RECONSTRUCTIVE
BREAST SURGERY

Patients with injuries, disease, congenital conditions, and who undertook a mastectomy surgery, need reconstructive surgery.

After breast cancer, every phase is important yet the most critical one is linked to the self image. Here is where reconstructive plastic surgery plays a crucial role.

Before reconstructing a woman’s breasts after cancer, Dr. Tarek Husami, has learned the pioneering microvascular techniques from the surgeons who devised them.

Graduated from New York University as a fellow of plastic surgery in 1990, Dr. Husami, MD, Cosmetic, Plastic and hand surgeon, brings experience and expertise as well as knowledge of the most effective and innovative techniques available.

Experienced in all forms of reconstruction, including microvascular surgical options, from the first consultation to the final check-up, he makes himself accessible to patients and their families.

WHEN TO HAVE RECONSTRUCTIVE BREAST SURGERY

Delayed Breast Reconstruction
This options is for women who undertook, long time ago, a mastectomy without having considered a cosmetic solution back then.

Staged Breast Reconstruction
The plastic surgery old school used to advise Staged Breast Reconstruction several months after radiation is completed. Nowadays, immediate reconstruction is recommended since it psychologically boosts the patient especially that radiation does not affect the implants.

Simultaneous Breast Reconstruction
Immediate reconstruction of the breast, at the same time as their mastectomy. (If no need breast irradiation is needed.)

AUTOLOGOUS MICROVASCULAR FREE FLAP OPTIONS

Superior Gluteal Artery Perforator (SGAP)
Flap uses tissue from the top of the buttocks to create breast tissue, with the added benefit of a “bottom lift”. SGAPs are the best route to reconstructing a breast that looks and feels similar to the way their breasts felt before cancer treatment.

Deep Inferior Epigastric Artery Perforator (DIEP)
Flap is the technique where skin and tissue (no muscle) is taken from the abdomen in order to recreate the breast.

Transverse Rectus Abdominis Myocutaneous (TRAM)
Flap is no longer recommended because of hernia risks. In Tram, the tissue remains attached to its original site, creating a pocket for an implant.

DIFFERENCE BETWEEN A PROPHYLACTIC AND A THERAPEUTIC MASTECTOMY
Prophylactic mastectomies are those performed on women at high risk for developing breast cancer, or have had genetic testing that confirmed the presence of the cancer-related genes BRCA1 or BRCA2. The removal of the healthy breast(s) is performed before cancer is found.

A therapeutic mastectomy is performed on women diagnosed with breast cancer. The surgery removes the breast along with the cancer.

Prophylactic and therapeutic mastectomies can be performed in a single surgery if a woman is diagnosed with cancer in one breast and decides to have both breast removed to prevent the development of cancer in the disease-free breast.

THE NIPPLE AND AREOLA
The nipple-areola may be spared in case the skin flap is safe. Keeping the nipple-areola intact does not increase risk of cancer although many physicians prefer to stay on the safe side by removing them.

SIDE EFFECTS
A reconstructed breast will not have the same sensation and feel as the breast it replaces.
Visible incision lines will always be present on the breast, whether from reconstruction or mastectomy.

RECOVERY
Healing will continue for several weeks as swelling decreases and breast shape and position improve.