procedures

Dr. Bucky specializes in breast reconstruction.

You may be a candidate for breast reconstruction surgery if you have had or are going to have a simple mastectomy, total mastectomy, or modified radical mastectomy. You may also be a candidate for reconstruction if you are missing significant breast tissue due to lumpectomy or radiation therapy. The goal of breast reconstruction is to create a breast that looks as normal as possible. The goal of breast reconstruction is to allow you to look good in clothes, a bra, and a bathing suit. Successful breast reconstruction allows you to get up every day and go about usual activities without being reminded of having had breast surgery. Some patients look very good without clothes, however, there are many variables that contribute to the very best aesthetic results. Another goal of breast reconstruction surgery is the restoration of a complete body image, resulting in a more positive self image.

Breast reconstruction may be accomplished using one of the techniques listed below. Dr. Bucky can make recommendations for you when you visit for a personal consultation.

• Breast Reconstruction Using Expander: An tissue expander is placed under the skin and chest muscles and saline is injected into the expander over a period of weeks or months. The overlying skin expands and "grows" with continued expansion. When enough skin is present, the expander is removed and a permanent breast implant is placed. If desired, nipple reconstruction can be completed at a later time. It is also possible that other adjustments may be appropriate at a future date in order to obtain the best possible result. Initial discomfort is controlled with oral medication. Light activities can be resumed as tolerated. This procedure is associated with the shortest recovery.
• Breast Reconstruction - TRAM Flap: This is the most common type of breast reconstruction. A flap of lower abdominal skin, fat, and muscle  is transferred to the area of missing breast tissue with its own blood supply. There are standard, free, and turbocharged variations of TRAM Flap breast reconstruction. Dr. Bucky will be able to recommend which technique he believes is best for your case when you have a personal consultation with him. The abdominal donor site is closed leaving a horizontal scar and a tighter abdomen. The surgeon endeavors to create a "normal" breast mound and shape at the first operation, but subsequent smaller procedures are often necessary. Nipple/areolar reconstruction is performed at a later date and is elective. TRAM Flap is a major procedure requiring 4-5 days of hospitalization. Complete recovery usually takes about 6 weeks.
• Breast Reconstrucion - Latissimus Flap: A flap of skin and muscle is elevated from the upper outer back and rotated to the breast defect. Usually, but not always, a breast implant is placed under the flap to provide the correct volume to the reconstructed breast. The back defect is closed directly. If desired, nipple reconstruction can be completed at a later time. This is a major procedure requiring 3 days of hospitalization. Discomfort of the back and reconstruction site will be present for several weeks. Full use of the area will require about 6 weeks of healing.

Breast reconstruction is almost always covered by insurance. The specific risks and the suitability of breast reconstruction for a given individual can be determined only at the time of consultation. All surgical procedures have some degree of risk. Minor complications that do not affect the outcome occur occasionally. Major complications are rare.

Information about Additional Plastic Surgery Procedures for Breasts:

comprehensive plastic surgery care

Louis P. Bucky, MD, FACS
230 West Washington Square · Suite 101
Philadelphia, PA 19106
215.829.6320