Mayo Clinic-trained, board-certified Nashville plastic surgeon Chad Robbins, M.D., F.A.C.S., performs breast reconstruction using several reconstructive plastic surgery techniques. Each technique works to restore a breast to near normal shape, appearance, and size following mastectomy. The specific technique(s) he uses depend on each patient’s medical history, existing breast tissue following mastectomy, and the desired look after reconstruction.
What is Breast Reconstruction?
Dr. Robbins offers sophisticated breast reconstruction procedures and techniques to patients following mastectomy. Breast reconstruction refers to the cosmetic procedures done following a mastectomy to restore or enhance the shape, size, and appearance, of the breasts. Dr. Robbins carefully consults with each patient regarding their desire for breast reconstruction.
Some women choose to have their breasts returning as close to their previous size and shape, while someone women prefer to try something new with the reconstruction. Dr. Robbins offers many techniques to reconstruct the breasts post-mastectomy to meet the needs of all patients. These may include:
- Flap techniques that reposition a woman’s own muscle, fat, and skin to create or cover the breast mound (A “flap” refers to the portion of tissue used).
- Tissue expansion that stretches healthy skin to provide coverage for a breast implant.
- Surgical placement of a breast implant to create a breast mound.
- Grafting and other specialized techniques to create a nipple and areola.
- Skin-sparing mastectomy.
- Nipple-sparing mastectomy.
Dr. Robbins recommends that women undergoing mastectomy typically have the breast reconstruction procedure done the same day. This allows Dr. Robbins to take advantage of the skin’s elasticity and minimizes the patient’s discomfort following two procedure days versus just one. However, some patients choose to wait a while after the mastectomy due to cancer treatment or simply needing a break, and Dr. Robbins will ensure those patients achieve desired results, as well.
Dr. Robbins will work to understand each patient’s desired outcomes for breast reconstruction and provide guidance on making the entire process as easy on the patient as possible. Dr. Robbins has much experience in this field and is proud to provide his most courageous patients with the experience and care necessary to make breast reconstruction a positive and rewarding experience.
Who is a Strong Candidate for Breast Reconstruction?
If you have gone or are planning to undergo breast removal, or mastectomy, you are likely a strong candidate for breast reconstruction. Many women feel unfeminine following mastectomy and breast reconstruction can help rebuild confidence and respect for the body. Furthermore, Dr. Robbins will consult each patient and any relevant medical providers to the patient to ensure breast reconstruction is beneficial for the patient at that time.
TRAM Flap Breast Reconstruction in Nashville, TN
TRAM stands for Transverse Rectus Abdominis Myocutaneous. A TRAM flap breast reconstruction procedure relies on using a patient’s own tissues, taken from the abdomen, to build a new breast. Dr. Robbins will carry the lower abdominal skin and fat up to the chest wall. He will then create a breast shape using this tissue. In order to transfer the flap to the chest, the muscle is tunneled under the upper abdominal skin. The result is a more natural-appearing breast reconstruction.
The TRAM flap can be used for reconstructing one or both breasts. For women undergoing unilateral reconstruction, the TRAM flap can potentially offer better symmetry than using an implant.
Capsular Contracture in Nashville, TN
Have your breast implants developed a hard look or feel? You may have a capsular contracture. Patients in Nashville and Franklin, TN, trust board-certified plastic surgeon Chad Robbins, MD, FACS, for this delicate procedure. Contact his office today to schedule your personalized consultation.
What Is Capsular Contracture?
When an implant is inserted into the breast, the body forms a protective layer of tissue around it called a capsule. In some women, that capsule may begin to shrink and constrict the implant, causing the breast to feel firm and possibly distorted. The reason why this happens to some women and not others is not entirely known, but it may result in asymmetrical breasts and even discomfort. An experienced, board-certified plastic surgeon, such as Dr. Chad Robbins can conduct a physical examination to determine if you have capsular contracture and discuss the treatment options.
How Do I Know If I Have Capsular Contracture?
The severity of capsular contracture is measured on a scale of I to IV. A common symptom of capsular contracture is harder breasts than usual, distortion of the original shape of your implants, and pain or discomfort in your breasts.
During your consultation, Dr. Robbins will examine your breasts to determine if your capsular tissue is contracting, and grade it based on this scale:
- Grade I: The breast looks soft and normal
- Grade II: The breast is beginning to feel slightly harder than usual
- Grade III: The breast is firm and is beginning to loose its shape and appear distorted.
- Grade IV: The tissue capsule is hard and compressing the implant. You may feel soreness or discomfort.
Can I Prevent Capsular Contracture?
The exact cause of the tightening of the capsular tissue is unknown, but preventative measures can be taken to possibly lower your risk of developing it.
- Using textured implants. When placed above the muscle, these implants can help discourage the tissue from contracting.
- The No Touch Technique. Getting a breast augmentation (LINK) by a doctor who uses this procedure may help reduce the possibility of surface bacteria introducing itself into your body. It is believed that this may help reduce the risk of capsular contracture.
- Subpectoral placement. Having your breast implants placed underneath the muscle can reduce the likelihood of capsular contracture to 8 – 12%, whereas other placement techniques have a 12 – 18% chance.
- Closed Filling System. This method is only available for saline implants. By filling the implants using sterile tubing, you eliminate the possibility of contamination by foreign bacteria, which can possibly help prevent capsular constriction.
- Gently massage the breasts. This method has neither been proven nor disproven and may be helpful depending on your unique situation.
What Treatment Methods Are Available for Capsular Contracture?
There are few different ways that capsular contraction can be treated. The most effective method is a capsulectomy, which is a procedure to remove the entire capsule. This technique also helps to reduce the possibility of it reforming once the implant is replaced. A capsulotomy can also be performed, which will break up the tissue without removing the implant altogether. Non-surgical techniques are also available. Additionally, high doses of vitamin E may be beneficial in softening scar tissue, which can help your breasts stay supple and soft. If you are exhibiting any symptoms of capsular contracture or are concerned you may have capsular contracture; we encourage you to contact the office of Dr. Robbins to schedule an examination.
What Does Capsular Contracture Treatment Cost in Nashville?
The cost of capsular contracture treatment will vary greatly depending on the severity of your condition and your unique body make-up. To ensure the procedure is affordable and available to those who may need it, financing is offered via CareCredit® and Prosper Healthcare Lending.
Capsular contracture is a condition where the tissue capsule around your breast implant becomes contracted and may result in deformity or discomfort. Dr. Chad Robbins, MD, FACS, is a board-certified surgeon who was trained at the Mayo Clinic and is experienced in breast augmentation and revisions, including capsular contracture treatments. Residents of Nashville and Franklin may contact our office to schedule an appointment.
Latissimus Flap Breast Reconstruction in Nashville in Nashville, TN
The latissimus dorsi flap method is a procedure for breast reconstruction that has been in use for more than 30 years. This method uses skin from the patient’s body and is commonly combined with a tissue expander and a breast implant.
The latissimus flap technique offers Dr. Robbins additional options with regard to the appearance of the reconstructed breast. The skin flap can create a more natural-looking breast shape when compared to a breast restored through the use of tissue expanders and breast implants alone.
Very thin patients with small breasts can sometimes rely on a latissimus dorsi flap by itself for breast reconstruction because they don’t need implants.
Tissue Expanders in Nashville, TN
Post-mastectomy breast reconstruction with a tissue expander and an implant requires a staged approach. Dr. Robbins will use a tissue expander as a temporary device, placed on the chest wall deep in the pectoralis major muscle. He may place the tissue expander immediately following the mastectomy or later, which is called a delayed procedure.
A tissue expander is designed to create a pocket to contain the permanent breast implant. Tissue expanders are available in a variety of shapes and sizes to fit the size of the implant the patient and Dr. Robbins choose.
In some cases, Dr. Robbins may use Acellular Dermal Matrix (ADM) as part of breast reconstruction with tissue expanders. This involves grafting sterile donor tissue to provide a framework into which the patient’s own skin tissue can grow, contributing to a more natural-looking breast shape and providing support for the implant.
Skin-Sparing Mastectomy in Nashville in Nashville, TN
In a skin-sparing mastectomy or breast-conserving surgery, the entire breast, nipple, and areola are removed without removing the breast skin. To preserve the skin, breast reconstruction is performed immediately after the mastectomy.
In this case, the cancer surgeon and Dr. Robbins work together. To remove the cancerous breast tissue, the cancer surgeon makes a small incision around the areola and maintains the rest of the breast skin to optimize the results of cosmetic reconstruction. This leaves a natural breast pocket that Dr. Robbins then fills with either a breast implant or other tissue from the patient’s body.
Nipple-Sparing Mastectomy in Nashville, TN
For some patients, a nipple-sparing mastectomy is an option. To preserve the nipple, breast reconstruction is performed immediately after the mastectomy. In this case, the cancer surgeon and Dr. Robbins work together.
Nipple-sparing surgery is performed by:
- Removing only the breast tissue.
- Hollowing out the area of the nipple.
- Analyzing the tissue that is left for any signs of cancer.
- Immediately reconstructing the tissue back into the breast skin.
Good candidates for the nipple-sparing mastectomy are women who have smaller tumors positioned away from the nipple, as well as those who have elected to have a total mastectomy as a preventative measure.
Following surgery, gauze or bandages are applied to the incisions. After the surgery, the sensation of the nipple and areola are not maintained.
Dr. Robbins sends the patient home with an elastic bandage or support bra, which compresses the surgical area and should minimize swelling while supporting the reconstructed breast. Healing continues for several weeks. Localized swelling should decrease. Over time, the breast shape should normalize and improve.
How Much Does Breast Reconstruction Cost?
Breast reconstruction costs vary among patients. To provide accessibility to quality care for all patients, Dr. Robbins does offer financing options at his office. Schedule a breast reconstruction consultation with Dr. Robbins today to learn about the options for your own procedure.
Dr. Robbins is board certified in plastic surgery and is skilled in the most advanced cosmetic and reconstructive surgery techniques. His focus is on helping patients in and around Nashville and Franklin enhance their quality of life in addition to achieving aesthetic goals. Please contact us to schedule a consultation with Dr. Robbins in Nashville.