Breast Reconstruction in NYC

Women in NYC who are seeking breast reconstruction surgery need the assistance of an experienced and compassionate reconstructive surgeon. Whether your reconstruction is precipitated by a mastectomy or a congenital defect of your breast (such as tuberous breast deformity or Poland’s syndrome), Dr. Nina Naidu will support you through the reconstructive process.

The goal of breast reconstruction is to restore your breast(s) to a normal shape, appearance and size following surgery, trauma, disease or congenital defects. This is a highly individualized process that may require several surgeries. It also requires a surgeon – such as Dr. Naidu – who will treat you with compassion and respect; has the medical expertise to complete your reconstruction; and will take the time to educate you about your options.

For many of Dr. Naidu’s patients, the decision to have breast reconstruction is about more than their breasts. The choice to have breast reconstruction is a way to take control of their body during a difficult medical journey. It is a decision to feel more feminine and confident. Dr. Naidu’s goal is to help her patients understand their options, so that every woman can look and feel her very best.

Reconstruction Following a Mastectomy

Reconstruction following mastectomy may be performed immediately following the initial surgical procedure or at a later date. Beginning the reconstruction process at the time of the mastectomy can lessen the emotional trauma of the mastectomy, because the patient doesn’t see herself without a breast. Dr. Naidu will help you determine the best timing of breast reconstruction based on your medical needs, your anatomy, and your preference.

Patients who are candidates for mastectomy are generally referred to Dr. Naidu by their breast surgeon. If you do not yet have a breast surgeon, but have been advised that you require a mastectomy, Dr. Naidu is happy to refer you to one of her oncological surgery colleagues.

Your First Consultation with Dr. Naidu in NYC

The first part of your breast reconstruction process is a comprehensive consultation in our NYC office. Dr. Naidu will get to know you and your goals for the breast reconstruction.

At that time of your visit, Dr. Naidu will review your medical history and perform an examination of your breasts. She will explain your options for reconstruction and whether you are a good candidate. Your options for reconstruction depend on your anatomy, preference, and additional therapy that may be required for the treatment of breast cancer. Dr. Naidu will fully answer your questions and address your concerns about breast reconstruction.

Dr. Naidu will never pressure you to have surgery. She will help you determine if a non-surgical solution (such as a prosthetic) is a better solution. She will also help you determine if a less-invasive surgery – such as making your scar flatter or removing “dog ears” (pockets of fat under your arms) – can make you more comfortable without the need for a full reconstruction.

The decision to have breast reconstruction is highly personal. Dr. Naidu’s goal is to help you fully understand your options and to support your decision, whether or not you decide to proceed with breast reconstruction.

Options for Breast Reconstruction

Implant Reconstruction

The most common types of breast reconstruction is implant reconstruction. This procedure has a shorter recovery time than flap reconstruction and can sometimes be completed in one step. It also uses the same incision site as the mastectomy, so there will not be an additional scar.

The downside of implant reconstruction is that it requires a longer preparation time. Following mastectomy, there is usually not enough breast tissue to place an implant. Implant reconstruction usually requires a period of tissue expansion to stretch out the remaining skin and allow placement of permanent implant at a later time. The tissue expander acts like a “balloon” which is placed beneath the skin and pectoralis muscle. Through a small valve in the expander, salt water is periodically injected to gradually fill the expander over a period or 2-3 months.

After a waiting period of 6-8 weeks, which allows the skin to accommodate to its new size, you will have a second surgery. At this time the expander is replaced with a permanent implant. (The implant size and material are chosen at your consultation.) Reconstruction of the nipple-areolar complex is generally performed at a third stage several months later.

Flap Reconstruction

Flap reconstruction uses tissue from another part of your body to create a new breast. This is a more extensive surgery than implant reconstruction, because your muscle and tissues are being used to create the flap. Flap reconstruction also creates more visible scarring. However flap reconstruction is an ideal choice for someone who wants more natural-feeling breasts, doesn’t want the maintenance involved with implants, or doesn’t have enough skin available for implant reconstruction. There are three types of flap reconstruction available:

TRAM Flap Reconstruction: The TRAM (transverse rectus abdominus myocutaneous) flap is a procedure that involves the transfer of skin, fat, and muscle – along with its blood supply — from the lower abdomen to the chest. Following surgery, scars will be present on both the abdomen and the breast. However, the TRAM flap generally produces a more natural feel and appearance of the breast. In addition, your abdomen will appear slimmer and flatter from the removal of tissue! Reconstruction of the nipple-areolar complex is performed at a second stage several months later.

Latissimus Flap Reconstruction: The latissimus flap uses muscle (and sometimes skin) from your back to create a breast mound. In some cases, an implant is also placed underneath the transferred muscle to produce an adequately sized breast. Reconstruction of the nipple-areolar complex is performed at a second stage several months later.

Free flap reconstruction: There are an increasing number of options available for free flap reconstruction of the breast, in which microsurgery is used to transfer tissue from distant sites. Dr. Naidu no longer performs microsurgery. If you are interested in seeing a microsurgeon, please call our office for a referral.

Good Candidates for Breast Reconstruction in NYC

You are a good candidate for breast reconstruction if you would like to restore your breasts to a more natural shape, have realistic expectations for the procedure, and do not have a condition that will impede healing. You also need to have good skin quality. Unfortunately, patients who have had radiation may have a difficult time expanding their skin to accommodate implants.

Having realistic expectations is essential. Your reconstructed breast will not have the same sensation as your natural breast tissue and will not look exactly like your natural breasts. You will require additional procedures to create nipples. Breast reconstruction also means that you will have incision lines on your breast. If you choose flap reconstruction, you will also have incision lines at the donor site (usually the upper back or abdomen). These scars will fade over time.

The use of implants has risks and requires additional monitoring with yearly examinations. In our experience, despite these drawbacks, most women are extremely happy with their decision to have breast reconstruction.

Your Second Consultation with Dr. Naidu

If you decide to proceed with breast reconstruction, you will have a second consultation with Dr. Naidu in our NYC office. At this appointment, Dr. Naidu will explain your surgery in detail. You will understand how your breast reconstruction will affect the size, shape and volume of your breasts. Dr. Naidu has a large variety of sizers available so that you can see how you will look following the reconstruction.

Dr. Naidu will also explain the length of your surgery, the location of your incisions (if you elect to have flap surgery), and what to expect during your recovery.

At this appointment, you will complete the necessary paperwork for the surgery. We will also take pre-operative photographs. These photographs are an important part of your surgical planning and are considered part of your medical record. They will never be shown to other patients without your written permission.

Depending on your medical history, Dr. Naidu may advise you to discontinue certain medications prior to surgery. If you are a smoker, you must not smoke for eight weeks before or after the surgery. For your safety, Dr. Naidu will request your medical records and may order additional screening tests.

Breast Reconstruction Surgery in NYC

Breast reconstruction is performed using general anesthesia. The breast reconstruction process is highly individualized and may require several surgeries. During your consultation, Dr. Naidu will explain her surgical plan and make sure that you understand the details of your surgery. This include knowing the donor sites (if you are having flap surgery) and the shape and volume of your augmented breasts (if you are having implants).

Your first reconstructive surgery will likely be performed in a hospital setting and may require a short hospital stay. Additional surgeries, if required, may be performed in a hospital or a surgery center.

Additional surgery may be required for minor revisions to the reconstructed breast. In the case of reconstructive surgery, where the goal is to match your opposite breast, an additional surgery may be needed to enlarge, reduce, or lift the remaining breast.

Recovery from Breast Reconstruction

You will wake up from your breast reconstruction with a surgical bra and surgical dressings on your donor sites. Dr. Naidu will give you specific instructions to follow after your surgery. You must rest for the first 48 hours after your surgery. She will give you prescriptions for antibiotics and for pain management, as well as instructions about how to take care of your incisions. Immediately following surgery, it will be difficult to lift your arms over your head and you will need assistance with personal activities.

Dr. Naidu will describe what to expect during your recovery, which varies widely depending upon the procedure and the individual patient. In general, implant reconstruction patients return to normal activities more quickly than flap breast reconstruction patients.

Many of Dr. Naidu’s patients are strong, independent women who are reluctant to ask for help. These patients need to understand that breast reconstruction surgery is major surgery and post-surgical assistance will be required. We strongly recommend that you create a plan to take care of yourself and your family, so that you can focus on your recovery.

Cost of Breast Reconstruction Surgery in NYC

We recognize that cost is a very important concern of our breast reconstruction patients. The Women’s Health Act of 1998 requires group and individual health insurance plans that cover mastectomy to also cover breast reconstruction surgery. This includes reconstruction of the breast on which mastectomy has been performed; surgery and reconstruction on the other breast to produce a symmetrical appearance; and implants.

We will provide you with specific information about insurance coverage after your consultation with Dr. Naidu. Please call our NYC office at 212-452-1230 and we will be happy to answer your questions.

Choosing Dr. Naidu for Breast Reconstruction in NYC

Aesthetic and reconstructive surgery of the breast comprise a large part of Dr. Naidu’s NYC surgical practice. She has a special interest in breast augmentation and in reconstruction of the breast. Since 2006, Dr. Naidu has served as a clinical investigator in the Breast Implant Follow-Up Studies (BIFS) trials. Dr. Naidu offers her patients the full range of breast implants. She is excited to be one of only none plastic surgeons in NYC to offer the Ideal Implant®, which combines the natural feel of silicone with the safety of saline.

Dr. Naidu completed her undergraduate studies at The Johns Hopkins University and obtained her medical degree from Cornell University Medical College. After completing her general surgery and plastic surgery training at New York Presbyterian – Weill Cornell Medical Center, she performed an additional year of fellowship training at the University of Pennsylvania. Dr. Naidu is Board Certified by the American Board of Plastic Surgery and is a Clinical Assistant Professor of Surgery at Weill Cornell Medical College.

Schedule a Breast Reconstruction Consultation in NYC

Our office is conveniently located at 1021 Park Avenue in NYC. If you’d like to learn more about breast reconstruction – and whether it is right for you – please call our office at 212-452-1230 and schedule an appointment.

 
 
 

Breast reconstruction is available for patients both following mastectomy for breast cancer and for congenital defects of the breast, including tuberous breast deformity and Poland’s syndrome. Reconstruction following mastectomy may be performed immediately following the initial surgical procedure, or at a later date. Immediate breast reconstruction allows the patient to awaken from surgery with a breast mound already in place, sparing her the experience of seeing herself without a breast. There are several options for reconstruction, which include implant reconstruction or reconstruction with your own tissues (autologous reconstruction). The determination of the appropriate reconstruction for a given patient is dependent upon her body type, preference, and additional therapy that may be required for the treatment of breast cancer.

Patients who are candidates for mastectomy are generally referred to Dr. Naidu by their breast surgeon. If you do not yet have a breast surgeon but have been advised that you require a mastectomy, Dr. Naidu can refer you to one of her oncological surgery colleagues. At that time of your visit, Dr. Naidu will review your medical history, perform an examination of the breast and body, and make a recommendation based upon these factors. Your questions and concerns regarding breast reconstruction will be fully addressed.

Implant Reconstruction: The most common type of breast reconstruction is implant reconstruction. Following mastectomy, there is a relative skin deficit. Therefore, implant reconstruction requires a period of tissue expansion to stretch out the remaining skin and allow placement of permanent implant at a later time. The tissue expander acts like a “balloon” which is placed beneath the skin and pectoralis muscle. Through a small valve in the expander, salt water is periodically injected to gradually fill the expander over several months. After a waiting period which allows the skin to accommodate to its new size, the expander is replaced at a second operation with a permanent implant. Both saline and silicone implants are available for use. Reconstruction of the nipple-areolar complex is generally performed at a third stage several months later.

TRAM Flap Reconstruction: The TRAM (transverse rectus abdominus myocutaneous) flap is a procedure that involves the transfer of skin, fat, and muscle with its blood supply from the lower abdomen to the chest to create a new breast. This type of surgery is more complex than skin expansion and implant placement, and scars will be present on both the abdomen and the breast. However, the TRAM flap generally produces a more natural feel and appearance of the breast. In addition, your abdomen will appear slimmer and flatter from the removal of tissue. Reconstruction of the nipple-areolar complex is performed at a second stage several months later.

Latissimus Flap Reconstruction: The latissimus flap uses muscle and sometimes skin from the back to create a breast mound. In some cases, an implant is also placed underneath the transferred muscle to produce an adequately sized breast. Reconstruction of the nipple-areolar complex is performed at a second stage several months later.

Free flap reconstruction: There are an increasing number of options available for free flap reconstruction of the breast, in which microsurgery is performed for transfer of tissue from distant sites. Dr. Naidu no longer performs microsurgery. If you are interested in seeing a microsurgeon, please call the office for a referral.

Recovery varies depending upon the procedure and the individual patient. Implant reconstruction patients generally return to normal activities more quickly than autologous breast reconstruction patients. Additional surgery may be required for minor revisions to the reconstructed breast. Because the goal of reconstructive breast surgery is to match your opposite breast, an additional operation to enlarge, reduce, or lift the remaining breast may be suggested. The Women’s Health Act of 1998 requires group and individual health insurance plans that cover mastectomy to cover breast reconstruction surgery, including reconstruction of the breast on which mastectomy has been performed; surgery and reconstruction on the other breast to produce a symmetrical appearance; and implants.

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