Breast Reconstruction

Breast reconstruction after mastectomy can be done in a variety of ways. The most commonly performed technique involves placement of tissue expanders to create the skin envelope of the new breast. The expanders are replaced with saline or silicone implants at a second surgery approximately 6 months later. Some patients may need reconstruction using their own tissues.  These procedures may use the back muscle and skin (latissimus dorsi musculocutaneous flap) or abdominal muscle and skin (TRAM or DIEP flap). Patients who have had radiation often require this type of reconstruction. All reconstructions require a series of surgeries over 9-12 months to achieve a completed breast mound and nipple, but patients typically return to normal activities in 2-4 weeks after surgery.

Immediate breast reconstruction is the term used for reconstructions that are initiated at the same time as the mastectomy. The reconstruction is only rarely completed in one step. Not all patients are good candidates for immediate reconstruction. Such factors as the possible need for postoperative radiation, size of the breast and health of the patient are important variables. Immediate reconstruction has a higher rate of complications.

Delayed reconstruction is a term used for reconstructions that are initiated after the mastectomy is completed. The timeframe can be as short as 8 weeks (sometimes referred to as delayed immediate reconstruction) or as long as years after the mastectomy.  Patients are sometimes overwhelmed by the volume of information they must process at the time of the cancer diagnosis. There may be a variety of options for treatment and for reconstruction. Sometimes it is less stressful for patients to concentrate first on the cancer treatment and consider reconstructive options at a later time. Breast reconstruction is always an option.

Nipple areola reconstruction is the final component of the breast reconstruction process. Dr. Mistry creates the nipple from the existing skin on the breast mound. The areola is tattooed as a separate procedure done in the office. Meet Danni Nicholson, a breast cancer survivor and our certified micropigmentation specialist in this video done by KTVB Boise in 2019. Read the full article here.

Dr Mistry is the only plastic surgeon in Boise with specialized fellowship training at the MD Anderson Cancer Center in Houston, Texas for cancer reconstruction surgery. She has been providing breast cancer reconstruction to patients in southern Idaho since 2001. She understands that the breast reconstructive process is challenging for the patient and the surgeon. She spends time with each patient reviewing her unique issues and tailoring a reconstructive plan to fit individual needs and desires. Dr Mistry and her staff bring years of experience to the task and provide professional and empathetic support during the entire reconstructive process.

Click below for information on textured implants and BIA-ALCL

Case 1

Patient with immediate reconstruction with implants after nipple sparing mastectomies of both breasts.

Case 2

Patient with immediate reconstruction with implants of breasts and nipples after mastectomies of both breasts

Case 3

Patient with delayed reconstruction of breasts after mastectomies of both breasts and radiation to the left. The right reconstruction was with a tissue expander/implant, the left with a latissimus flap and implant

Case 4

Patient with delayed reconstruction of the left breast with an implant after left mastectomy. The right breast was augmented with an implant for symmetry

Case 5

Patient with immediate reconstruction with implants of both breasts and nipples after mastectomies of both breasts

Case 6

Patient with delayed reconstruction of right breast and nipple. The right chest was also radiated. The reconstruction was with a latissimus flap and implant; the left breast was augmented for symmetry.

Case 7

Patient with a delayed reconstruction with an implant of the right breast and nipple after mastectomy on the right. The left breast was augmented with an implant for symmetry.

Case 8

Patient with a right delayed breast and nipple reconstruction with an implant after right mastectomy. A lift with an implant was performed on the left for symmetry

Case 9

Patient with existing implants. The left mastectomy was performed leaving the old implant in place. The left reconstruction was done with an implant exchange and nipple reconstruction. The right breast underwent implant exchange and breast lift for symmetry.