Breast Reconstruction in Houston, TX

Our board-certified plastic surgeon, Dr. Jay Shenaq, is passionate about breast reconstruction. Known throughout Houston, TX and the surrounding area, Dr. Shenaq is the plastic surgeon many oncology doctors refer their patients to for their breast restoration as a final step in cancer recovery. Breast reconstruction is also common following traumatic accidents or to fix birth defects. We provide multiple  techniques (including creating a tissue flap, a tissue expander, and/or breast implants to restore the shape of the breasts) to help you design a personalized treatment plan to restore your body and confidence.

Breast reconstruction is a transformative procedure that offers numerous advantages for individuals who have undergone mastectomy or experienced breast trauma. This surgical option not only restores physical wholeness but also has profound emotional and psychological benefits. A personalized breast reconstruction surgery designed by Dr. Shenaq provides functional, aesthetic, and quality-of-life benefits, including:

• Offers multiple, customizable surgical options
• Creates dramatic, natural-looking results
• Enhances body proportion and balance
• Helps to restore self-image and confidence
• Supports physical and emotional harmony
• Improves sexual intimacy and sexuality
• Allows you to wear more of the type of clothing you want

• DIEP (deep inferior epigastric perforator) flap reconstruction is an advanced technique used in breast reconstruction after mastectomy in which excess abdominal skin and fat are removed from the lower abdomen to reconstruct the breast. In DIEP flap reconstruction, the blood vessels are safely separated from the muscle using a microsurgical technique while preserving the muscular integrity. The abdominal tissue is completely detached from the abdomen with its blood vessels and reattached to the small blood vessels in the breast area using vessels between the ribs resulting in a microsurgical transfer. Once this is complete, the flow of the blood to the tissue is restored. The tissue is then shaped to form the new breast. The procedure is less invasive than previous methods resulting in less postoperative pain and faster recovery. Also, the procedure leaves a horizontal scar on the lower abdomen similar to that created in tummy tuck resulting in a more pleasing abdominal contour.

• SIEA (superficial inferior epigastric artery) flap reconstruction where the difference from the DIEP flap reconstruction that the blood vessels are more superficial and they travel in the fatty parts of the abdominal tissue. Therefore, it requires less dissection, but usually, the blood vessels are very small and not all patients are candidates for this procedure.
• SGAP (superior gluteal artery perforator) flap reconstruction is ideal for those who do not have enough excess abdominal tissue. These women may have a breast reconstructed from fat and skin from the upper part of the buttock area. This is done without sacrificing the underlying gluteal muscle. This procedure is considerably more demanding and lengthy because it requires Dr. Shenaq to change the position of the patient during surgery.
• TRAM (transverse rectus abdominus myocutaneous) flap reconstruction uses the lower abdominal skin and fat are transferred to the breast area by keeping the tissue attached. This procedure requires the sacrifice of the rectus muscle and is more invasive and might leave the patient with a lower abdominal bulge or a hernia. Candidates for this procedure often opt for the DIEP flap in order to preserve the rectus muscle and avoid future abdominal complications.
• Latissimus flap reconstruction utilizes the muscle on the back latissimus dorsi. This flap, usually used in combination with a tissue expander or an implant because of the limitation of the amount of breast tissue in that area. It leaves the patient with the scar on the back, and this procedure is advised only when the previous options are not available.

Breast reconstruction with a tissue expander or an implant is a common breast reconstruction technique, which involves expansion of the breast skin and muscle using a temporary tissue expander (an inflatable implant designed to stretch the skin and the muscle to make space for a future implant). After completion of the expansion process (2-3 months later), the expander is exchanged with a silicone or saline implant, which is done in the office. Although this technique requires two small separate surgeries, it is less invasive than other procedures and has a faster recovery time. The process of expansion usually begins 2-4 weeks after mastectomy, and continues until the desired size is achieved.

AeroForm is designed for women who want to take their breast cancer head on, and want to undergo breast reconstruction on their terms and their timeline. AeroForm is a revolutionary needle-free, patient controlled breast tissue expander for women who choose to have reconstructive surgery following a mastectomy. Unlike traditional tissue expanders, which require weekly doctor visits and expansion with saline injected by a needle, AeroForm patients are able to reach full expansion with just a push of a button. AeroForm is designed to bring control, convenience and comfort to the breast reconstruction process.

Dr. Shenaq's main goal of breast reconstruction is to restore breast shape, size, and symmetry in order to achieve an aesthetically pleasing outcome. Additional procedures to obtain symmetry may be necessary after the original reconstruction. This is to ensure the reconstructed breasts are as close as possible in shape, size, and have the same position of the nipples.

Our secondary procedures are: 

• Nipple reconstruction: This is usually required in the patient who had their nipples removed during their mastectomy. 
• Breast augmentation: An implant is often required to match the size of the breasts and to gain symmetry.
• Breast lift/breast reduction: Women with one reconstructed breast after a mastectomy usually will have a lift or reduction 
• Fat grafting: This secondary procedure is usually combined with implant reconstruction or partial breast deformity, after lumpectomy, or a previous flap surgery. 

Breast reconstruction surgery is common to restore one or both breasts after:

• A mastectomy or lumpectomy
• A traumatic injury that damaged the breast tissue
• Congenital/birth defects such as tubular or unsymmetrical breasts
• Extreme weight loss

There are three common breast reconstruction techniques:

• Transferring skin, muscle, and fat tissue from other areas to the breast
• Using a tissue expander to create space and then placing an implant
• A combination of implant and natural tissue enhancements

You may also need nipple reconstruction, breast augmentation, a breast lift, breast reduction, or a combination of these surgeries to enhance symmetry and provide the best aesthetic results. If only one breast is being reconstructed, the surgeon will try to match the reconstructed breast to your natural breast.

Surgical breast reconstruction is done in various stages. During some phases (like the flap creation, tissue expansion, or implant placement), general anesthesia is often used. Some patients may need to stay overnight — this is based on the current treatment phase. When the final step is completed for your breast reconstruction, you should wear a compression bra for the chest and you may be given medication by Dr. Shenaq to minimize swelling, bleeding, and discomfort. In time, the breast(s) should look more normal so you can feel more confident. Ongoing checks with breast exams and mammograms are critical and recommended for long-term health.

To create a tissue flap, the surgeon will remove a section of skin, fat, and muscle from one area of the body to move it to the breast. Tissue may be taken from the abdomen, upper back, or buttocks. Surgeons may also use a tissue expander to gradually enlarge and open space for an implant. When the skin has been stretched to the needed size, the expander will be removed and replaced with either a silicone or saline implant.

The Women's Health and Cancer Act (WHCA) was signed into federal law in 1998 and requires that health insurance companies cover breast reconstruction surgery after breast cancer. For more information on this law and breast cancer, please visit www.cancer.org.

How much does breast reconstruction surgery cost?
Breast reconstruction surgery can be complicated, so to get the best results, you should concentrate on finding a plastic surgeon who has years of experience like Dr. Shenaq instead of the cheapest price. At your consultation, Dr. Shenaq will take the time to understand your needs and goals before creating your unique treatment plan. Then, he can talk to you about costs, options for payment, and where to find low-interest financing.

Does insurance cover my breast reconstruction surgery?
Enacted in 1998, the Women's Health and Cancer Rights Act (WHCRA) requires health insurance plans that cover breast cancer surgery (mastectomy) to cover reconstruction surgery as well. If you have insurance, someone from Plastic Surgery of Houston will help you understand your coverage. We can also help you submit any needed information and paperwork to your insurance carrier.

Which breast reconstruction technique should I choose?
There is no single reconstruction technique that works for everyone. The recommended technique for you will depend on your needs, goals, and physique. In your initial consultation, Dr. Shenaq will go over your choices, including both implants and flaps, so you understand the pros and cons before deciding which is best for you. Whether you choose a flap or implants, Dr. Shenaq will do his best to give you natural-looking results.

Is nipple reconstruction included in my breast reduction?
Reconstruction of the nipple-areola complex is typically performed using 3D cosmetic tattooing. If you're interested in nipple and areola reconstruction, you should tell Dr. Shenaq during your consultation. He will discuss your options to help you decide whether you want nipple and areola reconstruction to be included in your surgical plan.

Should I have breast reconstruction with my mastectomy or wait?
When you choose to have breast reconstruction is dependent on many factors. Some patients decide to get their reconstruction performed along with their mastectomy, while others prefer to wait. Dr. Shenaq suggests you make an appointment for a consultation following a diagnosis of breast cancer so you can start thinking about your choices and when you may want breast reconstruction surgery. If you decide to have reconstruction with your breast cancer treatment, Dr. Shenaq will collaborate with your oncology team to plan your care.

How long does it take to perform breast reconstruction?
The total time of the procedure can vary from patient to patient depending on a number of factors, namely the number of breasts being reconstructed. One breast can usually be reconstructed in under 3 hours. However, if both breasts need reconstruction, the surgery could take up to 7 hours to complete.

We understand that losing the breasts as a result of cancer or an accident can result in lowered self-esteem, but having a breast reconstruction surgery may help your physical and emotional recovery. Please contact our office to schedule your consultation and learn about your breast reconstruction options.