Breast Reconstruction Surgery

Davinci plastic surgery | Washington dc | steven p. davison, md

BREAST RECONSTRUCTION CAN BE dONE WITH DIFFERENT TYPES Of FLAPS OR IMPLANTS. Dr. DAVISON ALSO DOES RECONSTRUCTION FOR PATIENTS THAT ARE BRCA POSITIVE.

BREAST RECONSTRUCTION CAN BE dONE WITH DIFFERENT TYPES Of FLAPS OR IMPLANTS. Dr. DAVISON ALSO DOES RECONSTRUCTION FOR PATIENTS THAT ARE BRCA POSITIVE.

frequently asked questions

BREAST RECONSTRUCTION PROCEDURE QUICK REFERENCE

PROCEDURE
AVERAGE SURGERY TIME
HOSPITAL STAY
RECOVERY
CHARACTERISTICS
Expander Implants
1 hour per side
1 day
2 weeks

Multi-stage; No visible scars beyond mastectomy; No muscle impairment

Latissimus Flap
2-4 hours
3-5 days
2-3 weeks
Implants needed. Scar on back, possible weakness
TRAM Flap
4-6 hours
3-6 days
4-8 weeks
No implant. Abdominal scars, possible weakness
DIEP Flap
3-6 hours
3-6 days
4-8 weeks
Muscle is spared. Abdominal scar, no weakness.
Gracilis Flap
4-6 hours
3-5 days
4-8 weeks
Muscle can be spared, blood supply intact, well hidden groin incision

 

Will Insurance Cover Breast Reconstruction Surgery?
Yes. Federal law mandates that all insurance plans pay for breast reconstruction procedures if you had a mastectomy.  Many times they will also cover revision surgery.  There are limitations – so be sure to check with your own insurance carrier for complete information.

How Long Will I Need To Be Out Of Work?
This depends upon the procedure and your body’s healing/recovery time.  Most of Dr. Davison’s patients take 2-6 weeks off from work to allow for recovery and medical follow-ups. 

How Long Will I Be In The Hospital?
Usually 2-5 days – depending upon the procedure and stage of reconstruction. Most follow-ups procedures are out-patient.

Which Hospitals Does Dr. Davison Use?
Dr. Davison has privileges and performs procedures at several area hospitals including Georgetown, Sibley, Fairfax and the new world-class NBCS Breast Cancer Center at Virginia Hospital.

How Long Do Breast Implants Last?
Breast implants typically last between 10-15 years. 

Does It Hurt When The Tissue Expander Fluid Is Increased?
It causes some discomfort since the tissue and muscle are being forced to stretch.  We do this very gradually – and make every attempt to keep you as comfortable as possible.

When Does Tissue Expansion Stop?
Dr. Davison discontinues tissue expansion when your skin has stretched enough to do the next stage surgery – that is putting the breast implants in place.  In the case of permanent expander implants – “fillings” are stopped when the desired size and shape has been achieved.

Can I Choose My Breast Size – When Reconstruction Is Complete?
Yes – you help determine your breast size and shape – based upon the reconstruction technique that had to be used.  The goal in all reconstruction surgeries is to achieve balance – symmetry and a pleasing shape and appearance.

What’s The Purpose Of Tissue Implant Expanders?
These are basically temporary implants that are placed after your mastectomy and serve as “place savers” for your permanent implants.  Patients who require radiation treatments experienced burning and shrinking of the skin – plus loss of elasticity and color.  After radiation treatments are finished – Dr. Davison can perform a “Flap” reconstruction with the flap serving as your final breast mound.

What Happens To The Other Breast After Unilateral Mastectomy?
Dr. Davison’s goal in all reconstructive surgeries is to achieve symmetry and as natural looking outcomes as possible.  He does everything possible to make the other breast symmetric with your newly reconstructed breast.

Do I Need To Have Breast Reconstruction?
Not all women choose breast reconstruction.  Some decide to use prosthetics.  Reconstruction is an elective procedure and is not medically necessary.  More women each year choose to have reconstruction because of the many positive benefits. Many women, especially those at risk for BRCA1 and 2 – decide on prophylactic mastectomies to gain peace of mind by eliminating the possibility of cancer in the other breast or in either breast – whichever is the case. The bottom line is – the choice is yours. 

What Is The Difference Between Immediate and Delayed Breast Reconstruction?
Immediate reconstruction is performed at the time of your mastectomy – under the same anesthesia.  Delayed reconstruction is just that – it is delayed for several weeks/months until you decide you are ready. 

Is It Better To Have Immediate Breast Reconstruction?
There are definitely some benefits to having immediate versus delayed breast reconstruction – if you have immediate breast reconstruction – you wake up whole.  Immediate reconstruction minimizes the number of surgeries you will need to have, it means you will wake up with a breast(s) mound in place and a feeling of being whole. Often better cosmetic results are achieved with immediate reconstruction – and hands down – the psychological benefits are too numerous to tell.

Are All Women Candidates For Immediate Breast Reconstruction?
The vast majority of women are candidates for immediate breast reconstruction.  There are a variety of reconstructive options – you may be a candidate for all or just some of them.  Dr. Davison will determine this during your consultation. 

What Are The Major Types of Breast Reconstruction?
They are 1) Tissue Expander/Implant reconstruction.  2) Flap reconstruction – using your own living muscle, skin and vessels.  3) Latissimus Flap with Implant reconstruction – uses your own tissue and muscle from your back – plus an implant.

I May Need Chemotherapy – Can I Still Have Implants?
Yes – women who need post-mastectomy chemotherapy can have implants.  We typically need to juggle schedules and postpone your second stage surgery until you are in a safe period from your last chemo treatment.  We work closely with your Oncology doctor and correlate appointments that will work for you.

What About Post-Op Visits?
Follow-up visits are critical!  It is important that you schedule them and keep them so that Dr. Davison can monitor your progress and address any concerns that may develop.  We become your “primary” caregiver over the next year following your mastectomy and reconstruction procedures. 

Will I Always See Dr. Davison At Follow-Up Appointments?
No.  Sometimes you will see is Nurse Practitioner for minor procedures such as to remove your pain pump, dressings and drains and tissue expander fills. Our Nurse Practitioner and Physician Assistant are highly trained, patient sensitive, competent and available to our Breast Reconstruction patients.

When Are Drains Removed After Breast Reconstruction?
Dr. Davison or his Nurse Practitioner removes the drains when the volume is less than 30cc’s.

How Often Do You Schedule For Tissue Expander Fills – Is It Painful?
Expander fills are typically done 2-3 weeks apart based upon your pain level, activity level, radiation treatments and other factors.  This varies patient by patient. Expander fills do not require anesthetic and are done by Dr. Davison’s Nurse Practitioner or Physician’s Assistant. 

What Is The Purpose Of Planning Appointments?
These appointments are critical to determining the size of your implant and the implant route – meaning which implants, what placement (over or under the pectoral muscle) and other issues important to the overall reconstruction process. 

What’s The Difference Between Flap & Implant Reconstruction?
This has been explained in detail in another area – but in brief the difference is:
Implants are used to restore a breast mound – the size and shape you desire without using your own living tissue and muscle.  This is not possible for every woman who has a mastectomy because there is not always sufficient skin tissue and muscle to accommodate an implant placement.  In those cases a flap reconstruction is performed using your own living skin tissue and sometimes muscle to rebuild a breast mound.  Often a flap reconstruction involves the use of an implant also to achieve the desired outcome.  Flap/Implant surgery is called Stage II Reconstruction.

What Is Beautification Surgery In Breast Reconstruction?
This is called Stage III surgery and involves achieving breast symmetry and beautification of the breast by creating a new nipple/areolar.

What’s The Significance Of Choosing A Board Certified Surgeon?
The importance of choosing a qualified – board certified surgeon cannot be overstated. Board certification ensures that your surgeon has the education, skills and experience needed to perform the surgery in question. A board certified surgeon has many years more education, training, skill development and experience than a surgeon who is not board certified.  In addition to board certification is “fellowship training.”  A surgeon who is fellowship trained – has even more invested in his career in all the areas already listed and he has received this training under the direct supervision of a world renowned surgeon who is specialized in certain surgical sub-specialties.  Dr. Davison is triple board certified and fellowship trained.  He is an expert in all surgeries of the breast – has performed hundreds of them and he performs them regularly.

 

facebook
Follow us on Facebook

 

 

Steven P. Davison, MD

Steven P Davison - board certified plastic surgeon

Breast Reconstruction
Plastic Surgeon
Washington, DC and Northern Virginia

Dr. Davison is board certified and fellowship trained with a special interest in breast cancer reconstruction.  His unique and desirable skillset places him in a special league of surgeons who can provide unequaled expertise in full-spectrum plastic and reconstructive surgery.  He is able to effectively deal with other cancers as well, including melanoma and successfully manages many  surgeries of the body, both cosmetic and reconstructive.  Dr. Davison’s interest in breast and body contouring facilitates in his creation of a natural, aesthetic breast that is pleasing to the patient and grants him hundreds of happy patients.