operation. The first stage, whether done at the same time as the mastectomy or later on, is usually performed in a hospital.
Follow-up procedures may also be done in the hospital. Or, depending on the extent of breast surgery required, Dr. Shaun Parson may prefer an outpatient facility.
Breast reconstruction surgery is performed with a general anesthetic. A board certified anesthesiologist will be with you throughout the entire operation. They will closely be monitoring our progress and make certain that you are comfortable throughout the entire surgery. Breast reconstruction usually takes 2 to 3 hours. Dr. Parson will utilize one of several techniques depending on the amount of initial breast droopiness. When the amount of breast droopiness is small, Dr. Parson will employ only an incision around the areola. For more severe forms of breast ptosis, an “anchor-type” incision may be necessary.
The Post-Operative Breast Reconstruction Period
It is important that a capable adult be available for the first 24 hours help patients with transportation, meals, pain control, etc. following the surgery. Pain should not be severe, and is usually well controlled by a combination of: narcotics, anti-inflammatories, and local pain medications. Local pain medication it delivered to the patient via an On-Q Pain Buster Post-Op Pain Relief System (which is an optional benefit provided by Dr. Parson). Dr. Parson recommends this system to his patients and finds that they require fewer narcotics than normal. Antibiotics are continued for 7 days after the procedure to lower the risk of infection. Activity should be restricted to no lifting of greater than 20lbs for the first 4 weeks.
Dr. Parson will provide you with a sports bra and instruct you to stay in the bra 24/7 over then 4 to 6 weeks. This helps with pain and swelling and provides support to the breast. A slight amount of bleeding at the incision sites is normal. The breasts should not be manipulated in any way, unless Dr. Parson directs you to do so. One should be up and walking on the morning following surgery, and a light solid diet begun to the point of tolerance.
Dr. Parson should be contacted immediately for the following:
- Temperature over 101.5 degrees
- Chills or sweats
- Significantly different degree of swelling between sides
- Increasing rather than decreasing pain
The first post-operative visit occurs 2-3 days after the operation. Any dressings or bandages are removed and healing is assessed. After removal of the sports bra, Dr. Shaun Parson will ask you to wear a soft bra or sports bra for 6 weeks. Bras with under-wires are discouraged as these may push the implants upward, creating an unnatural appearance. Reconstructive surgery patients are then allowed to shower and to wash their hair. Submerging in a bath, pool or hot top is not permitted, as this may cause the incisions to separate. Most patients resume a reasonably normal activity pattern and can return to non-physical jobs within 5-7 days after surgery.
Risks of Breast Implants/Expanders
Capsular contracture (breast hardening secondary to internal scar formation) – Every individual forms some scar around the implant. This is a normal response of the immune system to a foreign body. For not completely understood reasons, some individuals form thicker scars than others. A thick scar may distort the breast and even cause discomfort. The incidence of this problem has decreased since the use of smooth implants and submuscular placement and is approximately 10%. When treatment is warranted, the scar is incised or removed and the implant is replaced.
Deflation – The incidence of implant leakage is approximately 2% per year. Today’s implants are better than a decade ago, and so it is difficult to accurately predict what the true leakage rate is. It may actually be lower. In the event of implant deflation, saline (the solution of which 70% of our bodies are made up of) leaks into the surrounding tissues and is absorbed. A relatively brief, simple surgical procedure is required to remove the old implant and replace with another. Implant manufacturers cover the cost of implant replacement for up to 10 years and assist with the cost of surgery as well.
Visible rippling -Individuals with small breasts that have had a large augmentation can be at risk for visible rippling of the overlying skin. This problem is more common in woman with textured implants positioned on top of the pectoralis muscle.
Finally, breast reconstruction has no known effect on the recurrence of disease in the breast, nor does it generally interfere with chemotherapy or radiation treatment, should cancer recur. Dr. Parson and your oncologist may recommend continuation of periodic mammograms on both the reconstructed and the remaining normal breast.
Schedule a Breast Reconstruction Consultation Today
Dr. Shaun Parson understands how difficult the circumstances surrounding breast reconstruction can be, and is committed to providing attentive, compassionate and professional care. If you are interested in learning more about breast reconstruction, schedule a free, private consultation with Dr. Parson by calling 480-282-8386.