Being told that you have breast cancer, or that you are at high risk for developing it, can be frightening and overwhelming. If surgery is recommended, many women worry about what effects it will have on their appearance, happiness, and sense of femininity. Fortunately, there are several excellent options for restoring breast shape, appearance, and contour.
Dr. Seth has become a trusted name in Chicago and the North Shore for patients seeking the latest techniques in breast reconstruction following lumpectomy or mastectomy. Dr. Seth's expertise includes:
- DIEP Flap Reconstruction (using your own abdominal tissue)
- Implant Reconstruction
- Above (pre-pectoral) or Below (sub-pectoral) the pectoralis muscle
- One- or Two-stage
- Reconstruction after Nipple-Sparing Mastectomy
- Reconstruction after Prophylactic or Risk-Reducing Mastectomy
- Reconstruction after Lumpectomy using Oncoplastic Surgery techniques
- Revision of a Previous Breast Reconstruction
Why Breast Reconstruction?
The purpose of breast reconstruction is to restore body image and enable you to wear clothes without restriction. Most women can wear revealing styles of clothing with confidence after their breast reconstruction and it is usually difficult, if not impossible, to tell which side was reconstructed side while dressed. The need for an awkward and sometimes embarrassing external prosthesis is eliminated by surgical reconstruction of the breast. Although no method of breast reconstruction will precisely duplicate a normal breast, breast reconstruction is generally quite effective and can helping to restore your dignity and self-esteem. In most cases, women are quite satisfied with their results and, in retrospect, would chose to undergo the procedure again.
Case ID: 433
Why Choose Dr. Seth?
Dr. Seth is a board-certified plastic surgeon who is known nationally for his expertise and skill in breast reconstruction, having written several scientific articles and given several lectures on the topic. Having trained at Harvard and Memorial Sloan Kettering Cancer Center, two of the highest volume breast reconstruction programs in the country, Dr. Seth is an expert in the most advanced breast reconstruction techniques. After being recruited to NorthShore University HealthSystem specifically to enhance their breast reconstruction program, he now works closely with all of their breast cancer surgeons to help provide both compassionate care and exceptional results. Dr. Seth's patients come from all over the Chicagoland area including the city of Chicago, the North Shore and Northwest suburbs including Lake Forest and Arlington Heights, as well as Southern Illinois and Northwest Indiana.
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What Can I Expect During Breast Reconstruction?
- Breast reconstruction, by whatever method, should be viewed as a staged effort (typically two or three stages). Dr. Seth's goal during these stages is to ultimately achieve an attractive, symmetrical outcome.
- Stage 1: This is the “rough draft” reconstruction where Dr. Seth recreates the breast mound.
- Stage 2: This stage is aimed at improving breast symmetry and fine-tuning the reconstructed breast in terms of size, shape, and position. Dr. Seth uses this stage to perform minor revisions to the reconstructed breast(s), as well as surgery of the opposite breast as needed, such as a breast reduction, lift, or augmentation, to further achieve breast symmetry.
- Stage 3: If needed, Dr. Seth uses this stage to perform the 'finishing touches' to your reconstruction. This is when patients can undergo nipple reconstruction and/or areola tattooing, or additional revisions to the breast mound if desired.
- Immediate or Delayed
- Dr. Seth typically recommends performing breast reconstruction at the same time as the lumpectomy or mastectomy (immediate reconstruction). However, if you choose to perform reconstruction at a later date (delayed reconstruction) due to personal or medical reasons, you still have options. Dr. Seth routinely performs delayed breast reconstruction that provides aesthetically pleasing results.
- Radiation and Chemotherapy
- Some women may need chemotherapy or radiation as part of their breast cancer treatment. As an integral part of your breast cancer care team, Dr. Seth works closely with your oncologist to ensure that your breast reconstruction surgery is timed to optimize both your cancer care and your aesthetic result.
What Are My Options For Breast Reconstruction?
- Implant-based reconstruction is the most common form of reconstruction after mastectomy. Dr. Seth has developed a reputation in Chicago and the North Shore for his excellent outcomes and patient satisfaction following implant-based breast reconstruction. Generally, reconstruction with implants can be completed in one- or two-stages. Based on your anatomy and your goals, Dr. Seth will help you choose which approach can achieve the best outcomes for you.
- One-Stage: Dr. Seth places an implant at the same time of your mastectomy. Although this can be a 'one-and-done' approach to breast reconstruction for some, many patients still desire an additional stage to optimize their cosmetic result. It is important to know that not everybody is candidate for one-stage reconstruction, making it less common.
- Two-Stages: Dr. Seth places an adjustable balloon, known as a tissue expander, at the time of the mastectomy. The expander is periodically inflated in the office until a satisfactory size has been reached. Dr. Seth then replaces the expander with a permanent implant during a second procedure. Based on your goals, Dr. Seth may also recommend additional procedures at the time of implant exchange to achieve the ideal breast shape and symmetry. This is the most common approach to implant-based breast reconstruction.
- Above (pre-pectoral) or Below (sub-pectoral): Using cutting-edge surgical techniques, Dr. Seth is able to perform implant-based reconstruction either above or below your pectoralis muscle. Dr. Seth will discuss with you the advantages and disadvantages of each approach so that you can make an informed decision.
- Implant Type: Implants are with filled with either silicone or saline. Based on your goals and body type, Dr. Seth will help you choose which implant is right for you. In general, the vast majority of patients choose silicone implants, which are both very safe and tend to look and feel more natural.
Case ID: 64
- Dr. Seth is well-regarded as an expert in breast reconstruction using your own tissue, which often requires cutting-edge microsurgical techniques. After a microsurgical breast reconstruction fellowship at Memorial Sloan Kettering Cancer Center, he now serves as the Director of Reconstructive Microsurgery at NorthShore University HealthSystem. If you are interested in breast reconstruction using your own tissue, Dr. Seth will work closely with you during your initial consultation to ensure that you are a good candidate.
- DIEP Flap: With a DIEP flap, part of your lower abdominal fat and skin is transplanted to the area of missing breast tissue, along with blood vessels to help keep the abdominal tissue alive. DIEP flaps can be used to reconstruct either one or both breasts, and they provide the additional benefit of sparing your abdominal muscles. This is the most common way that Dr. Seth performs breast reconstruction using your own tissue.
- TRAM Flap: A TRAM flap is similar to a DIEP flap, except that part or all of your abdominal muscle must be sacrificed to help preserve the blood vessels needed for reconstruction. Although Dr. Seth always tries to perform a DIEP flap, a TRAM flap is sometimes necessary depending on your anatomy.
- Latissimus Flap: A latissimus flap utilizes skin and muscle from your back to recreate your breast mound, and is often used in combination with an implant. Although not as common as DIEP flaps, Dr. Seth may recommend this option for certain patients.
Case ID: 208
Reconstruction After Lumpectomy (Oncoplastic Breast Surgery)
- Dr. Seth also performs reconstruction following a lumpectomy or partial mastectomy, called oncoplastic breast surgery. Working closely with your breast surgeon, Dr. Seth will evaluate if you are a candidate for reconstruction at the same time as your lumpectomy. This can help optimize the aesthetic appearance and symmetry of your breasts.
- If you have already had a lumpectomy in the past, Dr. Seth may still be able to improve the symmetry and shape of your breasts through breast revision surgery that uses state-of-the-art reconstructive techniques.
Case ID: 379
What About My Nipple?
In some cases, your nipple can be saved during a mastectomy (nipple-sparing mastectomy). The decision to save the nipple is primarily dependent on both the characteristics and location of your breast cancer, and the overall anatomy of your breast. Dr. Seth will discuss whether or not nipple-sparing mastectomy is an option for you during your initial consultation.
It is important to know that preserving the nipple may improve the cosmetic result of your reconstruction, but does not preserve nipple sensation. If your nipple is removed during your mastectomy (skin-sparing mastectomy), Dr. Seth will recommend how to optimize your cosmetic result and options for nipple/areola reconstruction during your second- or third-stage of reconstruction. Fortunately, nipple/areola reconstruction is often done in the office under local anesthesia with no additional recovery time.
How Long Is The Recovery After Breast Reconstruction?
Surgery and recovery timelines can vary from patient-to-patient. Dr. Seth will work with you every step of the way during your breast reconstruction process to ensure that you achieve your goals in a safe and comfortable manner. Below is the typical recovery timeline for Dr. Seth's patients:
- Stage 1
- Implants: Outpatient or short overnight hospital stay, 2-3 weeks of recovery at home
- Flaps: 2-3 night hospital stay, 4-8 weeks of recovery at home
- Stage 2: Outpatient, 1-2 weeks of recovery at home
- Stage 3: Outpatient (often in the office), minimal to no recovery
What If I've Already Had Breast Reconstruction?
For women that have had previous breast reconstruction, but are unsatisfied with their results, there are still options to improve or change your reconstruction. Patients from Chicago and the North Shore often seek out Dr. Seth to discuss options for revising their breast reconstruction. In particular, Dr. Seth commonly sees patients for:
- Revision of an existing implant-based reconstruction to improve symmetry
- Conversion of an implant-based reconstruction to a flap-based reconstruction