Specializing in DIEP-Flap breast reconstruction surgery, plastic surgeon Dr. Timothy Mountcastle in Northern Virginia is a trusted physician who tailors breast reconstruction surgery to beautifully restore and reshape the breasts following a mastectomy. Many breast cancer patients will effectively undergo breast removal surgery as part of their cancer treatment, then they will have a cosmetic surgery in the recovery process. Today, it is common for cancer surgeons and plastic surgeons to work together to treat the cancer and restore a woman’s physical appearance for best results in patient-centered care.
Things to Consider
During your first consultation to discuss reconstruction surgery, it is important to disclose where you are in the treatment process and which cancer surgeon is treating you, as well as provide any necessary pathology reports. The reconstruction process may take place in multiple steps if the breast tissue needs to be stretched to make room for implants. This discovery phase will help guide the reconstruction process so patients end up with a new breast that is the size, shape and look they want.
Breast Reconstruction Reviews
"From the front desk, to the nurses, to Dr. Mountcastle, I felt very well taken care of & comfortable. I had a breast reduction & tummy tuck done at the same time. Dr. Mountcastle answered all of my questions & was very accommodating when I came in for a 2nd appointment before scheduling my surgery. I was very nervous about the final results. But now I am so happy I had both of these surgeries!! After 3 c-sections and nursing all of my kids, I finally have my stomach back (flatter than it was before) and my breasts are back where they were before kids. I'm very happy with my results and have been so pleased with the friendliness and helpfulness of everyone in the office. "- D.G. / Google / Mar 03, 2016
"As a two time Breast Cancer Survivor, I thought I had exhausted all options of breast reconstruction and would have to deal with continuous tightness and pain. In 2008 after my bi-lateral, skin sparring, mastectomy, I had saline implants put in. In 2009 after my second diagnosis, and radiation, I had silicone implants put in to replace the saline ones. After numerous breast reconstruction revisions, throughout five years, and the frustration of constant checks of my implants; I began researching DIEP Flap Breast Reconstruction and one thing remained constant Dr. Mountcastle?s name kept coming up. After a call to the office and an initial office visit I was on board with this surgery. I can honestly say, this was the best decision I?ve made throughout my Breast Cancer recovery. Dr. Mountcastle and his team were amazing. It began with a thorough explanation about the DIEP Flap procedure and literature to take home. Within a month, I was scheduled for surgery and I couldn?t wait. The surgery was ~7 hours and then I spent 2 days in the ICU and 1 day in step down. Throughout my stay in the hospital, I was visited by nursing care, Dr. Mountcastle and his team almost hourly. I went home with 4 drains, pain meds and instructions on how to care for myself. I must admit, I followed the home care directions to a tee and by the 3rd day home, I was able to take care of myself. I moved around pretty slowly, but was amazed that I was able to get around (minus driving). My recovery went really well and as expected by the discussions Dr. Mountcastle and I had in his office. I am four months out from surgery and couldn?t be happier. I have the breasts I had before cancer got me. I am able to lie comfortably on my stomach, sleep on my side, wear a bra and most importantly, feel like I have REAL BREASTS. I cannot begin to thank Dr. Mountcastle and his team for all they did. They gave me my confidence back. They made me feel complete. I would HIGHLY recommend Dr. Mountcastle if you are considering breast reconstruction."- P.B. / Google / May 20, 2014
Each reconstruction technique will be tailored according to the patient’s physical health, aesthetic goals, and personal preferences. There are many factors playing into the approach that will be taken. The ultimate goal is to ensure the patient is healthy and happy with their final breast results.
There are two primary categories of breast reconstruction techniques:
- Procedures that involve using a breast implant
- Procedures that are autologous (use the patient’s own body’s tissue to reconstruct and recreate the breast)
Reconstruction With Implants
Breast reconstruction using silicone or saline implants is a common approach that generally starts with the use of a tissue expander to help form a suitable pocket for an implant. The expander may be inserted after the mastectomy procedure or during the same operative session. Over the course of several months, the expander will slowly be enlarged using a sterile solution injected through a port residing under the skin. During the scheduled reconstruction surgery, the expanders are removed and replaced with permanent implants.
If there is limited tissue inside the breast, or limited skin on the outside, tissue may be used from another part of the patient’s body to supplement this loss. The most common areas to support this process are the buttocks, thigh or abdomen. This is an autologous approach to breast reconstruction. The TRAM flap (Transverse Rectus Abdominus Myocutaneous), the DIEP flap and SIEA flap techniques involve taking skin and fat from the abdomen and relocating it to the breast. The Latissimus Dorsi Flap is another common method using tissue from the patient’s back.
During a mastectomy, the nipple and areola often cannot be saved. The loss of one’s nipple and areola can be as unnerving as the removal of the breast itself. However, reconstruction techniques have advanced greatly, allowing plastic surgeons the opportunity to recreate these areas of the breast to give a natural, aesthetically appealing appearance. In a separate procedure, the nipple is created using existing breast skin or from the abdominal or latissimus flap. Using a tattoo technique, the areola is recreated with a skin graft taken from the thigh, abdomen or back.
Breast reconstruction surgery is performed under general anesthesia at an accredited surgical facility. Some patients may be required to stay in the hospital to be monitored for complications. Patients who have had reconstruction using a flap technique will usually be required to stay in the hospital for 2-5 days. The recovery process can be somewhat lengthy, but many view it as the final step in their cancer journey thus the experience can be very rewarding. Most women are thankful to have had the opportunity to restore their breasts and are satisfied with their results.
Plan Your Procedure
- Average Cost
- $10,000 - $250,000
Breast Reconstruction FAQs
This is a very specialized surgery that requires extensive knowledge, skill and experience. It is very important to research and find a qualified and reputable plastic surgeon who has experience with breast reconstruction surgery.
Can I Delay This Surgery?
In many situations, it is recommended to start the reconstruction process at the same time as the mastectomy. Therefore, it is a good idea to have your breast cancer surgeon and your plastic surgeon begin communicating about the steps that will follow. An advantage of doing the procedure immediately is waking up from your mastectomy surgery with the reconstruction process in place. The soft tissue that surrounds the breast will heal simultaneously with the reconstruction, which can enhance the final results.
A reconstructed breast will not have the same sensation as the breast did before the mastectomy. However, over time, some of this sensation will return to normal. This will depend on the extent of the reconstruction process and will vary by patient.