Breast Reconstruction & Restoration

Highly trained reconstructive surgeons at Houston Methodist offer patients the most advanced breast restoration techniques in a caring, supportive environment that helps each individual successfully rehabilitate from breast cancer and other breast-related problems. As Houston’s first accredited breast program by the American College of Surgeons NAPBC (National Accreditation Program for Breast Centers), a multidisciplinary team of oncologists, surgeons, radiologists, radiation oncologists, pathologists and psychologists evaluates each patient and sets forth a precise sequence of therapies all individualized to the patient.

With a full offering of breast reconstruction options, our physicians specialize in delivering the most innovative treatments, including DIEP, SIEA and SGAP flaps. During these procedures, the surgeon transplants excess abdominal tissue, which closely resembles breast tissue, and achieves results that surpass traditional implants in both durability and form. 

Skin Sparing

Breast reconstruction takes place at the time of the mastectomy. In most cases, surgeons perform skin sparing during mastectomy, a technique that preserves the skin of the breast, and resect only the underlying tumor and affected breast tissue. Often, the nipple is resected because the ducts from which the cancer cells originate exit at the nipple. In this type of breast reconstruction, the volume of the breast, as well as a small skin patch must be restored.

Delayed Reconstruction

In cases of high likelihood for radiation after mastectomy, reconstruction is usually performed at a later date. The delay is due to the fact that the flap, or tissue used for reconstruction, can adversely and unpredictably be affected during radiation. In this type of reconstruction, entire breast skin and volume are restored.

Breast restoration includes three stages.

• Stage 1: The surgeon performs a flap procedure to reconstruct the breast and restore sensation by microsurgically connecting the sensory nerve of the breast to the sensate nerve of the abdominal tissue. Three to six months following this initial procedure, the nerve grows slowly and offers the possibility of regaining normal sensation.
• Stage 2: Approximately three months following stage 1, the surgeon will perform a secondary symmetry procedure, usually completed in clinic with no hospital stay required. The reconstructed breast is "sculpted" to match the other breast. In many cases, the unaffected breast is lifted for a more youthful appearance.
• Stage 3: In the final stage, the surgeon reconstructs the nipple from flap tissue. The areola is tattooed onto the breast during an office procedure.

Risks and Benefits
Microsurgical reconstruction provides new treatment options with better results for patients affected by breast cancer. As noted, expendable segments of tissue are harvested from the patient and transplanted to restore form, function and sensation to the breast. The major benefit of the new microsurgical procedures  is the restoration of a natural appearing breast without the patient losing any muscle from the abdominal or buttock donor site. Patients experience a relatively short hospital stay (four to five days) and can return to normal daily activities after approximately two weeks. Most patients are able to resume exercise and lifting in four to six weeks.

One risk of flap procedures is loss of the flap due to the complexity of the microsurgical techniques required to connect the tiny blood vessels. Flap loss occurs in less than three percent of cases. When an issue arises, the surgeon will perform a re-exploration procedure. All breast reconstruction and breast symmetry procedures, including the SIEA, DIEP, and SGAP, are covered by insurance.

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