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Breast Reconstruction


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Breast Cancer Reconstruction

Avant Aesthetics and Plastic Surgery is committed to helping patients in their fight against breast cancer. During his training as a plastic and reconstructive surgeon, Dr. Liu trained with world-renowned micro-vascular surgeon, Fu-Chan Wei, and the world-renowned breast reconstruction expert and pioneer, Dr. Robert Allen. As such, Dr. Liu is able to offer you the latest and most advanced techniques in breast reconstruction.

While the decision to pursue breast reconstruction is very personal and individualized, Dr. Liu is ready offer you the information and resources you need to make the best decision for you. Together with his team at Avant Aesthetics, they can safely, quickly, and efficiently perform the latest, most complex and demanding reconstructions available today. Dr. Liu has vast experiences performing all types of breast reconstructions, ranging from simple implant reconstructions to DIEP, SIEA, and SGAP/IGAP autologous reconstructions.

While many surgeons are able to perform breast reconstruction procedures, Drs. Liu believes that breast reconstruction involves more than simply making either a mound of tissue or some semblance of a breast where your own breast had been. He not only strive to achieve a natural and normal looking breast, but also to improve upon what had been there. The term “aesthetic breast reconstruction” integrates aesthetic breast rejuvenation into the reconstructive process. This is why his patients believe he delivers some of the best breast cancer reconstruction surgery Beverly Hills has to offer.


Expander / Implant

Breast reconstruction following cancer surgery can be accomplished using the same silicone implants that are often used for breast augmentation. The procedures are similar, but using them for reconstruction is a more difficult procedure because of the lack of native breast tissue to hide the implants for a more natural result. Implants are placed underneath the pectoralis major muscle, which can hide the implant superiorly. Inferiorly, we place cover the implant using a piece of acellular dermis that helps camaflouge the implant. Reconstructions are typically performed in two stages, where a tissue expander is placed first to recruit more of your own tissue for the reconstruction. During a second stage, the expanders are exchanged out for silicone implants. Sometimes patients may be good candidates for a single-staged procedure, without the need for expander placement.

Pedicled Flaps

Various types of rotational flaps can be utilized to create neo-breasts. Two of the most common and popular options include TRAM flaps and Latisimus Dorsi flaps. Post-reconstruction, patients usually have to stay in the hospital several days to recover.

TRAM flaps are Transverse Rectus Abdominus Myocutaneous flaps and takes the fatty tissue from your abdomen to create a new breast. This is a popular option because patients get a tummy tuck in addition to a new breast. In most people, there is sufficient tissue to create a nice sized breast. The drawback to this procedure is that patients often have a weak abdominal wall.

Latisimus Dorsi flaps are muscle-skin flaps taken from your back to reconstruct your breast. These flaps often lack the volume to create a full-sized breast and are used in conjunction with breast implants. These types of reconstruction often look and feel more natural than implant-alloderm reconstructions because you have both muscle and fat camouflaging the implant.

Microsurgery / Free Flaps

These are the most advanced and technically demanding breast reconstruction techniques available today. We are able to take spare tissue from different parts of your body, from areas where it won’t be missed, and utilize it to make a new breast. Using perforator flaps, only skin and fat will be removed, leaving your muscles intact. These are the best reconstructive options in terms of donor site morbidity and aesthetic appearance of the reconstructed breast.

The most common area to take tissue from is the abdomen. Like the TRAM flap, patients get a tummy tuck along with the reconstruction. However, unlike the TRAM, there will be no abdominal weakness following this procedure.

Other areas we can take tissue from include the buttocks (IGAP, SGAP), the inner thigh (Gracilis, TUG), and outer thigh (ALT). These can all create very nice breasts with relatively minor donor site morbidity.

Despite the superior aesthetic results of autologous free tissue transfers, the drawbacks to these procedures is the need to be hospitalized for several days. The flap needs to be monitored carefully during the post-operative period and there is always a risk of flap failure and the need to surgically re-explore the flap. Overall, free tissue transfers have a success rate of 95-98%.

Autologous Fat Grafting

Autologous Fat Grafting is a safe and effective procedure for secondary breast reconstruction. This procedure can help to improve contour, volume, and over breast symmetry. Autologous breast reconstruction involves taking skin and fatty tissue from another part of your body and moving it to the chest area to give the reconstructed breast natural feeling volume. The donor tissue can be grafted on from your stomach or back (e.g. TRAM flap reconstruction, Latissimus Dorsi reconstruction) or from other parts of your body where the vessels are divided and reconnected to your chest blood vessels. This later type of breast reconstruction is a free flap micro-surgical reconstruction (e.g. DIEP reconstruction, ALT reconstruction, SGAP reconstruction, or IGAP reconstruction).This procedure is continuing to grow in popularity because of the resulting appearance of the breast and the near-normal sensation.

Revisional Breast Reconstruction

Revisional Breast Reconstruction can be performed as maintenance or corrective procedure. Dr. Liu performs revisions and enhancements on previous reconstructions and augmentations to shape, contour and redefine breast symmetry. As the field continues to improve and evolve, advances are being made in surgical techniques to help enhance any previous procedures.