Procedures: Breast

There are many reasons why women have plastic surgery performed on their breasts. Some women wish to enlarge their breasts; others wish to make them smaller, higher, or more even. Breast reconstruction following cancer surgery works to restore natural, matched breasts. In any case, Dr. Vaniver's goal is to achieve a balanced result that is in harmony with the rest of your body.



Breast Reconstruction

Breast cancer now affects one out of eight women. Current treatment for early stage breast cancer includes lumpectomy and radiation or mastectomy. Breast reconstruction can be performed to improve the appearance of a breast deformed by lumpectomy and radiation, to recreate a breast removed by mastectomy, or to balance the non-cancerous breast so that the two breasts match as closely as possible.

Breast reconstruction can be done either immediately (at the same time as surgery) or delayed for a later time. Delayed reconstruction is performed in a patient who has advanced disease, smokes, is obese, has numerous medical problems, or who is not ready to make a decision on reconstruction. The need for postmastectomy radiation therapy may also affect the timing of reconstruction.

The concepts underlying breast reconstruction include respect for the breast footprint, which is where the breast rests on the chest wall, creation of a skin envelope, and provision of fill. Skin is either left behind, as in a skin or nipple sparing mastectomy, stretched with a tissue expander, or brought in from the abdomen or back as a flap. The breast mound is either filled with a silicone implant or fat from the abdomen or back as a flap. Silicone implants have been proven to be extremely natural, safe and durable. Fat injections may also be done to smooth out uneven areas at a later stage. The nipple may be saved, or a new nipple may be created at a later stage. Surgeries take from two to several hours. Reconstruction may require one to four operations to reach completion, and revisions may be necessary in the future as the breast ages. Reconstruction can be integrated with chemotherapy and radiation therapy. Breast enlargement, lift or reduction may be performed to the opposite breast to create symmetry. While breast reconstruction may create a very natural breast mound, it is important to have realistic expectations. Remember, breasts are sisters, not twins, and will never match perfectly!

In patients who elect lumpectomy and radiation, breast reconstruction may play a role in repairing a post-lumpectomy deformity of the cancer breast, or raising or reducing the opposite breast for matching.

These are some of the terms you may hear during discussion of reconstruction:

  • Oncoplastic surgery
  • Balancing procedure
  • Expander/Alloderm
  • Implant/Alloderm
  • Latissimus flap
  • TRAM flap
  • Silicone gel implant
  • Composite nipple graft
  • In situ nipple areola reconstruction

As a breast cancer survivor, Dr. Vaniver appreciates how difficult the road to wellness can be. She dedicates a large portion of her practice to working with breast cancer patients. She also facilitates a support group, “Girltalk”, which uses breast cancer as a stimulus for positive life growth. You can visit us on Facebook at Seattle Plastic Surgery.

Breast Augmentation

Breast augmentation can enhance you appearance, improve your self-confidence, and broaden your ability to wear different clothing fashions by changing the shape and size of your breast to better match your body style. Breast augmentation is also used to rebalance a voluptuous figure, correct lost volume resulting from age or pregnancy, and balance uneven breasts. It can give women with small or unevenly-sized breasts a fuller, firmer, better-proportioned look through the placement of implants in the breast. The procedure may be combined with others such as a breast lift for more satisfying results.

Breast implants are silicone shells filled with either saline (salt water) or silicone gel (recently approved by the FDA). Incisions are made in the fold under the breast or around the areola. The implants are placed beneath either breast tissue or the chest wall muscle. The procedure takes one to two hours and is typically performed as an outpatient under general anesthesia. The majority of patients can return to work within a week. While most swelling resolves in a month, it takes 9-12 months to see the final results. Bra size may be increased by one or more cup sizes.

Dr. Vaniver will help you decide which size, material and shape are best for your goals and body size.

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