Breast Reconstruction

What Is Breast Reconstruction?

Reconstructive breast surgery can help to restore the size, shape, and appearance of your breasts that have been altered due to a mastectomy. Breast reconstruction in Rochester, NY at the Quatela Center for Plastic Surgery can be accomplished using implants or your natural tissue, depending on your unique situation. Board-certified plastic surgeon Dr. Emese Kalnoki offers several different methods of breast reconstruction to best suit your desired cosmetic goals.

Many breast reconstruction patients travel from Syracuse and Buffalo to the Quatela Center for Plastic Surgery to have Dr. Kalnoki perform their procedures. Request a consultation using our online form to meet personally with Dr. Kalnoki, or call our office at (585) 244-1000 to schedule an appointment.

Dr. Emese Kalnoki Dr. Emese Kalnoki

Emese Kalnoki, M.D.

Specializes in Body Contouring & Breast Procedures

A talented artist and board-certified plastic surgeon, Dr. Kalnoki specializes in plastic surgery after weight loss or pregnancy and other body contouring procedures. As a woman, Dr. Kalnoki brings a unique perspective to the Quatela Center for Plastic Surgery.

Read On

Your Consultation

During your consultation Dr. Kalnoki reviews your medical history including past conditions, allergies and medications, and history of breast cancer or other breast issues. She offers several different breast reconstruction methods including tissue expander to implant reconstruction, immediate implant reconstruction, latissimus dorsi (back flap) reconstruction, and TRAM flap reconstruction. Dr. Kalnoki offers both silicone and saline implants to help you achieve the look that you want for your new figure. During your consultation, she will carefully analyze your condition and determine which treatment plan will work best for you.

Ideal Breast Reconstruction Candidates

If you have recently undergone a mastectomy on one or both breasts, or are planning to have the procedure done in the near future, you may be a good candidate for breast reconstruction with plastic and reconstructive surgeon, Dr. Kalnoki. Reconstructive breast surgery can help to restore size, shape, and appearance of your breasts that have been altered due to a mastectomy. Breast reconstruction with Dr. Kalnoki can be both a physically and emotionally rewarding procedure for breast cancer survivors as it symbolizes their victory over the disease that they battled.

Before Your Procedure

Once your breast reconstruction has been scheduled, there are some things that you can do to best prepare for your surgery and recovery period. By taking time several days before your procedure to prepare, you can be assured of the best results and a smooth recovery.

  • If you are having an immediate reconstruction at the same time as your mastectomy, you will spend one night in the hospital after the surgery to recover. If your breast reconstruction is done at a later date than your mastectomy (delayed reconstruction), Dr. Kalnoki will perform it as an outpatient procedure. You must have a ride home from the surgery center. If you plan to stay overnight at our Carriage House, you must arrange for an adult to drive you home the next morning.
  • Fill all prescriptions prior to surgery.
  • Plan to take off about two to four weeks from work after the procedure to heal and rest at home.
  • Arrange for assistance during the first few days after your breast reconstruction.
  • Carefully review the postoperative instructions. Contact our office immediately if you have questions.
  • Keep important phone numbers and all emergency contact information in an easy to reach location.
  • Put all follow-up appointments on your calendar—these are very important to attend, even if you don't have any questions.
  • Stop aspirin and any specified herbal supplements two weeks before your breast reconstruction.

If you are a smoker, it's also important that you commit to stop smoking at least six weeks prior to your breast augmentation procedure.

The Breast Reconstruction Procedure

Breast reconstruction is rarely a "one and done" procedure. The reconstructive process is usually done in two to three stages over a period of nine to twelve months. The mastectomy removes breast tissue as well as the blood supply to the surrounding skin and soft tissue, and doing an extensive reconstruction immediately afterward can jeopardize the remaining blood supply causing tissue loss (known as mastectomy flap necrosis). To avoid this complication, reconstruction is done gradually, allowing the body to heal between stages. Some patients are good candidates for what is known as immediate implant reconstruction, but even with these patients, a "touch-up" surgery such as fat grafting or implant replacement may be necessary in the future.

Tissue Expander Breast Reconstruction

Tissue expander breast reconstruction is the most popular type of reconstructive procedure performed today. With the variety of implants, expanders, acellar dermal matrices (internal slings for the breast), and fat grafting, a beautiful reconstruction can often be achieved. This type of reconstruction has the least amount of postoperative "downtime" and the shortest surgical operating room time. Dr. Kalnoki may perform your breast reconstruction using a tissue expander, a device that is temporarily placed within your chest. Over time, the expander will help to create a soft pocket where she can place a breast implant to reconstruct your breast. You can have a tissue expander placed immediately after a mastectomy or you may choose to wait after cancer treatments are complete.

Reconstructing the Breast with Tissue Expander Reconstruction

Stage 1: When placing the tissue expander, Dr. Kalnoki will carefully position it within your chest wall and fill it partly with saline. You will be given a few weeks to heal before she can begin the expansion process. This will take place at scheduled intervals, two to three weeks apart for several months, and can be coordinated with chemotherapy treatments.

Using a needle, Dr. Kalnoki can access a built-in fill port located in the front of the expander. She will slowly continue to inject the saline fluid into the expander, keeping in mind the tightness of the surrounding skin so as not to stretch it out too much. Expansion is usually painless.

Stage 2: This stage of your reconstruction can begin once expansion is complete. During this stage of your procedure, Dr. Kalnoki will replace your expander with a soft breast implant to give your breast a long-lasting and natural look. She will spend time with you discussing the various options that you have for choosing your breast implants. Once you feel comfortable and confident with your choice, you can continue with the exchange.

Your surgery will be performed under general anesthesia. If only one of your breasts is being reconstructed, Dr. Kalnoki may perform a symmetry procedure on the opposite breast (this may include a breast lift, augmentation, or reduction).

Latissimus Dorsi (Back Flap) Breast Reconstruction

The latissimus dorsi flap, or back flap, procedure has been used for breast reconstruction since the 1970s. This form of reconstruction is commonly used in combination with tissue expansion to help achieve a more natural look for the breast, and is especially useful if radiation was involved in the treatment plan. This technique may be right for you if you:

  • Are thin and have smaller breast volume
  • Have excess back tissue
  • Have thin skin
  • Want a more natural look

This procedure can be performed immediately after your mastectomy or as a delayed reconstruction.

Reconstructing the Breast with Back Flap Reconstruction

Dr. Kalnoki will explain your procedure in depth during your consultation so that you feel comfortable heading into surgery. If a breast implant is needed, she will guide you through the decision process to help you find an implant that gives you the unique and natural look that you desire for your breasts. General anesthesia will be used for your surgery. Dr. Kalnoki will carefully remove excess muscle tissue from your middle back. This flap may be used alone for reconstructing the breast, or could provide complete coverage of a breast implant, creating a very natural appearance.

TRAM Flap Breast Reconstruction

The TRAM flap reconstruction procedure is used if the breasts have been radiated for cancer treatment and the patient does not want an implant for reconstruction.

You may be a good candidate for a TRAM flap procedure if you:

  • Have enough excess tissue along your lower abdomen for reconstructing one or both breasts
  • Have not had abdominal surgery before (such as a tummy tuck)
  • Have a BMI below 30

The TRAM flap reconstruction can be performed immediately after a mastectomy or it can be delayed.

Reconstructing the Breast with TRAM Flap

With a TRAM flap procedure, muscle, fat and skin will be used from a female donor's abdomen in order to reconstruct your breast. Dr. Kalnoki uses this excess abdominal tissue to create the shape of your new breast. Because this tissue is removed from the abdomen, you may also benefit from a flatter stomach following your surgery with Dr. Kalnoki.

Your TRAM flap reconstruction will not require the use of breast implants. Patients may experience better symmetry with a TRAM flap than with breast implants; however, results and methods will vary from patient to patient. Surgery will take roughly four to five hours to complete.

Recovery after Breast Reconstruction

Tissue Expander Recovery

Recovery from tissue expander reconstruction is normally easier than that of a flap procedure. As your body heals, you will notice an increased amount of comfort with the breast implants than with the expanders. Your implants will also help to achieve a more natural, firm look of your breasts. Secondary procedures, such as nipple reconstruction or a breast lift, may be performed after a couple months to further refine the look of your breasts.

Back Flap Reconstruction Recovery

Recovery from a latissimus dorsi muscle flap is usually about 4 to 6 weeks. In about three months, you can undergo secondary procedures to further improve the appearance of one or both breasts. You may be a good candidate for nipple reconstruction surgery or a breast lift.

TRAM Flap Recovery

Recovering from your TRAM flap breast reconstruction will take some time and patience. Patients can expect the recovery period to be about 6 to 8 weeks. Over time, you will begin feeling like your old self again, and can finally overcome breast cancer once and for all.

Reconstructing the Nipple

A mastectomy also can leave a woman without a nipple. This can be fixed with a nipple reconstruction. Dr. Kalnoki can create a nipple using many techniques, and often this is done under local anesthesia in the office. Coupled with a 3-D tattoo, this puts the "finishing touch" on a reconstructed breast.

Choosing the Right Breast Reconstruction Surgeon

Dr. Kalnoki specializes in breast reconstruction and can help you overcome breast cancer by giving you back the feminine figure you deserve. She has done specific training in this field with a renowned plastic surgeon, Dr. Dennis Hammond. She has performed approximately 400 breast reconstruction procedures and 350 breast reconstruction revision surgeries to help women feel better about themselves after this difficult diagnosis.

Frequently Asked Questions

Am I a candidate for breast reconstruction if I have undergone chemotherapy?

Yes, women who have undergone chemotherapy are still candidates for breast reconstruction.

Can I have breast reconstruction if I am undergoing radiation therapy?

If you are currently undergoing radiation therapy or have had radiation therapy to the breast area in the past, it is important that you discuss this with Dr. Kalnoki. Breast reconstruction with implants is known to have a higher complication rate in patients who have had radiation to the breast area, specifically capsular contracture or scarring around the breast.

When can I resume work after my breast reconstruction?

You should plan to take off one to four weeks from work depending on the method of breast reconstruction that was implemented in reconstructing your breasts. The two flap methods of breast reconstruction require more recovery time than the tissue expander method.

What are the risks of breast reconstruction?

The risks involved with breast reconstruction are dependent upon the method of mastectomy, reconstruction, and post-surgical treatments that may be necessary (chemotherapy and/or radiation). Some risks associated with breast reconstruction include infection, bleeding, and tissue loss from the mastectomy. Risks associated with either a TRAM or latissimus flap include loss of sensation at the donor and or reconstruction sites as well as abdominal wall weakness. Implants have a higher risk of capsular contracture as compared to breast augmentation.

What is immediate vs. delayed breast reconstruction?

Immediate breast reconstruction occurs directly after the mastectomy in the same operation. Many women choose to have immediate breast reconstruction for a number of reasons. Delayed breast reconstruction occurs several months or years after a mastectomy.

When can I exercise again after my breast reconstruction?

You should avoid strenuous activity and lifting for four to six weeks after your breast reconstruction. You should start lifting your arms above your head within 48 hours after your mastectomy. It may be necessary to avoid exercise that may strain your chest or abdomen for up to six weeks after your surgery. Dr. Kalnoki will advise you about when it is safe to resume exercise.

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Quatela Center
for Plastic Surgery

The Quatela Center's reputation as one of New York's finest cosmetic plastic surgery practices attracts patients to Rochester from throughout the state. Choose one of the locations below for driving directions to our practice.

Contact Us

The Lindsay House

973 East Avenue
Rochester, NY 14607
Phone: (585) 244-1000

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