A breast cancer diagnosis is one of the most challenging experiences a woman can face—and the decisions that follow, including whether and how to reconstruct after mastectomy, are deeply personal. At Beverly Hills Plastic Surgery, Drs. David Kim and Eugene Kim provide a full spectrum of breast reconstruction options to patients in Beverly Hills and the greater Los Angeles area. Their goal is to ensure that every patient has the information, the options, and the compassionate support needed to make the decision that is right for her.
Understanding Your Right to Reconstruction
Under the Women’s Health and Cancer Rights Act (WHCRA), health insurers who cover mastectomy are required to also cover breast reconstruction surgery, prostheses, and treatment for complications of reconstruction at any stage of the process—including procedures on the opposite breast to achieve symmetry. This federal law applies to most health insurance plans and ensures that cost should not be a barrier to reconstruction for women who want it.
Immediate vs. Delayed Reconstruction
Breast reconstruction can be performed immediately at the time of mastectomy or delayed until cancer treatment is complete:
- Immediate reconstruction: Performed in the same operative session as the mastectomy. Preserves the breast skin envelope, which often allows for better cosmetic outcomes. Eliminates the need for a second anesthesia for reconstruction. May not be appropriate if radiation is planned or if there are concerns about the mastectomy margins.
- Delayed reconstruction: Performed weeks, months, or even years after the mastectomy. Allows the patient to complete all cancer treatment before undergoing reconstruction. Provides more time for consideration and decision-making without the pressure of the cancer treatment timeline.
Implant-Based Reconstruction
The most commonly performed reconstruction technique. In two-stage implant reconstruction, a tissue expander is placed at the time of mastectomy and gradually filled over subsequent weeks or months to stretch the skin envelope. Once the desired volume is achieved and the patient has completed radiation if needed, the expander is exchanged for a permanent silicone or saline implant in a second procedure.
Advances in technique—including the use of acellular dermal matrix (ADM) and prepectoral (above the muscle) placement—have significantly improved outcomes and may allow single-stage implant reconstruction in appropriately selected patients.
Autologous (Own Tissue) Reconstruction
Autologous reconstruction uses the patient’s own tissue—typically from the abdomen (DIEP flap), back (latissimus dorsi flap), or thigh—to create a new breast mound. The results feel and age like natural breast tissue and are generally preferred for patients who have received or will receive radiation therapy. The DIEP flap—which uses abdominal skin and fat without sacrificing the underlying muscle—is Dr. David Kim’s preferred autologous technique for appropriate candidates.
Nipple and Areola Reconstruction
For patients who want the most complete reconstruction, nipple reconstruction and areola tattooing are performed as the final stages. Nipple reconstruction creates a three-dimensional nipple projection; areola tattooing, performed by a specialized medical tattoo artist, completes the natural appearance. These procedures are typically performed three to six months after the primary reconstruction.
The Consultation at Beverly Hills Plastic Surgery
The reconstruction consultation at Beverly Hills Plastic Surgery is a comprehensive discussion of all options in the context of each patient’s cancer treatment plan, anatomy, lifestyle, and personal priorities. There is no single right answer for every patient—the goal is to identify the approach that best serves each individual woman.
Drs. David Kim and Eugene Kim provide breast reconstruction to patients in Beverly Hills, Los Angeles, West Hollywood, Santa Monica, and throughout Southern California. To discuss your reconstruction options, contact Beverly Hills Plastic Surgery today.
Schedule a Consultation with Beverly Hills California Plastic Surgeon Dr. Kim
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