Breast Reconstruction
Dr. McClellan and his team take Breast Reconstruction very personally and want to make sure your journey is safe and successful. We do this by leveraging the latest technology and techniques possible, some of which has been developed by Dr. McClellan himself. For example we use special incisions, equipment, devices, and take every facet of your health history into consideration in order to improve outcome.
Below you will find some information to help you understand breast reconstruction. This information will be updated and expanded periodically, so make sure to check back. We are here with you throughout your journey and look forward to taking care of you.
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What is a Breast Reconstruction?
Breast reconstruction is a surgical procedure performed following a mastectomy. It helps restore the natural look and feel of a woman’s breast. Breast reconstruction can allow clothing to fit better, help maintain the natural proportion of a woman’s body, and most importantly boost the self-confidence for women that have lost one or both breasts to mastectomy. Breast reconstruction is most generally a multi-staged procedure, meaning there are general at least 2 surgeries to achieve the final result.
What is a Allograft or ADM Breast Reconstruction?
Breast reconstruction is a surgical procedure performed following a mastectomy. It helps restore the natural look and feel of a woman’s breast. Breast reconstruction can allow clothing to fit better, help maintain the natural proportion of a woman’s body, and most importantly boost the self-confidence for women that have lost one or both breasts to mastectomy. Breast reconstruction is most generally a multi-staged procedure, meaning there are general at least 2 surgeries to achieve the final result.
Dr. McClellan uses an Allograft also called an Acelluar Dermal Matrix in order to help rebuild the area around your breast following a skin sparing mastectomy. This structural matrix help to stabilize the implant, reduce capsular contracture, and thickens the skin flap as you body grows into the matrix following surgery.
What type of incision is used for mastectomy?
The standard incision used for mastectomy is a simple ellipse around the nipple areola complex. When this incision is closed its becomes a straight line across the chest. This type of incision has been used for more than 40 years to complete the mastectomy. Dr. McClellan doesn’t like the surgical look that this straight line creates. This led him to design a new incision for the skin sparing mastectomy. He designed the “Lazy Lateral” skin incision specifically for the skin sparing mastectomy. This incision provides a more natural breast shape and projection for the woman while giving outstanding visualization for the cancer surgeon to remove tissue and lymph nodes. Please see the paper below that Dr. McClellan wrote on the design of a better, more aesthetic, mastectomy incision to improve patient outcome and satisfaction.
Click to read Dr. McClellan's paper on the Lazy Lateral Incision
How do you make sure the skin flaps are ok from the mastectomy before reconstruction?
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Using state of the art technology of Laser Assisted Indocyanine Green Angiography
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This technology is named SPY-PHI and has had a remarkable improvement on Dr. McClellan's practice to improve safety and outcomes.
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Making sure the skin flaps have good perfusion is a combination of both the breast surgeon as well as the plastic surgeon who is inspecting the flaps. Blood supply to the skin flaps is critical because robust blood supply is needed for incision healing as well as to get the Acellular Dermal Matrix integration in implant based reconstruction.
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Utilizing the SPY-PHI system from Stryker involves injecting a harmless die called indocyanine green into the bloodstream through your IV and looking at the skin with a special camera to evaluate blood flow to the edges of the wound. This technology is so important because skin edges that appear viable to the naked eye may in fact not be viable when examining blood flow digitally. Knowing this information helps to determine if the breast reconstruction can be completed, guides the filling of the Tissue expanders, and shows the Plastic Surgeyr where to resect non viable tissue to improve skin healing.
Click the picture watch a Video in which Dr. McClellan uses the SPI-PHI system from Stryker to evaluate skin flaps following a skin sparing mastectomy.
Will my reconstruction be 1-step or 2-steps?
The number and length of surgeries depends on what type of breast reconstruction you elect to have. The most common way to reconstruct the breast is called a Tissue Expander Implant reconstruction. Typically you would receive the tissue expander, or balloon, at the time of mastectomy followed by a second stage operation that would occur approximately 3 months later.
How long do I have to stay in the hospital after breast reconstruction?
Hospital stay following skin sparing mastectomy it typically just one night in the hospital. Surgeries are performed at Mon Health Center in conjunction with the general surgeon of your choosing. Following surgery you're are admitted for observation to a private floor bed. The next day both the general surgery team and the plastic surgery team will see you and determine to send you home.
What is the pain like after mastectomy and breast reconstruction?
After you go to sleep to undergo the mastectomy, the anesthesia team will perform a pectoralis block on you in order to provide pain relief after the procedure. The shots typically last a few days if the drug named Exparel is used; which is a long acting bupivicane. This medication is placed below and between the pectoralis muscle groups providing very good non-narcotic pain relief. Although the block doesnt provide total pain relief it reduces pain significantly.
