The Aesthetic Center in Connecticut offers breast reconstruction by Dr. Yuen-Jong Liu for women who have undergone mastectomies, either individually or bilaterally, or who were born without breasts due to developmental or congenital conditions. Dr. Liu’s goal is to meticulously recreate natural breasts in their most authentic form, capturing their size, shape, and positioning with remarkable precision.
Age is not a barrier to achieving a renewed sense of self through breast reconstruction, as long as the patient is in good general health. However, we advise women with pre-existing medical conditions like obesity, high blood pressure, or smoking to delay the procedure until their health is recovered sufficiently for the procedure.
Dr. Liu’s breast reconstruction, often performed in stages, offers two primary approaches. The choice will depend on the availability of sufficient tissue on the chest wall to support an implant. Regardless of the method chosen, collaborative efforts between a woman's breast surgeon and a plastic surgeon are crucial for achieving optimal results.
A Neurotized DIEP Flap is an advanced form of breast reconstruction surgery that not only focuses on the aesthetic restoration of the breast after a mastectomy but also aims to restore sensation. The Deep Inferior Epigastric Perforator flap consists of skin and fat from the lower abdomen, around and below the belly button, and its blood vessels which are used to reconstruct the breast. In a standard DIEP flap procedure, skin and fat are taken from the lower abdomen and transferred to the chest to rebuild the breast.
The neurotization aspect involves the additional step of connecting nerves in the reconstructed breast with microsurgical techniques. This is typically achieved by connecting nerves from the donor tissue in the abdomen with chest nerves. The goal is to re-establish neural pathways, potentially restoring some degree of sensation to the reconstructed breast, which is a significant advancement over traditional reconstruction methods that focus solely on appearance. This complex procedure requires a high level of surgical expertise in both microsurgery and breast reconstruction.
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Alloderm Breast Reconstruction is a specialized technique used in breast reconstruction surgeries, particularly following a mastectomy. Many women who undergo mastectomies opt for breast reconstruction. AlloDerm® Regenerative Tissue Matrix, which is manufactured by LifeCell, is frequently used during the reconstruction process.
Alloderm refers to an acellular dermal matrix, which is a type of tissue graft processed from donated human skin. In this procedure, the Alloderm tissue acts as a natural scaffold that integrates with the patient's tissue, providing support and coverage. This technique is commonly used in combination with implant-based breast reconstruction. Alloderm helps in creating a more natural-looking breast shape, as it allows for better positioning and support of the implant. It also contributes to a smoother contour and can reduce the risk of complications such as capsular contracture, where scar tissue forms around the implant.
Alloderm Breast Reconstruction is particularly beneficial for patients who do not have enough natural tissue to cover and support a breast implant after a mastectomy. This method has become increasingly popular due to its ability to enhance the aesthetic outcomes of breast reconstruction while maintaining safety and durability.
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The latissimus muscle is a large, flat muscle below your shoulder blade. Your surgeon can use this muscle to support and protect a tissue expander and implant reconstruction, particularly after radiation therapy. Our Connecticut plastic surgeon, Dr. Liu, performs an innovative scar-free latissimus flap where there is no scar left on the patient’s back.
In this innovative technique, the Dr. Liu will take a tissue expander, which is an inflatable saline implant, wrap it in a sheet of collagen and secure it in front of the pectoralis muscle of the chest. The advantage of this method over subpectoral expander placement includes less pain and no animation deformity-movement and displacement of the implant with contraction of the pectoralis muscle.
In some cases, patients may not have much fat in the areas of the abdomen or thigh areas. It is possible to use these tissues stacked on top of each other to reconstruct one larger breast. Alternatively, a Hybrid combination of a DIEP flap, breast implant, and fat grafting may be employed in concert to reconstruct a larger breast with a natural look and feel.
The Transverse Upper Gracilis flap takes advantage of the soft skin and fat of the inner thigh which is creatively fashioned into a breast. The incision is concealed near the groin to complete the recontouring of the inner thigh. The DIEP or TUG flap results in a breast reconstruction made from your own tissue so it looks and feels natural. Since it is living tissue, there is no implant that could break or need replacement. Your surgeon will discuss the options for the best reconstruction.
This method involves stretching the skin and using an expander to prepare the area before placing an implant underneath the skin. First, a balloon-like device called a tissue expander is implanted under the chest muscles and skin. Over several weeks to months, your provider will inject saline solution through a valve, gradually expanding the expander. This stretches the skin and creates a pocket to accommodate the future implant.
The expander can then be left as the final implant or exchanged for an implant filled with silicone or saline. Finally, a procedure is done to reconstruct the nipples and areola. Not all patients will need the tissue expansion stage, allowing for direct implant placement and a potentially faster completion timeframe.
For women who desire a natural look and feel after a mastectomy, autologous-tissue breast reconstruction offers an alternative to implants. This procedure utilizes your own skin, fat, and occasionally muscle from other areas like the abdomen, back, buttocks, or thighs, to rebuild the breast mound.
During the process, a section of tissue, known as a "flap," is meticulously removed and either reattached to the chest with microsurgical techniques (free flap) or transferred while remaining connected to its original blood supply (pedicle flap). The specific technique chosen depends on individual factors such as available tissue, blood vessel characteristics, and desired breast size. In some cases, implants may be incorporated alongside autologous tissue for added fullness.
Nipple and areola reconstruction, performed separately, adds the finishing touches to the reconstructed breast. It's important to approach this process with realistic expectations, as natural variations in tissue shape and texture are inevitable. Despite this, autologous-tissue breast reconstruction offers the unique advantage of a natural-looking and feeling breast, restoring confidence and reclaiming a sense of wholeness.
The healing process following breast reconstruction surgery can vary significantly depending on the specific procedure performed and whether reconstruction is conducted immediately after a mastectomy procedure. Hospital stays typically range from one to six days. Fairfield County breast reconstruction patients can expect to experience fatigue and soreness for approximately one to two weeks, taking between three to six weeks for overall recovery.
Compression garments are generally worn during the recovery period to aid in healing and support the reconstructed breast. Stitches are typically removed within one to ten days. A surgical drain may be inserted to prevent fluid accumulation in the reconstructed breast. If a drain is used, it is typically removed within one or two weeks.
As time progresses, the recovery journey leads to significant milestones. A month after breast reconstruction, patients may notice a reduction in pain, occasional discomfort, and changes in body contours. Following the prescribed aftercare program strictly is essential for optimal results. At six weeks post-surgery, individuals typically experience increased confidence as incisions heal, allowing a return to light activities and work. Emotions may vary, and counseling is available to support those navigating the psychological aspects of the transformation.
Three months into recovery, patients may consider nipple reconstruction to enhance the appearance of the reconstructed breast further. This stage fine-tunes the initial results, offering additional options such as nipple sharing, skin graft, skin flap, or medical tattooing. Finally, at the one-year mark, patients can review the overall results of their breast reconstruction. Scars may fade, and emotional control often improves, reflecting a successful journey from surgery to full recovery, supported by the experienced and compassionate team at The Aesthetic Center.
Fairfield breast reconstruction provider, Dr. Liu is a distinguished board-certified plastic surgeon with specializations in cosmetic surgery, breast reconstruction, and complex reconstruction. He earned his M.D. from Yale Medical School and graduated summa cum laude from Harvard University with a B.A. in Computer Science and Biochemical Sciences. His professional journey includes extensive research and publications in various domains of plastic surgery. He holds double board certification from the American Board of Plastic Surgery and the American Board of Surgery. Dr. Liu also serves as the Chief of Maxillofacial Surgery at Norwalk Hospital and Saint Mary’s Hospital, highlighting his expertise in maxillofacial aesthetics and reconstruction. His advanced training includes a hand and microsurgery fellowship at Yale University's Section of Plastic Surgery and a plastic surgery residency at the University of North Carolina at Chapel Hill, where he gained comprehensive experience in a range of surgical procedures. Additionally, Dr. Liu completed his general surgery residency at Beth Israel Deaconess Medical Center in Boston, where he was a Clinical Fellow at Harvard Medical School. There, he worked in a Level 1 trauma center and tertiary referral hospital, treating patients across a broad spectrum of surgical specialties.
Breast reconstruction procedures, like any surgical intervention, carry inherent risks. In addition to the general risks that are associated with anesthesia and surgery, implant-based breast reconstruction techniques may lead to specific complications, including infection around the implant, implant leakage or rupture, and implant shifting or deflation. Autologous breast reconstruction techniques, depending on the specific method employed, may result in fat necrosis, abdominal weakness, hernia formation, or a mismatch between the reconstructed breast and the surrounding chest tissue. Addressing these reconstructive issues often necessitates additional surgical procedures.
The return of sensation in the reconstructed breast varies among patients and depends on the type of reconstruction performed. In cases where nerve reconstruction is not part of the procedure, the sensation in the breast may be significantly reduced or absent. However, new surgical techniques, such as the neurotized DIEP flap, aim to reconnect nerves and potentially restore some sensation. It's important to discuss your expectations regarding sensation with your surgeon prior to the procedure, as results can differ from person to person.
Following breast reconstruction Fairfield County patients should continue wearing the surgical bra, and keep the dressing clean & dry. Patients should also avoid heavy lifting, excessive bending, strenuous activities, and sexual activities. Emotional support and having someone with you during this period are recommended.
Patients may start noticing results a month after breast reconstruction, with a reduction in pain and occasional discomfort. Significant improvements continue at six weeks, allowing a return to light activities and work and a gradual adjustment to the new body contours.
Nipple reconstruction is typically considered around three months after breast reconstruction. Options include nipple sharing, skin graft, skin flap, or medical tattooing to help enhance the appearance of the reconstructed breast.
The best time to review the final results is approximately one year after breast surgery. By this stage, patients have worked extensively with their plastic surgeon, scars may have faded, and they can expect a settled appearance with improved emotional well-being.
If you are considering plastic surgery in Fairfield County or anywhere in Connecticut, contact us to schedule a one-on-one consultation with one of our expert plastic surgeons.
722 Post Road, Suite 202, Darien, CT 06820