(413) 731-7877
100 Wason Avenue
Springfield, MA 01107
Pioneer Valley Plastic Surgery
Pioneer Valley
Plastic Surgery
Reconstructive & aesthetic plastic surgery

Breast Reconstruction

Breast Reconstruction is a surgical procedure used to reconstruct the breast mound after a mastectomy. There are a variety of surgical techniques for breast reconstruction. Some Breast Reconstruction procedures include TRAM Flap, Tissue Expander with implant, and Latissimus Muscle Flap.

Breast reconstruction is a rewarding procedure for a woman who has lost her breast to cancer. It is important that you feel emotionally ready to undergo reconstruction and to accept the results. The creation of a new breast can help you feel better about yourself in clothing, however, the reconstructed breast will never feel or look like your original breast.

We love questions!

How should I prepare for my breast reconstruction consultation?

If you have friends or family who have had breast reconstruction, ask them about their experience. Researching breast reconstruction surgery on reputable internet sites such as the American Society of Plastic Surgeons can provide an informative overview. The best information for your personal case, however, will be obtained by making an appointment and speaking with your surgeon. It may also be helpful to view before and after photos of patients that have had the procedure. It's best to view photos of women with a similar body type as yours. Remember to write down any questions or concerns you have so they can be addressed at your consultation. Know what your surgical expectations are so your surgeon can discuss them with you. If you are a smoker we recommend you quit to help reduce the risk of wound healing. We also recommend a healthy lifestyle to help your recovery process.

Will I be seen by the surgeon?

Yes. Dr. Johnson will meet with you and she will discuss all your surgical options. You may also see Christina, PA, first. Together they will provide you with the necessary information so that you feel confident and comfortable with your surgical decision.

Is the plastic surgeon board certified?

Yes. Dr. Johnson is board certified by the American Board of Plastic Surgery, is a fellow of the American College of Surgeons, and is a proud member of the American Society of Plastic Surgeons. Additionally, she is a member of the American Society for Aesthetic Plastic Surgery, which recognizes surgeons who specialize in cosmetic plastic surgery.

Will I be charged for an initial consultation?

No. Your initial consultation will be billed through your insurance carrier. After your consultation, if all criteria is met, we will obtain authorization through your insurance carrier to cover the surgery.

Are there different types of breast reconstruction procedures?

Yes. Dr. Johnson performs many different types of reconstruction procedures utilizing a number of techniques, including TRAM flap, Latissimus muscle flap, and tissue expander reconstruction.

Where will my breast reconstruction surgery take place?

In Springfield, Dr. Johnson has privileges at Baystate Medical Center and Mercy Medical Center. She also performs surgery at Noble Hospital in Westfield, MA. All are accredited by the Joint Commission and have been awarded the Gold Seal of Approval.

What is the TRAM flap technique of breast reconstruction?

This technique involves the use of the abdominal muscle flap made from the rectus abdominus muscle. The muscle and a portion of lower abdominal skin and fat are tunneled up through the chest wall and repositioned to reconstruct a breast mound. The TRAM flap may be created at the time of your mastectomy or it may be delayed as a separate stage. During a TRAM an incision is made at the lower abdominal fold and the muscle, fat and skin are tunneled up through the chest wall and repositioned on the chest wall to recreate a breast. On the breast you will have an ellipse shaped incision around the flap skin. You will have two drains in the abdominal area and one or two at the chest site.

What can I expect after TRAM flap surgery?

The surgery is performed at a hospital. During surgery you will receive general anesthesia and an epidural catheter is recommended for post-operative comfort. The surgery will take between 4-5 hours. Once you are awake you are taken to the recovery room for another 1-2 hours and then you are taken to your hospital room where you will spend 3-5 days in the hospital. During your hospital stay we will slowly advance your activity level and transition you to pain meds by mouth.

Am I a good candidate for TRAM flap breast reconstruction?

During your consultation, Dr. Johnson will provide you with her expert opinion as to whether a TRAM flap is a good option for you. A TRAM flap is an appropriate procedure for you if you have an adequate amount of abdominal tissue to recreate a breast and if you do not have any medical conditions that will inhibit the success of the flap. The risks and benefits and possible complications of surgery will all be discussed. Once you are fully informed, you will be able to determine whether having a TRAM flap is for you.

Are there risks involved with a TRAM flap?

Yes, there are risks with any surgical procedure. The most common risks with a TRAM flap are pain, infection, hematoma/seroma, loss of the flap (complete or partial), sensation changes to the abdomen and breast, the need for another operation due to asymmetry, unsatisfactory scarring or results, fat necrosis.

What is the recovery process?

The first couple of weeks you may feel pain/discomfort in the abdominal area and the chest region. You will notice that the discomfort decreases with each passing day. You are sent home on pain medications which will decrease your discomfort. We will recommend that you do no strenuous exercise or any heavy lifting for at least one month following surgery.

What is the Latissimus Muscle Flap technique of breast reconstruction?

This technique involves the use of the latissimus muscle from the back. The muscle and a portion of the back skin and fat are tunneled to the mastectomy site to reconstruct the breast mound. In some instances, the muscle flap is sufficient enough to recreate the breast, however, often an implant is needed to augment the size of the breast. The latissimus flap may be created at the time of your mastectomy or it may be delayed as a separate stage. During a latissimus flap an incision is made at the upper back just above the latissimus muscle and the muscle, fat and skin are tunneled through to the mastectomy site. In some instances a tissue expander or implant are also placed to augment the size of the new breast mound. On the breast you will have an ellipse shaped incision around the flap skin. You will have two drains in the back area and one or two at the chest site.

What can I expect after Latissimus Muscle Flap surgery?

The surgery is performed at a hospital. During surgery you will receive general anesthesia and an epidural catheter is recommended for post-operative comfort. The surgery will take between 4-5 hours. Once you are awake you are taken to the recovery room for another 1-2 hours and then you are taken to your hospital room where you will spend 3-5 days in the hospital. During your hospital stay we will slowly advance your activity level and transition you to pain meds by mouth.

Are there risks involved with a latissimus flap?

Yes, there are risks with any surgical procedure. The most common risks with a latissimus flap are pain, infection, hematoma/seroma, loss of the flap (complete or partial), sensation changes to the back and breast, the need for another operation due to asymmetry, unsatisfactory scarring or results, fat necrosis.

Are there risks involved with a latissimus flap?

Am I a good candidate for Latissimus Muscle Flap breast reconstruction?

During your consultation, Dr. Johnson will provide you with her expert opinion as to whether a latissimus flap is a good option for you. A latissimus flap is an appropriate procedure for you if you do not have any medical conditions that will inhibit the success of the flap. The risks and benefits and possible complications of surgery will all be discussed. Once you are fully informed, you will be able to determine whether having a latissimus flap is for you.

What is the recovery process?

The first couple of weeks you may feel pain/discomfort in the back and chest area. You will notice that the discomfort decreases with each passing day. You are sent home on pain medications which will decrease your discomfort. We will recommend that you do no strenuous exercise or any heavy lifting for at least one month following surgery.

What is Tissue Expander breast reconstruction?

This technique is a multi-stage process. It first involves placing a silicone balloon-like tissue expander that is inserted beneath the skin and chest muscle. Saline is gradually injected into the tissue expander to fill it over a period of weeks or months. In most cases, once the skin has been stretched enough, the expander is surgically removed and replaced with a permanent implant.

What does the procedure involve?

The tissue expander may be placed at the time of your mastectomy or it may be delayed as a separate procedure. During the tissue expander procedure the mastectomy incision is used to place the expander under the skin and the chest muscle. With an immediate tissue expander placement, a piece of acellular dermal matrix is used to help provide more coverage to the expander and to help create a more natural breast appearance. The mastectomy incision is closed and one to two drains are placed to help prevent seroma formation. Slowly over the next few weeks to months the expander is filled with saline in our office. Once the skin is stretched adequately a second surgery is needed to exchange the expander to the permanent implant.

What can I expect after Tissue Expander breast surgery?

The surgery is performed at a hospital. During surgery you will receive general anesthesia. The tissue expander portion of the surgery will take between 1-2 hours. Once you are awake you are taken to the recovery room for another 1-2 hours and then you are taken to your hospital room where you will spend one night in the hospital. You are discharged home the next morning with the drains.

What is the recovery process?

The first couple of days/weeks you may feel pain/pressure in the chest area. You will notice that the pain decreases with each passing day. You are sent home on pain medications which will decrease your discomfort. We will recommend that you do no strenuous exercise or any heavy lifting for at least one month following surgery. We will recommend that you wear a breast binder or sports bra for support.

Are there risks involved with a tissue expander/implant reconstruction?

Yes, there are risks with any surgical procedure. The most common risks with a tissue expander/implant reconstruction are pain, infection, hematoma/seroma, sensation changes to the chest skin, rupture of the expander/implant, capsular contracture (scarring around the implant), the need for another operation due to asymmetry, unsatisfactory scarring or results.

What is Nipple Reconstruction?

This technique involves the restoration of the nipple-areolar complex lost due to injury, breast cancer, or other conditions. A variety of different techniques exist for reconstruction of the nipple and its surrounding areolar tissue. These include the use of skin grafts taken from other regions of the body, local flaps of breast skin that are re-shaped into a nipple, or the sharing of tissue from the opposite nipple-areolar region. Additional techniques such as tattooing may be used to add color to the tissue if needed.

What is the surgical process?

The surgery is performed at a hospital. During surgery you will receive local anesthesia vs. IV sedation. The surgery will take about 1 hour. If you receive anesthesia you are taken to the recovery room for another 1-2 hours and then you are discharged home. You will have a bulky dressing on that will remain in place until your follow up visit in the office.

What is the recovery process?

Most patients have no pain from this procedure. If you have any discomfort is it very mild. You are sent home on pain medications which will ease the discomfort. We will recommend that you do no strenuous exercise or any heavy lifting for at least one month following surgery.

Are there risks involved with a nipple reconstruction?

Yes, there are risks with any surgical procedure. The most common risks with a nipple reconstruction are pain, infection, loss of the nipple (complete/partial), loss of projection, sensation changes to the skin, the need for another operation due to asymmetry, unsatisfactory scarring or results.

Breast reconstruction before & after photos

BEFORE & AFTER: Breast reconstruction #1
Breast reconstruction (Trans-Rectus Abdominal Repair). Recurrent Breast Cancer.
Age: 62. Height: 5' 5". Weight: 182 pounds. After photos were taken 4 weeks after surgery.
BEFORE & AFTER: breast reconstruction #2
Breast reconstruction.
Age: 67. Height: 5'3". Weight: 114 pounds. After photos were taken 10 days after surgery.
BEFORE & AFTER: Breast reconstruction #3
Right Breast Reconstruction, Left Breast Reduction (due to asymmetry)
Age: 52. Height: 5' 4". Weight: 191 pounds.
BEFORE & AFTER: Breast reconstruction #4
Breast Reconstruction
Age: 59. Height: 5' 3". Weight: 112 pounds. After photos were taken 11 months after 1st of 3 surgeries.
BEFORE & AFTER: Breast reconstruction #5
Left Breast Reconstruction (previously done), Right Breast Mastopexy (for assymetry)
Age: 42. Height: 5'6". Weight: 142 pounds. After photos taken 2 months post-op.
Breast reconstruction #6
Breast Reconstruction, Nipple Reconstruction and Areola Tattoo.
Age: 48. Height: 5'7". Weight: 188 pounds. Breast reconstruction, nipple reconstruction and areola tattoo.
BEFORE & AFTER: Breast reconstruction #7
Right Breast Reconstruction, Left Breast Reduction (due to asymmetry).
Age: 59. Height: 5' 3". Weight: 204 pounds.
BEFORE & AFTER: breast reconstruction #8
Breast Reconstruction, Nipple Reconstruction and Areola Tattoo.
Age: 57. Height: 5'7". Weight: 157 pounds. After photos were taken 10 days post-op.
BEFORE & AFTER: breast reconstruction #9
Breast Reconstruction, Right Breast with TRAM Flap (Trans-Rectus Abdominal Repair).
Age: 71. Height: 5'2". Weight: 145 pounds. After photos taken 5 months post-op.