OVERVIEW
Unfortunately, breast cancer affects 1 in 8 women in the United States. Sometimes this is genetically linked to your family and can happen before the age of 40. However, most breast cancers seem to happen later in life, completely randomly, and are usually found either by a yearly screening mammogram, which Dr. Schwartz recommends, or during a self exam or doctor's visit.
What a breast reconstruction offers is a chance for a woman who has been diagnosed with breast caner to regain her identity and femininity.
WHY DR. SCHWARTZ?
Dr. Schwartz has over 10 years of experience performing plastic and reconstructive procedures. He has assisted hundreds of women through their breast reconstructions after a mastectomy, which means that if you choose Dr. Schwartz, you will receive the safest and most aesthetically pleasing breast reconstruction available today.
Dr. Jaime S. Schwartz developed a breast cancer reconstructive program for a large hospital system in Southern California while serving as Chief of Plastic Surgery, and was instrumental in getting the breast cancer center national accreditation through NAPBC (National Accreditation for Breast Centers).
Dr. Schwartz is 1 of 10 plastic surgeons in the United States to create national guidelines for breast reconstruction using expanders and implants as well as autologous tissue, including fat. Dr. Schwartz also served as the Co-Principle Investigator for one of the first national breast cancer registries that focused on nipple-sparing mastectomies, and has served as Principle Investigator for several FDA clinical trials for breast implants. Additionally, Dr. Schwartz has published many articles on breast surgery and has developed his own technique for breast reconstruction in Beverly Hills, Ca, by utilizing your own tissues, called Autoderm.
BREAST RECONSTRUCTION REVIEWS
ONE-STAGE OR TWO-STAGE?
What is the difference between a one-stage and two-stage breast reconstruction procedure?
A one-stage, or direct-to-implant, reconstruction can sometime be utilized for women that want to the be same cup size or smaller. A one-stage reconstruction procedure allows Dr. Schwartz to place an implant at the same time the mastectomy is performed, though, most women that have a one-stage operation typically come back in the future for some sort of revision, as placing the implant at a later date allows them to have more control over the positioning and sizing.
Many women also do not have adequate tissue on their chest to allow for the implant, so a two-step procedure is used to expand the breast cavity. The two-stage breast reconstruction involves the placement of a tissue expander during the mastectomy operation. This will remain in place for several months until the skin has stretched to accommodate a permanent implant. At this point, a second operation will be scheduled.
Any woman who has lost a breast may find a one-stage or two-stage breast reconstruction very helpful to achieving their goals.
RECONSTRUCTION WITH IMPLANTS
There are three types of breast implants Dr. Schwartz typically uses: saline, silicone, or cohesive gel "gummy bear" implants. For clients undergoing a breast reconstruction, he tends to recommend cohesive gel "gummy bear" implants, as they are anatomically shaped and slightly firmer.
After a breast reconstruction with implants, some aesthetic problems can arise, including rippling or a palpable implant. In these cases, fat grafting can be used to disguise the contours of the implant. A fat transfer involves taking fat from the body, typically from the tummy, hips, or thighs, and places it in the breasts to improve or correct irregularities.
During your consultation with Dr. Schwartz, he can determine if you are a candidate for fat transfer, and if this is an appropriate additional treatment for you.
MOTIVA IMPLANTS
For women who choose to incorporate implants in their breast reconstruction procedure, Motiva Implants® is an option worth considering. Available in various styles and textures, Motiva Implants allow for a more natural-looking breast that feels and moves just like the real thing. Additionally, Motiva maintains softness over time and allows for a less invasive surgery when compared to other options. Patients often enjoy a faster recovery, less scar tissue, and a better overall experience with Motiva Implants. Currently, Dr. Schwartz only offers Motiva from his Dubai facility, but as Motiva Implants become available in the U.S., he is excited to offer them to Beverly Hills, CA patients as well.
AUTODERM
Autoderm is a one-of-a-kind technique developed by Dr. Schwartz for women undergoing a breast reconstruction who have large breasts with a lot of skin, as a way to utilized all of the breast skin, and in some cases, spare the underlying muscle.
Autoderm is an extremely safe and effective technique, as the patient’s own skin is used as a graft, which quickly adheres to the existing tissue. With Autoderm, tissue expansion is accomplished with an adjustable saline implant, which is placed during the initial surgery and may be left in permanently or swapped out later for a softer silicone implant. The expansion is generally fast, and the second operation to exchange the saline implant for a permanent silicone implant can be scheduled rather quickly in some circumstances. This is preferable to women who will require radiation or chemotherapy (which normally happens about eight weeks post-op). You also have the choice of leaving the saline implant and just removing the port, which may be done in the office.
NIPPLE/AREOLA RESTORATION
It is very possible to preserve your nipple/areolar complex during a mastectomy, but for women who are unable to undergo a nipple-sparing mastectomy, reconstruction can be an option. The projection of the nipple and the pigment can both be reconstructed using a combination of a surgical procedure and the application of a nipple pigment tattoo.
AFTER SURGERY
Dr. Schwartz will expertly close any incisions and cover the drains with bio patches and Tegaderm dressing. A well-padded bra with gauze rolls laterally for compression is worn for 3 weeks. You may shower after 48 hours. Dr. Schwartz will remove the drains when there is less than 20 ml of drainage in 24 hours.
PLAN YOUR PROCEDURE
Procedure Recovery Location Out-patient
This is the surgeon's fee only. Other fees apply.
BREAST RECONSTRUCTION FAQS
TISSUE EXPANSION?
A breast tissue expander is an inflatable breast implant. The expander is placed after a mastectomy, and then slowly filled with saline solution, stretching the tissues to make room for a permanent implant.
After your mastectomy, the skin and muscle that remain may not accommodate the placement of a breast implant. The tissue expander will slowly stretch this skin and muscle, allowing it to hold the desired size implant.
The tissue expander may be placed during the mastectomy procedure, or it may be part of a delayed reconstruction process. By making a small incision within the breast tissue, Dr. Schwartz will be able to carefully place the unfilled expander.
Once in place, dissolvable sutures will be used to close the incision. The expander will then be slowly filled with a salt-water solution, through a tiny port on the side of the breast. After the desired size breast pocket has been reached, the expander will be exchanged with a permanent breast implant.
WHAT IS A FLAP PROCEDURE?
A flap procedure entails harvesting the latissimus dorsi muscle and the overlying skin paddle from the upper back, and tunneling it around to the chest, creating a natural-looking breast mound. Once the mound is created, a tissue expander or a silicone implant may be placed to add more volume and contour to the breast. This type of breast reconstruction can be useful when a typical one-stage or two-stage reconstruction isn't possible, and blood supply may be a concern following the mastectomy. This is also an excellent option for women with tissue damage after radiation treatment.
CAN I DELAY THIS PROCEDURE?
Some women prefer to have breast reconstruction done, or initiated, at the same time as their mastectomy. This is called an immediate reconstruction. Delayed reconstruction is when you choose to have the mastectomy done and then the reconstruction months or years later. Ultimately, the decision will be yours, although with an immediate reconstruction, you may have a better chance of having optimal cosmetic results.
