To many women, breasts are an important part of femininity. Whether a woman has cosmetic issues they want to address through breast augmentation versus breast reduction or if they are a cancer survivor requiring breast reconstruction, having a trusted and experienced surgeon is essential.

CNSO features a team of specialists treating patients in Morristown, New Jersey, and at the surrounding hospitals. Dr. Hakan Kutlu, a board-certified plastic and reconstructive surgeon performs outstanding breast surgery using cutting-edge technology. Dr. Kutlu helps patients create the appearance they prefer so they can feel confident in their bodies.

Breast Surgery After Mastectomy

The diagnosis of breast cancer is alarming for the patients and their families. Learning of the treatment process is also daunting. If cancer was treated by the removal of a breast, a mastectomy, or a large lump then the patient will be left with an uneven appearance. Many women chose not to have the asymmetry and seek a solution with a reconstructive breast surgeon. Breast reconstruction helps women return their bodies to a more natural-looking condition. This procedure can significantly improve the aesthetic changes caused by breast cancer treatment, restoring the patient’s appearance and self-confidence.

Breast reconstruction surgery can be performed at the same time as the mastectomy in a process called immediate reconstruction but only if the patient is done with all other chemotherapy or radiation therapy. Breast reconstruction can also be performed after the mastectomy incisions have healed and physical therapy has been completed. Delayed reconstruction can happen months or even years after a mastectomy, depending on the patient’s required cancer treatment course. It is never too late to decide to reshape one breast or both.

Methods for Breast Reconstruction to Maintain or Enhance the Size of the Breasts

Women who consider breast reconstruction surgery to maintain or increase the size of their breasts, may be able to choose different methods of reconstructing the breast(s). Most breast reconstructive surgeries, whether purely cosmetic or secondary to cancer, use artificial implants to form the breast. More extensive breast cancer cases may require more extensive reconstruction needs that require the use of muscle from other parts of the patient’s body to form and shape the breast. In some cases, both implants and autologous tissue may be used.

Implant-Based Breast Reconstruction for Cancer Survivors

Synthetic breast implant reconstruction is the most common type of breast reconstruction performed. This approach uses an artificial implant to give the new breast shape and mass. It is typically performed as a two-part procedure.

During the first stage, the plastic surgeon inserts a device called a tissue expander. Mastectomy often removes much of the skin that would be necessary to cover a breast implant. The tissue expander is designed to stretch the skin until there is enough for the final procedure. During periodic visits to the doctor, the expander is slowly filled with saline (a solution of salt and water) until it reaches the desired size. This typically takes two to six months depending on the amount of tissue needed.

Once the expander has reached the desired size and the chest tissue has healed, in the second stage, the plastic surgeon will remove the expander and replace it with a permanent implant. Breast implants are typically filled with saline or silicone. In some cases, the surgeon may use a cellular dermal matrix – a kind of mesh made of donated tissue. The matrix acts as a sling or scaffold to provide better support for the implant.

DIEP Flap Breast Reconstruction

DIEP (deep inferior epigastric perforator) flap surgery is for breast reconstruction when there has been extensive tissue damage caused by cancer or cancer treatment. This procedure uses autologous tissue, or tissue sourced from the patient’s own body.

DIEP flap surgery takes a flap of skin, blood vessels, and fat from the patient’s abdomen, or stomach region. The flap is carefully cut from its place, leaving the underlying muscle intact. This allows for a reduced recovery period after surgery. The removal site is then stitched closed. The flap is moved to the breast, where its blood vessels are carefully reconnected to ensure a consistent blood supply. In some cases, a stacked DIEP may be performed using multiple layers of tissue to achieve the desired effect.

DIEP flaps may also include a breast implant. For example, a DIEP flap may be used to cover an implant if there isn’t enough skin left to allow for expansion. This technique may also be used if a large amount of breast tissue needs to be replaced, or if tissue must be taken from the sides of the abdomen (where fat is typically thinner) rather than the front.

Reconstructing the Areola

After reconstruction surgery, the chest must heal in order for the position of the breast mound to stabilize. It is then possible to reconstruct the nipple and areola. This is accomplished by cutting and moving small pieces of skin to the nipple site. These can then be shaped into a new nipple. There are then two methods for creating an areola:

• A skin graft is taken from the groin or abdomen at the time of nipple reconstruction and is attached to the breast to create a new areola.
• A few months later, when the new nipple has healed and stabilized, the surgeon uses tattoo ink to darken the skin and create an areola.

Mastectomies that preserve the patient’s own nipple and areola, called nipple-sparing mastectomies, are an option for some patients. However, some patients may not have this option depending on the size and location of the breast cancer. Nipple reconstruction provides an opportunity to restore a natural look for patients whose nipples could not be preserved.

Cosmetic Breast Surgeries at CNSO

Reconstructive breast surgery after mastectomy is not the only procedure performed at CNSO. Patients can receive a variety of medical and cosmetic surgeries. They include:

Breast Augmentation (Augmentation Mammaplasty)

Breast augmentation is among the most commonly performed cosmetic surgeries in the country. It may be used to give women a fuller, firmer, or more symmetrical look. It can also help balance breast sizes or compensate for lost mass after pregnancy or surgery.

When performing a breast augmentation, the surgeon begins by making incisions. These are placed in the armpit, in the crease underneath the breast, or around the areola. This placement minimizes the visibility of future scars. The breast is then lifted, allowing an implant to be placed either underneath the breast tissue or behind the chest wall muscle. As with reconstructions, the implant is a silicone shell filled with saline. Once the implant is placed, the incisions can be closed.

Patients may feel tired and sore for a day or two after receiving breast augmentation surgery, but this passes quickly. Most patients return to work within one week. Post-operative pain and sensitivity will continue to diminish over the next few weeks, and scars will begin to fade after a few months.

Breast Lift (Mastopexy)

Breast lift, also called mastopexy, is performed to reshape breasts that are sagging due to age, weight loss, pregnancy, or other factors. The results provide a more youthful contour to boost the patient’s body image. This procedure can also be done to create symmetry after reconstructing the other breast.

To perform this procedure, the surgeon carefully trims and tightens excess skin and tissue. This creates a firmer feel, higher placement, and more uplifted contour. The surgeon may also reposition or resize the nipple and areola to be more proportional with the rest of the breast. All incisions are placed to effectively hide or disguise future scars. Many patients choose to receive this procedure in combination with an augmentation or reduction to achieve their desired look.

As with an augmentation, patients may initially feel sore. This soreness passes quickly, and patients may return to work within a week. Post-surgical pain and sensitivity continue to diminish, and scars will begin to fade after a few months.

Breast Reduction (Reduction Mammaplasty)

Breast reduction, also called reduction mammaplasty, is performed to reduce the size of breasts. Large breasts can have a significant impact on a patient’s well-being, with consequences including pain, posture changes, skin irritation, and low self-esteem. Breast reduction provides relief.

During this procedure, the surgeon makes an anchor-shaped incision, starting from the location of the new nipple and cutting down toward the crease beneath the breast. He then removes fat and glandular tissue to reduce the breast’s mass. Liposuction is sometimes needed to remove fat from the armpit area as well. Skin and support tissue are then tightened to avoid wrinkling or dimpling, and the nipple and areola are relocated to their new position.

The patient will wear an elastic bandage or surgical bra after the surgery. This provides compression to hold the breasts in place while they heal. Drainage tubes may also be necessary to remove fluid during recovery. Stitches are removed after a week. The bra must be worn for about one month.

Receive Reconstructive and Cosmetic Breast Surgery in New Jersey

Breasts are an important factor in a woman’s body image and self-confidence. Women who need reconstruction or modifications can find high-quality care at CNSO. Based in northern New Jersey, CNSO is an all-inclusive team of leading board-certified neurosurgeons, orthopedic spine surgeons, interventional pain management physicians, physiatrists, rehabilitation specialists, and certified physical therapists.

This team provides personalized surgical and non-surgical care to patients with all needs, from medically necessary procedures to cosmetic enhancements. Their comprehensive treatment model delivers support at every stage, from diagnosis and planning to treatment. CNSO offers convenient locations, including Bergen, Passaic, Essex, Morris, and Hudson counties.

To learn more about breast reconstructive and cosmetic surgery, contact CNSO today.

Frequently Asked Questions About Breast Surgery

Who performs breast surgery at CNSO?

At CNSO, breast surgery is performed by Dr. Hakan Kutlu. Dr. Kutlu is a leading, board-certified plastic surgeon with extensive experience in breast reconstruction and cosmetic surgery.

Can surgeons treat both breasts simultaneously?

Not all breast surgeries require both to be treated. After a mastectomy, for example, reconstruction surgery may be needed to reshape only the affected breast. For many women, however, both breasts need to be modified to ensure they are symmetrical. It is difficult to match drooping breasts using a surgical procedure. To reduce drooping and achieve symmetry, the opposite breast is often shaped with a lift. Patients may also need both breasts modified when receiving a breast augmentation or lift.

If the patient needs both breasts to be modified, the surgeon will complete both during one procedure. This reduces costs for the patient and allows for a shorter recovery time.

Are breast implants permanent?

Breast implants are not permanent. Future replacements may be required to maintain the effects of the surgery. They may also be removed if desired, though the patient’s skin may dimple, pucker, or wrinkle afterward.

Do breast surgeries interfere with breastfeeding?

Whether or not a patient can breastfeed after surgery depends on the procedure received.

• Breast reconstruction: This surgery aims to restore the normal look of a patient’s breast and does not restore milk production. The patient cannot breastfeed.
• Breast augmentation: Depending on the size and placement, implants may interfere with milk production. The patient may or may not be able to breastfeed.
• Breast lift: This procedure does not interfere with milk production. Nursing can counteract the surgery’s benefits, however, so patients are advised to delay surgery until after their children no longer need breastfeeding.
• Breast reduction: This procedure removes most milk-producing organs. Patients cannot breastfeed after receiving this procedure.

Can I get pregnant after breast surgery?

It is possible for women to become pregnant and nurse children after receiving breast surgery. However, pregnancy can counteract the effects of reshaping. It is recommended that women interested in cosmetic breast surgery wait until after having children.

How do breasts look and feel after surgery?

With all breast surgeries, including reconstruction, the CNSO surgeon aims to achieve the most natural-looking results. However, reconstructed breasts do not have the exact feel of a natural breast. Patients should remember this to set realistic expectations before undergoing a reconstruction procedure.

Does breast surgery create scars?

Breast surgery does leave visible scars. Incisions are placed in locations to minimize visibility, such as in the armpit or around the areola. They begin to fade after several months and will continue to fade over a few years.