Dr. Saber’s Blog

We Need to Talk About Breast Reconstruction After Cancer

October is breast cancer awareness month. Since its foundation in 1985, National Breast Cancer Awareness Month has certainly reached its goal — people are very aware of breast cancer.

However, not quite enough attention is given to breast cancer survivors. Some of the breast cancer awareness messaging — looking at you “Save the Ta-tas” — can actually be harmful to survivors who chose to save their lives over “save the boobies.”

Breast reconstruction after cancer

Breast cancer treatment

JAMA Surgery published a study of 1.2 million women with early-stage breast cancer showed that 35% underwent a mastectomy. Mastectomy surgery removes the entire breast to treat or prevent breast cancer.

Oncological therapies that don’t remove the breast tissue can also cause appearance changes. Chemotherapy and radiation therapy both attack the cancer cells, but can also cause breast swelling, changes in skin thickness, and breast skin discoloration.

Lumpectomy vs mastectomy

As previously mentioned, a mastectomy completely removes the breast — removing any existing tumor(s) as well as reducing the risk of future cancer. The JAMA study also found that almost 20% of women who had a mastectomy had a double mastectomy — removal of both breasts.

A lumpectomy is a partial mastectomy. Instead of removing the entire breast, only a portion of the breast containing the tumor is removed.

Some patients may be able to have a nipple-sparing mastectomy, removing breast tissue while keeping the nipple and areola intact.

What is the goal of breast reconstruction after cancer treatment?

Patients who’ve had a mastectomy had a few options after surgery. Patients who’ve had a double mastectomy sometimes choose to not have reconstruction and instead just embrace their new flat chest. Tattooing over mastectomy scar tissue is a growing art that many patients choose.

Prosthesis are also available for breast cancer survivors. A breast prosthesis is a breast form that fits into your bra and matches your natural breast. The downside of a prosthesis is that it’s temporary and can be uncomfortable if it doesn’t fit perfectly into your bra.

The different types of breast reconstruction aim to create a new breast that matches the remaining natural breast. Breast reconstruction can also be combined with breast reduction, lift, or augmentation to improve the appearance of both breasts.

If the nipple could not be spared during your mastectomy, your breast surgeon can perform nipple reconstruction. They’ll reconstruct a nipple from your tissue and tattoo on an areola.

Breast reconstruction after cancer

According to the American Society of Plastic Surgeons, over 130,000 people had breast reconstruction surgery in 2020. Performed at the time of your mastectomy (immediate reconstruction) or sometime after your mastectomy (delayed breast reconstruction), the objective of these surgical procedures is to restore breast shape and appearance.

There are many reconstruction options depending on the patient’s needs, medical history, and any ongoing cancer treatment. Consult with your oncologist and a board-certified reconstruction surgeon to determine the best reconstruction option and timing for you.

Flap reconstruction after breast cancer

While breast surgery may call to mind implants, they aren’t the only way to rebuild the breast mound. Many people prefer flap-based reconstructive procedures because it’s autologous (it uses your own tissue instead of a foreign implant).

Pedicled vs free flap procedure

There are two types of autologous reconstruction:

  • Pedicle: The tissue, muscle, and blood supply all stay attached and are moved under the skin from the donor site.
  • Free flap: The donor tissue is completely removed from the body and transplanted to the new site.

Whether your reconstruction technique is pedicle or free flap will depend on which part of the body the donor tissue is coming from.

  • Latissimus dorsi (LD flap) uses skin, fat, and muscle from the back. The tissue is transferred under the skin to the breast while maintaining its connection to the blood vessels.
  • Superior gluteal artery perforator (SGAP flap) takes tissue from the buttocks and grafts it to the existing breast tissue, muscle, and blood supply.
  • Deep inferior epigastric perforator artery (DIEP flap) is another pedicled flap. The skin, fat, and blood vessels are moved from the abdomen.
  • Transverse rectus abdominis muscle (TRAM flap) also takes tissue from the abdomen, but also includes muscle.

Implant-based reconstruction after mastectomy

A popular choice for breast augmentation, breast implants have been used for decades to add volume to breasts. Breast implants can also be used in conjunction with flap reconstruction if the flap doesn’t contain enough tissue or fat.

Breast reconstruction after cancer

For implant reconstruction, the shape and size of the breast is recreated using a saline (salt water) or silicone implants. While the past was full of horror stories of leaking breast implants, our new implants are much safer. Rather than a more liquid silicone gel that can leak, modern silicone implants are “form stable” and retain their shape even if the shell breaks.

Patients who will continue to need radiation therapy after their mastectomy are advised to have delayed breast reconstruction if they’re having breast implants. A tissue expander can be placed instead, holding the shape of the breast until it can be swapped out for a permanent implant.

What are the risks of breast reconstruction surgery?

When performed by a skilled reconstructive surgeon, the risk of side effects is rare. Common risks of any surgery include:

  • pain
  • infection
  • build up of fluid (seroma)

A more severe (and rare) risk of breast reconstruction is capsular contracture. This complication of breast implants occurs when scar tissue around the implant begins to tighten. This scar tissue causes deformities and makes the breast feel hard. A skilled surgeon can release this tight scar tissue, resolving the problem.

Why is Dr. Saber the best breast reconstruction surgeon in Los Angeles?

Dr. Sepideh Saber, MD, FACS, and the Valley Institute of Hand & Reconstructive Surgery offer a more sensitive, female perspective for patients of all ages, genders, and orientations. Patients from all walks of life have praised their outcomes and their caring, thoughtful approach to all types of appearance and health-related matters.

A plastic and reconstructive surgeon, Dr. Saber earned her medical degree from Stanford University’s world-renowned medical school. She did her reconstruction and plastic general surgery residency at the University of Southern California, then completed a fellowship at New York University (NYU) in the Division of Plastic and Reconstructive Surgery in the extremely challenging and delicate area of hand surgery and microsurgery. She also did her clinical research in the Department of Surgery at Stanford Medical School.

To request a consultation, call (877) 205-4100 or schedule a consultation online.

The Valley Institute of Hand & Reconstructive Surgery and Dr. Saber is located in Encino, CA, for patients throughout the Los Angeles County area. We are also convenient to Encino, Woodland Hills, Sherman Oaks, Calabasas, Burbank, Glendale, Hidden Hills, Agoura Hills, Northridge, North Hollywood, Malibu, Topanga, Canoga Park, Reseda, Valley Glen, Chatsworth, West Hills, Winnetka, Universal City, Bel Air, Beverly Hills, Westwood, Downtown Los Angeles, Silverlake, and Echo Park.

The Valley Institute of Hand & Reconstructive Plastic Surgery also specializes in outpatient microsurgical reconstruction, upper extremity reconstruction, reconstructive microsurgery, breast reconstruction, extremity salvage, foot reconstruction, and microvascular surgery, to name a few. 

Dr. Saber graduated from Stanford University’s world-renowned medical school and did her plastic and reconstructive surgery residency at the equally lauded University of Southern California. She then completed a fellowship at New York University in the extremely challenging and delicate disciplines of hand surgery and microsurgery.

Dr. Saber offers a more sensitive, female perspective for patients of all ages, genders, and orientations. Former patients from all walks of life have praised not only their treatment outcomes but her caring, thoughtful approach to a wide array of appearance and health-related matters.
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    Dr. Sepideh Saber, MD, FACS

    👩🏻‍⚕️ Board Certified Plastic Surgeon
    🏫 Stanford/USC/NYU Trained
    🏥 Encino, CA | Book a Free Consult
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Give us a call to set up a complimentary consultation with #DrSaber who will create a customized plan for you!

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    ✨ Our lovely patient came in for our Bilateral Breast Reduction procedure✨

The procedure gave her tremendous relief of back pain, neck and shoulder pain, bra strap grooving, and rashes under her breast folds. Our patient also feels much more comfortable wearing any type of clothes she likes. 

Give us a call to set up a complimentary consultation with #DrSaber who will create a customized plan for you!
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  • What patients say about Dr. Saber

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    I was fortunate to find Dr. Saber after researching board-certified surgeons who specialize in breast cancer reconstruction revision surgery. I knew I was in good hands from the moment I spoke with the lovely and efficient Marlene, Dr Saber's office manager. Dr Saber patiently listened to my concerns and, after examining me, explained what I could realistically expect the outcome to be from another surgery. She also explained to me that she would need to review my previous surgery notes before we could discuss a possible further surgery, which I found comforting and highly ethical. I also discussed a couple of other procedures that I would like done, including fat removal from my large upper arms that had caused me great embarrassment for several years. Dr. Saber is an excellent surgeon who is incredibly kind and genuine. She truly understands the female body and the emotional aspect of body insecurities yet, she is transparent about what can and cannot be done and takes time to discuss realistic expectations and outcomes. My breast reconstruction revision surgery will take place in the New Year, but in the meantime, I have the most fabulous upper arms that I recently flaunted in a strapless dress (something I have not done in years). Dr Saber is truly one of a kind, and I still cannot believe how fortunate I am to have found her. I highly recommend Dr Saber.

    Linda DeCarlo November 29, 2023

    I don’t have enough wonderful words to describe Dr Saber and Marlene! I had a tummy tuck done this year and from start to finish the entire experience was amazing. Marlene is always so helpful and works so hard to make every detail a breeze for you. When I had my consultation with Dr Saber I was at a point of complete agony with my body. She instantly took that stress and frustration off my shoulders! As a woman not being heard by doctors for years I left that consultation with happy tears knowing I had finally found my Dr. It was a major surgery and I felt completely zen and at peace going in because she really does make you feel that safe. I didn’t think I would ever look the way I do now! She gave me the gift of having the body I kept fighting for. I will never stop recommending her.

    Monica Prusa October 9, 2023

    I saw Dr. Saber when I broke my wrist. I ended up having to have surgery. She did an excellent job and I am healing nicely. She was very professional, but was also very kind and compassionate. I would highly recommend her!!

    Sandy Schaupp September 13, 2022

    I LOVED DR SABER!!! There are a few reasons why I chose her. One was because she’s a female Doctor that was my goal who also did a good job (which I was able to confirm with all her before and after photos) and what sold me was my safety in mind. She made me feel like I was in the best hands ever along with Marlene who coordinated everything THANK YOU LADIES! Dr Saber helped me get back the body I have always desired. I had a lot of stomach fat from weight gain and I lost weight so a lot of my weight was in my front lower and upper abdomen. Now I have a super beautiful curvy body like an hourglass after a tummy tuck and lipo she did. She understood the assignment hahaha . I’m 32 years old no kids just wanted to enjoy my younger body looking and feeling beautiful and she really took good care of me. Even after hours I had an emergency due to my fault but she was there and got back to me very quickly and I’m very grateful. I also think her work says a lot because I stopped taking pain medication on the 3rd day after surgery and was fine with very minimal pain I was able to tolerate the healing process. Highly recommend going with her I just had a wonderful experience and would do it all over again if I had too. Maybe after I have kids. Thanks Dr Saber and team <3

    STEPHANIE d July 15, 2022

    Dr.Saber is by far one of the best plastic surgeons. I love how she takes her time to explain any procedure to the patients understanding. She always makes sure to answers any and all questions.From fillers to body contours she’s the one you want.

    Katherine Melara February 15, 2022

    Dr Saber is amazing! She is caring and very informative. I went in for fillers and she explained procedure step by step. I highly recommend her and look forward to future visits.

    Amanda Vazquez December 18, 2020

    Dr. Saber was friendly, knowledgeable and professional. She took time to listen, answer all my questions and was forthright in her recommendations. Her staff was friendly and helpful. I was very happy with the results and plan on going back. If you are looking for a first rate professional experience look no further she is the doctor for you!

    T R December 18, 2020

    Dr. Saber is one of a kind plastic surgeon with a heart of gold. She is a well verse plastic surgeon that puts her patient's needs before anything else. She genuinely cares about every single patient, and her work speaks for itself. I notice every post-operative result on her Instagram (@saberplasticsurgery) the patients have this glow that radiates through. I have been going to Dr. Saber for my Botox for the past 3 years, and love the results every time. I know who I will be going to for any future plastic surgery needs, and will confidently refer family and friends to Dr. Saber for any Botox, fillers, and plastic surgery consultations.

    Rudy Garcia December 16, 2020

    I have nothing but great things to say about Dr. Saber! I am so pleased with my results from a breast augmentation she performed on me back in late June! She answered all my questions and concerns before and after my surgery. She’s very easy to get in contact with and she’s so nice. She made feel so comfortable throughout the whole process. 100/10 Lover her work!!

    Amanda Villegas October 15, 2020

    Dr Saber is hands down the best surgeon! She took her time answering my questions and explained procedure in detail. After doing liposuction six months ago, I am extremely happy with my results and I appreciate her so much.

    Marlene Cosentino October 15, 2020

    Dr. Saber is so kind and thorough with her patients! She is an amazing doctor and genuinely cars about everyone she comes in contact with. I would recommend her to anyone for any hand surgery or cosmetic procedure.

    Rachel Meach October 15, 2020