Breast reconstruction is a very important appointment for women. Breast cancer can be overwhelming for the patient and her family once she learns of her diagnosis. We have taken care of hundreds of patients in Phoenix with breast cancer left in need of reconstruction. There are many options for reconstruction. All these options can be entertained immediately at the time of the mastectomy or can be performed in a delayed fashion. Spacing weeks, months or even years after the original mastectomy. Many patients choose to have the breast reconstruction at the time of the mastectomy. Other patients choose to have their reconstruction later. Some women, of course, choose not to have breast reconstruction at all.

Dr. Jacobsen recognizes there are many options for breast reconstruction services in Phoenix and Scottsdale. From his experience, most breast reconstruction consideration usually occurs during a very delicate time in a woman’s life, often having gone through chemotherapy and radiation, and even may have possibly gone through a failed breast reconstruction elsewhere. Often, women are emotionally, physically, and financially exhausted from the journey of their breast cancer, reconstruction and treatment. Here we believe all women in need of breast reconstruction deserve the best reconstruction, care, and surgeon to allow for a stress-free, supportive environment. As a Restorative Surgeon, Dr. Jacobsen feels very privileged for every patient that allows him to care for their breast reconstruction – a very personal, precious part of your life and body to entrust to a cosmetic professional.

Here at the office, we realize there are many competent surgeons in the Phoenix Valley that can do an excellent job for you. Many of these surgeons advertise themselves as the best breast reconstruction surgeon in Phoenix or even or the best breast reconstruction surgeon in Arizona. Here, however, not only does Dr. Jacobsen provide an excellent service, but will allow you all the care you need to provide you with the best, most comfortable experience as possible. Having over 26 years of experience, certification and backing with the Arizona Medical Board, Dr. Jacobsen is dedicated to providing all his patients with the utmost care. Having his close working staff answer questions, and providing a fastidious follow-up, available 7 days a week. A breast reconstruction is more than a procedure and requires special care. Dr. Jacobsen always assures an excellent, safe, surgical procedure for your breast reconstruction and will be there for you after surgery. As part of his post-op care, Dr. Jacobsen will be there for you, to answer your call, emails, and text messages post-surgery. He hopes that with his excellent surgical skills and wonderful caring postoperative service that you feel as though you experienced the best breast reconstruction and the best breast lift Phoenix has to offer.

For a Breast-Reconstruction, there are many ways to reconstruct the breast. The most common way is to use a tissue expander, which is placed under the muscle. Allowing the implant and breast to expand slowly over time. This type of breast implant is placed flat under the muscle without any volume in it. After the patient recovers for 2 or 3 weeks, we then began to place some fluid into this implant each week. Slowly expanding the muscle and the skin to create the newly formed breast. This type of reconstruction is done by placing a very small needle into the port in the implant located within the breast and is built to receive the fluid on a regular basis. Eventually, when the breast expands to an adequate volume, the secondary operation is performed. In this short, simple operation the tissue expander is removed, then typically replaced with a silicone implant; which generally is heavier and thicker than the previous expander. The gel silicone implant reshapes the breast and gives a softer more natural look for the reconstruction.

There are also more complex ways to reconstruct the breast. Some involving taking flaps from the abdomen or from the back. These are generally more complex and require more downtime and hospitalization. In most cases, procedures like these are only utilized in circumstances where adequate tissue for expander is not present, or where patients are dealing with other complications, such as radiation. Most women elect for the expander reconstruction because downtime is minimal, and complications are controlled. Hospitalization time is usually only overnight.

A latissimus dorsi flap uses muscle, fat and skin from the back tunneled to the mastectomy site and remains attached to its donor site, leaving the blood supply intact.

Occasionally, the flap can reconstruct and complete the entire formation of the breast, but often only provides the muscle and tissue necessary to cover and support a breast implant.

The appearance of the reconstructed breast is largely dependent on the health and the body contouring the habitus of the patient at the time of the mastectomy. The breast reconstruction helps to recontour the breasts and restore shape to the upper body. Women who undergo this procedure often feel whole and are happy with the results of how their new breasts fit in their clothing and brassiere. Dr Jacobsen realizes that breast reconstruction requires a relationship with your surgeon. For this type of procedure, it is not uncommon to see Dr. Jacobsen in the office 2 or 3 times before the process is complete. In case chemotherapy or radiation is required this process can be prolonged.

Complications associated with breast reconstruction can include infection and complications with the wound interfering with the healing process, requiring additional surgery. Due to the nature of reconstruction, reconstruction does require more attention than a typical breast augmentation. Dr. Jacobsen’s staff are very happy to help you through this whole process. If you stick with us we will stick with you during every phase of your breast reconstruction. Whatever that may be, we are here to help. Since this is such an intimate procedure most patients do not disclose photos to be used by the office at this time.

To keep a symmetrical appearance and avoid any complications later on, many women chose to remove both breasts and allow each side to be reconstructed. Even if the other side does not have any cancer present. In Dr. Jacobsen’s experience, these are among some of the happiest patients. This allows both sides to be lifted, augmented and reshaped in a similar fashion to reflect the changes of the reconstructed breast. Once both sides are removed mammograms are no longer needed, and there is no concern that the other breast may develop cancer as well. This service can be provided and covered by your insurance company.

Coming from an experienced breast surgeon in Phoenix, having both breasts removed is an option that often yields some of the best. Having both breasts removed and reconstructing both breasts removes the need for mammograms in the future, allows for more accurate symmetry, and a peace of mind knowing that the other breast will not form cancer. Generally speaking, it is difficult to make the reconstructed breast look the same as the natural breast. Dr. Jacobsen has found that women with both breasts removed are the happiest and most satisfied mastectomy patients he takes care of, and have the best symmetry as both breasts look the closest to one another as possible. Often the contour is different, the shape is different, and the quality of the skin is different as well so a bilateral mastectomy is often recommended by Dr. Jacobsen. We respect the women’s prerogative and it is entirely the woman’s choice but it is important to inform our patients of their options.

Partial mastectomies for breast cancer often create a separate set of reconstructive problems. Often a lumpectomy which requires postoperative radiation leaves a contour abnormality in 1 quadrant of the breast. The radiation then that is required after the lumpectomy can cause injury to the breast as well and some absorption and loss of volume in fat and can cause injury to the skin and scarring. As a result sometimes, this partial mastectomy and the subsequent radiation that is intended to preserve the breast often creates a separate problem for the patient. This can often be reconstructed with various techniques to release the scar remove the scar or to add an implant to fill out the defect caused by the radiation and the lumpectomy. These are important factors for you to remember when choosing your breast surgeon in Phoenix.

The effort to go through breast reconstruction requires a relationship with your surgeon. A patient will often see Dr. Jacobsen in the office 20 or 30 times before the process is complete. This will be prolonged if he happened require chemotherapy or radiation. There are complications with breast reconstruction which include infection and problems with wound healing that require additional surgery. It is more complicated to reconstruct her breasts that it is to perform a breast augmentation. But Dr. Jacobsen’s staff are very happy to help you through this whole process. If you stick with us we will stick with you when we will get you where you need to be with the breast reconstruction.

Also, many patients choose to have the other breast that does not have cancer on the other side to be removed at the same time so both breasts can be reconstructed and appear similar and give a better symmetrical look at a better fit and their clothing after surgery. The happiest patients in Dr. Jacobsen’s experience are those that have both breasts removed as a no longer needs mammograms and in no longer have the worry or concern over the years that the other breast may develop breast cancer as well. Also, the look is much better when both breasts are reconstructed as he fitting into clothing much more favorably.

Alternatively, the other breast, the breast without cancer, can be reconstructed as well and lifted her made larger or reshape to match the reconstructed breast. This service can be provided to you and is covered by her insurance company.

What do reconstructed breasts look like? Examples from Mentor:

Learn more about the different stages of breast cancer and the breast reconstruction options available to you after treatment.

Understanding the breast reconstruction procedure is part of your treatment and recovery journey. We’re here to help you explore your options so you have the best information when the time is right to consider reconstruction surgery.

If you or someone you know has been affected by breast cancer, you probably have a lot of questions. Get answers to some of the most frequently asked questions to help you start learning about the basics of breast cancer.

Breast cancer is a disease in which abnormal, cancerous cells form in the breast. These cancer cells are malignant—harmful and have a tendency to spread—and can, if untreated, affect other parts of the body.

Breast cancer can start in several places within the breast. The breast area is comprised of lobes, lobules, ducts, lymph nodes and lymph vessels surrounded by fatty tissue and structural muscles. Cancer most frequently begins in the cells of either the lobules (milk-producing glands) or the ducts (passages that drain milk from the lobules). Less commonly, malignant cells will develop in the stroma, the fatty and fibrous tissues surrounding the breast.

Hereditary breast cancer means that a genetic abnormality and predisposition to breast cancer is inherited from the patient’s mother or father. People who inherit this genetic abnormality inherit an increased risk of breast cancer. At this time, it is estimated that 5% to 10% of breast cancers are hereditary.

There is no easy way to predict who will be afflicted with breast cancer, but we do have some information on hereditary breast cancer and breast cancer risk factors.

The majority of breast cancer cases are not hereditary, resulting instead from genetic abnormalities that occur due to age or other breast cancer risk factors like these:

• Age: The chances of getting breast cancer increase as age increases.
• Amount of menstrual periods: Women who began having periods early (before the age of 12) or experienced menopause later (after the age of 55) have a slightly increased risk of breast cancer. These women have been exposed to a greater amount of estrogen and progesterone, because they have had a larger amount of menstrual periods.
• Dense breast tissue: Women with dense breast tissue have increased risk for breast cancer, because they have more glandular tissue and less fatty tissue.
• Child bearing at a later age or not at all: Women who give birth to children after the age of 30 or who do not give birth to any children have a slightly higher risk of breast cancer. This may be in part because pregnancies reduce the overall amount of menstrual periods.
• Alcohol consumption: The ingestion of alcohol is clearly linked to an increased risk of breast cancer. Risk increases with the amount of alcohol consumed.
• Race: White women are more likely to get breast cancer than most other races. African American women are more likely to suffer terminal versions of breast cancer. Asian, Hispanic and American Indian women have a lower risk of breast cancer.

It is important to note that having one or more risk factors does not mean you will contract breast cancer. Likewise, you may get breast cancer even if you do not have any risk factors.

Signs of breast cancer include—but are not limited to—lumps or other visible changes in the breast. If you experience a mass or thickening in or near your breast or underarm area, fluid leakage, a change in skin texture or a change in breast size or shape, you should consult your doctor right away. These symptoms may also be caused by conditions other than breast cancer.

Sometimes, in the early stages of breast cancer, there are no symptoms or visible signs. Screenings administered by medical professionals are the best way to find this type of breast cancer.

Your doctor may use one or more of the following breast cancer detection methods:

• Physical exam: an examination of the body to check for external signs of illness
• Mammogram: an X-ray of the breast
• Magnetic resonance imaging (MRI): a procedure that uses magnet and radio waves to produce an internal picture of the breast
• Ultrasound exam: a procedure that uses high-energy sound waves to produce an internal picture of breast tissues
• Biopsy: the removal of suspicious cells or tissues so they can be examined for signs of cancer

If breast cancer is found, further tests will be done to study the cancer cells and diagnose your breast cancer stage. Your treatment options will depend on the results of these tests.

If you are diagnosed with breast cancer, you should begin treatment right away. The treatment and reconstruction process can be complex. It is important to have a trusted team of doctors to advise and care for you every step of the way. Your breast cancer care team should include:

• Surgeon: He or she will perform any necessary biopsies of the breast and the subsequent lumpectomy or mastectomy.
• Pathologist: This doctor will study the tumor to determine the degree of malignancy (stage of breast cancer).
• Medical oncologist: This specialist administers anticancer drugs and/or chemotherapy.
• Radiation oncologist: This is a physician who administers radiation therapy.
• Plastic surgeon: He or she will guide you through the process of breast reconstruction after the cancer has been removed.

Breast cancer is a very complex disease that scientists are working hard to learn more about every year. You should talk to your doctor for more detailed answers and specialized concerns.

If you are undergoing a two-stage breast reconstruction, your surgeon will use a breast tissue expander.

The unfilled tissue expander is inserted during the breast reconstruction procedure. Sterile saline fluid is then gradually added over a period of several months by inserting a small needle through the skin into the tissue expander’s filling port. Your breast tissue expands to accommodate the growing size of the tissue expander.

Your surgeon will remove the tissue expander and replace it with the implant you have selected when your tissue has reached the appropriate size.

• FDA cleared
• Filled with a saline solution similar to the fluid found in the human body
• Flexible volume, can be adjusted by your doctor
• Two shell surface options: smooth or textured

CPX®4 Breast Tissue Expanders are placed after the breast tissue is removed. CPX®4 can be used during immediate breast reconstruction or delayed breast reconstruction to stretch breast skin and chest wall muscles to make room for a permanent breast implant.

MENTOR® ARTOURA™ Breast Tissue Expanders are designed to expand primarily in the lower portion of the breast by utilizing internal silicone components to control the expansion. The resulting pocket will accommodate your selected breast implant and slope like a natural breast. They also have a SILTEX® Texture textured shell that promotes a reduction in shifting with the goal to minimize capsular contracture.

In some immediate reconstruction procedures, an adjustable implant can be used in a one-stage procedure. MENTOR® SPECTRUM® Post-Operatively Adjustable Saline Breast Implants are the only saline breast implants that allow your surgeon to adjust the size of your implant for up to six months after your procedure. The MENTOR® SPECTRUM® Implant functions as a long-term saline breast implant. It can be placed with minimal volume of 105/235 cc’s, during your initial surgery, and your surgeon can gradually increase the fluid volume over time to a maximum of 690/780 cc’s, depending on which profile your surgeon chooses for your surgery.

BREAST RECONSTRUCTION WORDS TO KNOW

Pigmented skin surrounding the nipple.

Also known as augmentation mammaplasty; breast enlargement by surgery.

Also known as mastopexy; surgery to lift the breasts.

Reduction of breast size and breast lift by surgery.

A complication of breast implant surgery which occurs when scar tissue that normally forms around the implant tightens and squeezes the implant and becomes firm.

Deep Inferior Epigastric perforator flap which takes tissue from the abdomen.

An area of your body where the surgeon harvests skin, muscle and fat to reconstruct your breast – commonly located in less exposed areas of the body such as the back, abdomen or buttocks.

Surgical techniques used to reposition your own skin, muscle and fat to reconstruct or cover your breast.

Drugs and/or gases used during an operation to relieve pain and alter consciousness.

A surgical technique to recreate your nipple and areola.

Blood pooling beneath the skin.

Sedatives administered by injection into a vein to help you relax.

A surgical technique that uses muscle, fat and skin tunneled under the skin and tissue of a woman’s back to the reconstructed breast and remains attached to its donor site, leaving blood supply intact.

This flap is particularly useful for ladies who have very thin skin or had a great deal of skin removed from the mastectomy or that it had advanced radiation and have injury to the chest wall. Dr. Jacobsen has performed this surgery hundreds of times with a great degree of success. One common misconception is that this operation is painful, but in reality this operation much less painful than one would suspect. Usually this operation can be done in less than an hour and the patient can leave the hospital the same day.

A drug injected directly to the site of an incision during an operation to relieve pain.

The removal of the whole breast, typically to rid the body of cancer.

Superior Gluteal Artery perforator flap which takes tissue from the buttock.

A surgical technique to stretch your own healthy tissue and create new skin to provide coverage for a breast implant.

Also known as transverse rectus abdominus musculocutaneous flap, a surgical technique that uses muscle, fat and skin from your own abdomen to reconstruct the breast.