Breast Reconstruction in Washington D.C.

We are proud to have two breast reconstruction specialists on our surgical team at Center for Plastic Surgery. Dr. Samir Rao is experienced in multiple breast reconstruction techniques, including advanced prosthetic breast reconstruction using tissue expanders and implants, microsurgical breast reconstruction using the body’s own tissue, and oncoplastic surgery. Before joining Center for Plastic Surgery, Dr. Rao trained alongside internationally renowned breast reconstruction surgeons at Georgetown University Hospital and completed additional training in microsurgery at the Curtis National Hand Center.

Dr. Frank Albino specializes in natural tissue breast reconstruction using microsurgical techniques, including DIEP Flap, muscle-sparing TRAM Flap, thigh flaps (TUG, PAP), SIEA Flap, and fat-grafting, as well as prosthetic breast reconstruction using implant/tissue expander and direct-to-implant techniques. A graduate of the highly prestigious Integrated Plastic Surgery Residency Program at Georgetown University Hospital, Dr. Albino completed an additional year of intensive Fellowship training in reconstructive microsurgery for the breast and body at the University of Pennsylvania. He has also authored numerous peer-reviewed publications incorporating his research on advancements in autologous breast reconstruction.

For most patients, breast reconstruction will require two to three surgical procedures. The first and most involved procedure is the primary reconstruction of the breast mound or breast shape, which may be done in any of several ways. The second procedure usually consists of additional work on the breast shape or the placement of the implant. Any procedures needed to make the opposite breast more similar to the affected breast also would be done at this time. The final step usually is the nipple/areolar reconstruction. Location of the nipple/areolar area is critical to breast appearance and is usually done after all other reconstructive stages are completed.

Whether you undergo breast reconstruction at the same time as mastectomy, or as a separate procedure, depends on the nature of your breast cancer, your overall health, and the recommendation of your cancer surgeon. It is important, therefore, to choose a plastic surgeon who will communicate effectively and work closely with the cancer surgeon to determine the best course of treatment to achieve optimal results while prioritizing your safety and health.

Patients who are aware, prior to their surgery, of the possibility of breast reconstruction often elect to have the procedure started at the time of the mastectomy, with approval from the surgeon and oncologist. About three-fourths of our patients elect to begin breast reconstruction when the mastectomy is performed. Since the general surgeon must perform a complete mastectomy and also leave sufficient remaining healthy tissue to be used in the reconstruction, your plastic surgeon and general surgeon must work closely together.

The most obvious advantage of immediate reconstruction is that it allows you to avoid an additional hospital admission. Psychologically, mastectomy patients who have immediate breast reconstruction also experience less post-mastectomy depression, because their positive body image is retained. They also have the opportunity to balance the diagnosis of breast cancer against information about the positive aspects of breast reconstruction. Mastectomy patients who begin immediate reconstruction, however, sometimes have unrealistically high expectations about the results because they cannot see what the post-mastectomy results would be without reconstruction.

While patients who already have had a mastectomy cannot choose to have immediate reconstruction, they still are candidates for many of the same reconstructive techniques later on. Waiting has its own advantages. Not only is the mastectomy completely healed with delayed reconstruction, but the patient has had time to accomplish the following:

• Adjust psychologically
• Complete any chemo or radiation therapy
• Explore all the appropriate reconstruction options available
• Schedule reconstructive surgery at a convenient time

Both radiation therapy and chemotherapy can influence the type and timing of breast reconstruction. Radiation therapy affects the quality of the skin and may rule out or lend itself more easily to certain reconstructive procedures. Patients who are having chemotherapy may have to postpone the start or completion of reconstructive surgery until the chemotherapy is completed.