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Advanced Breast Reconstruction Techniques

The surgeons at Hill Country Plastic Surgery have the most advanced surgical techniques to perform breast reconstruction surgery. We offer implant reconstruction, oncoplastic reconstruction, and revisional breast surgeries and will work with your breast cancer team to achieve optimal outcomes.

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Advanced breast reconstruction surgery

Patients may need reconstruction in one or both breasts after cancer surgeries such as:

  • Lumpectomy (removal of a portion of the breast)
  • Reconstructive surgery after mastectomy (removal of the entire breast)

Reconstructive surgery can be done at the time of mastectomy or lumpectomy or after completion of the cancer treatment. Multiple factors influence the type and the timing of reconstruction, such as:

  • Cancer treatment plan, and if radiation is required
  • Your overall health
  • Your body type and shape and size of the breasts
  • Your lifestyle

What does Hill Country Plastic Surgery do differently?

  • Expertise: Our surgeons have years of experience in breast reconstruction and specialize in this area.
  • Collaboration: We work with your cancer doctors to plan the ideal approach in your case and are very familiar with performing complex surgeries and collaborating with multidisciplinary teams. They are dedicated to ensuring that your cancer reconstruction is well coordinated with your cancer team.
  • Female breast reconstruction surgeon: Dr. Amita Shah is one of the few female breast reconstruction surgeons in the San Antonio area. She brings a woman’s perspective to the process of evaluating patients, offering recommendations, and helping patients through recovery.
  • Innovation: Our goal is to offer the newest techniques for your reconstruction. Dr. Shah is a trained surgeon-scientist and has conducted research in the field of breast reconstruction and biomaterials.

What are the types of breast reconstruction surgeries?

Many women have breast reconstruction in the same procedure as cancer surgery. First, breast surgeons remove the cancer. Immediately thereafter, our plastic and reconstructive surgeons take the steps to create new breasts, so when you awaken from surgery, your new breasts are in place. This is called “immediate” reconstruction. In other cases, it is necessary to have the reconstruction after you have fully healed from cancer surgery. This is called “delayed” reconstruction. Many women are candidates for breast reconstruction even years after undergoing a lumpectomy or mastectomy.

What is the recovery time?

Breast reconstruction is a major surgery that will require several weeks of recovery. In some cases, the patient is released to return home on the day of surgery. For others, it may require several days in the hospital. We focus on minimizing discomfort and the use of the latest surgical techniques for a faster, less stressful recovery. After surgery, we stay in regular contact with our patients, with several follow-up appointments, check-ins by phone, and interactions on our advanced patient portal to track the recovery process and identify any developing issues for a fast,  uneventful recovery. 

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Breast reconstruction surgery after mastectomy

We offer the following types of breast reconstruction in San Antonio:

Implant-based reconstruction

Implant-based breast reconstruction is traditionally performed in two stages. An expandable implant is placed beneath the skin and typically beneath the chest muscle. The implant is expanded slowly by adding saline solution until the right size is achieved. Next, the expandable implant is removed and replaced with a permanent saline or silicone implant. In a one-stage surgery, also known as “direct to implant” or DTI, the implant is placed at the time of the mastectomy, either over or under the muscle. This option is appropriate for patients who do not have overly large breasts and are not interested in increasing natural breast size in the reconstruction. Read about the differences between saline or silicone implants here.

Flap reconstruction

Flap reconstruction involves creating a new breast by transferring a section of skin, fat, and muscle from another part of your body. Because this option does not involve removing muscle tissue, most women experience a faster, more comfortable recovery than surgeries that take muscle tissue. Women usually stay for three to four days after surgery in the hospital to monitor the reconstruction. Because this is a more involved surgery than implant-based surgery, the recovery takes, but the results are long-lasting and won’t require replacing implants over time, as the new breast is built from your own natural tissue.

Flap plus implant reconstruction

For patients who have experienced a failed prior implant reconstruction or are living with poor skin quality as a side effect of radiation, a latissimus (large, flat muscle on the back) flap and implant reconstruction may be the ideal approach. This procedure involves taking skin and muscle from the back to transfer healthy, more resilient skin to the chest. An expandable implant is placed beneath the skin flap and after the skin has expanded, is replaced with a long-lasting silicone or saline implant to create the new breast.

No implant, no flap reconstruction

Patients with large breasts who are satisfied with smaller breasts may be good candidates for this approach, which is performed in the same surgery as a mastectomy. It is important that this surgical approach is performed with a breast surgeon who is familiar with this advanced technique, as the incisions are not the standard, traditional mastectomy incisions.

Tissue-sparing mastectomies can be performed by cancer surgeons, which allow the natural skin and nipple structure to be retained and used to create a more natural-looking reconstruction. Talk to your cancer surgeon to find out if you are a candidate for this approach.

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Breast reconstruction surgery after lumpectomy

For patients planning to undergo a lumpectomy to treat breast cancer and want to keep as much of their natural breast tissue as possible, we offer “oncoplastic reconstruction.”  For those who have had a lumpectomy and were left feeling unhappy with the appearance of their breasts, our talented breast surgeons can perform custom revisions to resolve any aesthetic issues.

Oncoplastic reconstruction

This advanced breast reconstruction surgery is performed before the lumpectomy and before radiation. We can achieve breast reduction on both sides immediately following the lumpectomy for women with large, heavy breasts who would benefit from breast reduction. If you have a body shape that would not do well with a mastectomy or want to have the reconstruction performed at the same time as the cancer surgery, this is an option. Talking to your breast surgeon about this type of reconstruction when planning cancer surgery is essential, as some procedures cannot be done after radiation treatments.

Revision after lumpectomy

For women who desire a more symmetrical result or if there is collapse or dimpling of the treated breast, we offer reconstructive options ranging from fat grafting to flap reconstruction. If the breast has undergone radiation, we typically do not perform extensive reductions or breast augmentations. Still, we can adjust the other breasts to create a more symmetrical look to the breasts.

Fat grafting

Fat grafting is using fat from other parts of the body and injecting it into the breast to increase the size of the reconstructed breasts. This procedure can be combined with any of the breast reconstruction techniques. The fat is harvested with a gentle liposuction procedure. The liposuction is performed the same way cosmetic liposuction is completed, but the fat is saved instead of thrown away. Also, the fat collected is less than when patients have cosmetic liposuction. Once assembled, it is processed, purified, and injected to add natural volume to subtly increase breast size or soft volume to create a more natural look and feel.

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Areola and nipple reconstruction

After healing from any type of breast reconstruction surgery, you may want to have a nipple and areola reconstructed. This can be done with various techniques, and a surprisingly natural-looking nipple is created for a balanced appearance, although no actual nipple function.

Tattoo only

The nipple and areola are tattooed directly onto the skin. There is no nipple protruding, but by using 3D artistic techniques, a very real look can be achieved.

Nipple reconstruction

A nipple that appears more natural can be created by performing a surgery where the skin on the breast is folded to form what appears to be a nipple. Once healed, the newly created nipple and areola can be tattooed to get the appropriate coloring.

Areola reconstruction

If tattooing of the areola is not a desired change, the nipple can be reconstructed with skin grafts from the inner thigh.

Breast reconstruction to restore breast symmetry

If reconstruction is only necessary on one breast, the other side may need to be adjusted to create symmetry. Our surgeons may employ cosmetic breast techniques such as breast lifts, augmentations, and reductions. 

Breast reconstruction revision surgery

For some women, breast reconstruction revisions are needed. The surgeons at Hill Country Plastic Surgery are often called upon to correct problems that occur after breast reconstruction surgery due to infections, excess scar tissue, or uneven results. 

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Dr. Amita Shah

Why undergo breast reconstruction at Hill Country Plastic Surgery?

If you are scheduled for breast cancer surgery, planning your reconstruction at the same time is extremely important, as many women are candidates for reconstruction during the same surgery. When seeking a breast surgeon, you want to ensure you are under the care of a board-certified plastic surgeon with exceptional experience and access to the latest techniques. At Hill Country Plastic Surgery, we are widely recognized in the medical community as leaders in the field, with years as educators for young surgeons and experience performing some of the world’s most complex procedures.

Your journey to a full recovery after breast cancer surgery starts here.

During your appointment with us, we will learn more about you, and have a conversation about our recommendations for your breast reconstruction. There is a range of techniques for reconstruction, and we can advise you of your options, and what will be most successful for you. Prior to your appointment, we will review your cancer history, mammograms and other studies, biopsies, and treatments. Based on this information we will be able to determine what procedures you are a candidate for and discuss with you the pros and cons of each procedure.

We will perform a physical examination which will consist of a breast examination and measurements. We may also take photographs if you will be having surgery done soon. During your consultation, we will discuss many options and help determine the best course of treatment for you. You will receive the consultation notes and recommendations, plus other resources that can help you be informed and prepared for your upcoming surgery. The information we provide you is based on the latest research and our years of personal experience with patients who have undergone breast reconstruction.

Is breast reconstruction covered by my health insurance?

Breast reconstruction is often covered by insurance. Under federal law, health insurance plans that cover mastectomies must also cover reconstruction surgeries. If you need cancer surgery on one side, insurance from these plans typically covers the cost of the surgery to ensure both breasts match in size and shape as closely as possible. Our friendly staff will assist you regarding your insurance plan, what it covers, and whether you will have out-of-pocket expenses.

After your consultation, you will receive access to your notes on the patient portal in addition to information about your specific surgery. If you have not activated your patient portal, this can be done at your appointment by asking any of our staff to assist you. If you have questions after your appointment, you can contact our office or message us through the patient portal. Some patients will require medical clearance from their primary care physician or a specialist or additional tests before undergoing surgery.

Once you have determined that you would like to have surgery and have completed any clearances and tests that were requested, contact our office at (210) 658-3555 to schedule a pre-operative appointment with one of our surgeons.

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Breast Reconstruction FAQs

How do I choose a breast reconstruction surgeon?

Can I have breast reconstruction if I need radiation treatments?

Will my insurance cover my reconstruction?

Do you do surgery to fix lymphedema after breast cancer surgery?

When should I see a breast reconstruction surgeon?

How do I choose a breast reconstruction surgeon?

The breast reconstruction process can take up to a full year in some cases. It is important that you feel comfortable with and trust your surgeon to be able to meet your reconstruction goals. You will be able to meet and talk with your surgeon to determine if he or she is the right person for you.

Can I have breast reconstruction if I need radiation treatments?

Radiation, while warding off cancer recurrence, impacts skin healing, skin color, and its natural resilient quality, often leaving the skin harder. While the need for radiation therapy does not exclude you from reconstruction, it can increase the risks. Not all patients respond to radiation in the same way, so we will evaluate you, your skin, and your treatment to determine which reconstructive techniques will work best for you.

Will my insurance cover my reconstruction?

The Women’s Health and Cancer Rights Act of 1998 guarantees reconstruction after mastectomy or lumpectomy for women with insurance. While reconstruction is covered, there are many differences between insurances. Not every insurance provider covers all reconstructive procedures. We will work with your insurance company to determine what is covered under your plan.

Do you do surgery to fix lymphedema after breast cancer surgery?

We currently do not do surgery to correct lymphedema after breast cancer surgery. However, we do procedures to treat lymphedema and lipedema on other parts of the body.

When should I see a breast reconstruction surgeon?

It is recommended that you see us before any surgery is done. That way, we can determine the best timing for your reconstruction.

Breast reconstruction specialist in San Antonio

Breast reconstruction is different from cosmetic breast surgery, so during your consultation, your surgeons will discuss with you what is and is not possible to achieve. Prior to your appointment, we will review your medical history and your cancer evaluation from your doctors to determine your risks. Radiation therapy is a major factor in the quality of skin and wound healing after surgery. Risks can include pain, bleeding, infection, loss of implants, loss of flaps, need for additional surgery, and asymmetry. The risks and potential for complications are different for all people, and we will discuss them with you during your consultation.

The surgeon may adjust any of the above guidelines and instructions based on the patient and the type of surgery performed.

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Meet with us.

Are you interested in learning more about this procedure or any other, like a breast augmentation in San Antonio? To schedule a consultation, please contact us. Hill Country Plastic Surgery is the premier plastic surgery center in San Antonio, and our friendly team members are here to help you and will reach out promptly.

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Your journey to a happier, more confident life starts with a private, in-depth consultation with your surgeon, where we learn about you and your vision and goals. Discover San Antonio’s premier clinic for plastic surgery.

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