- Specialized expertise in reshaping and reconstructing breasts following treatment for any stage of breast cancer. Go to Conditions Treated
- Advanced treatments and a wide range of options, including innovative approaches for nipple preservation and to restore breast sensation. Go to Approaches
- Team-based approach from renowned plastic surgery experts with extensive experience performing all types of breast reconstruction procedures. Go to Your Care Team
- Clinical trials that offer eligible patients access to the latest advances in breast reconstruction surgery. Go to Clinical Trials
- Comprehensive services, including dedicated care coordination, wellness counseling, and women’s sexual medicine services to help you focus on health and healing. Go to Supportive Services
- Ease of access to care before and after surgery, with convenient locations and comprehensive follow-up care right in your community. Go to Accessing Care
Conditions Treated
Our surgeons specialize in breast reconstruction following treatment for breast cancer. We care for people who have received cancer treatments in the Stanford Medicine Breast Cancer Program at the Stanford Medicine Women’s Cancer Center. We also perform breast reconstruction procedures for people who were treated for cancer at other Bay Area hospitals and beyond.
Our expertise enables us to deliver natural-looking results to people who have received treatment for any stage of breast cancer. We even help people who have been told they are not eligible for breast reconstruction.
As leaders in reconstructive surgery, our team has developed precise techniques to address issues that result from breast cancer treatments, including:
- Mastectomy, removal of the entire breast
- Lumpectomy or breast-conserving surgery, which removes only the tumor and a margin of healthy breast tissue
- Radiation therapy, which uses high-energy X-rays to destroy cancer cells
At Stanford Health Care, you have access to the latest advances in reconstruction surgery, some of which were developed by our own nationally renowned surgeons. We take the time to listen to your needs and goals to develop a treatment plan just for you.
Your doctor will discuss all available options to help you decide when to have breast reconstruction. You may choose to have breast reconstruction along with breast cancer treatment (immediate), or you may choose to have surgery months or years later (delayed). Sometimes a reconstruction procedure requires more than one stage (multi-stage reconstruction).
PROGRAM HIGHLIGHTS
Our team focuses on delivering results that look and feel natural. We are at the forefront of the latest technology and most advanced techniques, including:
- Improved fat-grafting techniques: We use the most advanced techniques to remove fat from one part of the body and inject it into the reconstructed breast. Fat-grafting procedures meet a range of aesthetic needs while delivering natural results.
- Sophisticated neurotization techniques: Many people experience a loss of sensation in the breast following a nipple-sparing mastectomy. To address this issue, our team uses advanced procedures to transfer nerves and tissue to the breast from elsewhere in your body. These techniques have been shown to improve sensation in the breast following surgery.
- Advanced imaging for nipple preservation: Our team uses the SPY Elite® Fluorescence Imaging System to visualize the breast’s unique blood-flow patterns in real-time during surgery to preserve the nipple. This advanced technology is available at only a handful of breast care centers nationwide. It helps us customize surgery to your body’s unique blood vessel pattern, which protects the nipple, promotes faster healing, and produces a more natural look and feel.
- Faster return home: We use enhanced recovery after surgery (ERAS) protocols to return you home comfortably and as soon as possible after surgery. ERAS pathways for flap breast reconstruction after mastectomy (using tissue from your own body) can also dramatically reduce the need for narcotic pain medications.
Before recommending a type of breast reconstruction, your doctor considers many factors. These include your age, anatomy, health history, type and extent of cancer, and previous treatments. Your doctor will also consider your lifestyle and goals, including your desired breast size following surgery.
In addition to recreating and reconstructing breast tissue, we also focus on enhancing breast shape, contour, and symmetry. We discuss your options with you so you can make an informed decision about the procedure that’s right for you. The main types of breast reconstruction surgery are:
We perform a lumpectomy and breast lift or breast reduction during the same procedure. This frequently allows a wider margin to be removed around the tumor while restoring or improving the breast’s appearance.
Radiation therapy can cause indentations or abnormalities in the breast. After radiation therapy, we rearrange breast tissue, perform a fat graft, or place an implant to restore the breast’s appearance, shape, and symmetry.
Our team is specially trained in the latest advances in breast reconstruction using saline or silicone gel implants. Some techniques use a combination of implants and tissue from your own body. You can receive implants at the same time as a mastectomy or at a later date.
If you wish to have immediate breast reconstruction with implants, we offer a direct-to-implant procedure. It’s also called one-stage reconstruction. The doctor places the implant right after performing a mastectomy, during the same surgery.
You can also wait to have implants after mastectomy. Before getting an implant, your doctor may recommend inserting a tissue expander into the breast area. About once every other week, your doctor fills the tissue expander with saline or air, which allows your skin and soft tissues to stretch gradually. Once the skin has reached the desired size, your doctor will place a permanent implant.
Your doctor may place the implant under your chest muscle (subpectoral implant) or on top of it (prepectoral implant). The placement depends on several factors. We use innovative techniques and the latest advances in care to allow the implant to settle in to your body with a lower risk of complications.
During flap reconstruction, we reconstruct your breast using fat and tissue from another part of your body. This tissue is called autologous tissue. We call this flap reconstruction because we use a “flap” of your own tissue. Depending on the type of procedure, we may use tissue from your belly, buttocks, thigh, or back.
Your doctor will discuss the many types of flap reconstruction with you and recommend the most appropriate procedure. The types of flap reconstruction include:
- Muscle-sparing transverse rectus abdominis myocutaneous (MS-TRAM) flap: Your surgeon removes skin, fat, some muscle from your belly. They move the tissues and blood vessels to your chest area to form a breast. Your surgeon can also remove sensory nerves with the flap and connect them to your chest nerves. This technique, called neurotization, improves breast sensation after surgery.
- Deep inferior epigastric perforator (DIEP) flap: Similar to a MS-TRAM flap, the surgeon removes tissues from the lower belly. In a DIEP flap, however, the surgeon does not remove the abdominal muscle, but removes only skin, fat, and blood vessels. This can help preserve muscle function in the belly. Your surgeon can also perform neurotization along with this procedure to improve sensation following surgery.
- Superficial inferior epigastric artery (SIEA) flap: This procedure also removes the lower abdominal skin and fat, but it involves a different blood vessel. Unlike the DIEP and MS-TRAM flap, this technique does not make any incision in the tissue that surrounds the abdominal muscle (fascia). This flap most closely resembles a tummy tuck.
- Superior gluteal artery perforator (SGAP) and inferior gluteal artery perforator (IGAP) flap: The surgeon removes tissue and blood vessels from different areas of the buttocks. They use the tissue to form a breast. The surgeon does not remove muscle. Surgeons generally recommend these procedures when tissue from the abdomen or thigh is not available.
- Latissimus dorsi (LD) muscle flap: The surgeon moves a muscle with or without overlying skin and fat from your back to your chest area to create a breast. They may also insert a silicone or saline breast implant.
- Profunda artery perforator (PAP) flap and transverse upper gracilis (TUG) flap: A PAP flap uses skin and fat from your inner thigh. A TUG flap also uses a small thigh muscle.
Our surgeons may be able to perform nipple-sparing mastectomy. This procedure conserves and repositions the nipple immediately following a mastectomy.
A state-of-the-art imaging system allows our surgeons to visualize the unique blood-flow patterns in your breast during surgery. Doing so helps us preserve the nipple and promote healing.
In addition to advanced nipple preservation techniques, our surgeons perform expert nipple reconstruction following breast reconstruction surgery. We offer:
- 3D nipple tattooing: Our staff is specially trained in a 3D tattooing technique to achieve the most natural-looking results. We offer customized tattooing services that produce realistic color and shading.
- Fillers to enhance nipple projection: We use injectable fillers to create the shape and fullness of a natural nipple. Depending on the type of filler, the effects can last six months to a year or more. They can even be permanent.
- Combined procedures: We have pioneered a technique to reduce and lift breasts during a nipple-sparing mastectomy. This means you can combine breast enhancement procedures with cancer treatments to avoid additional surgery.
We work with you to create your ideal breasts following breast cancer treatment. You may want breasts that are close to your original size and shape. Or you may prefer a profile that is smaller, fuller, or more lifted or symmetrical. Breast reconstruction is an opportunity to shape your new profile however you wish.
Clinical trials are research studies that evaluate a new medical approach, device, drug, or other treatment. As a Stanford Health Care patient, you may have access to the latest advanced clinical trials.
Open trials refer to studies currently recruiting participants or that may recruit participants in the near future. Closed trials are not currently enrolling, but similar studies may open in the future.
To learn more about the clinical trials we offer, visit Stanford Cancer Institute Clinical Trials.
Our multispecialty teams work closely together to provide coordinated, individualized care. You receive care from experienced and dedicated breast cancer specialists, breast reconstructive surgeons, advanced practice providers, nurses, and staff.
Your Doctors
Breast Reconstructive Surgeon
Breast reconstructive surgeons are plastic surgeons with a focus on rebuilding and reshaping breasts after cancer surgery.
View All {0} Breast Reconstructive Surgeons »Advanced Practice Provider
Our skilled nurse practitioners and physician assistants specialize in facial plastic and reconstructive surgery care. These advanced practice providers (APPs) see patients independently and occasionally alongside your doctor. They can give you a thorough exam, write prescriptions, and help prevent or treat any issues. Our APPs meet weekly to discuss patient needs.
View All {0} Advanced Practice Provider Doctors »Extended Care Team
Radiologist
A radiologist who specializes in breast cancer has additional training in imaging technologies, including X-ray, ultrasound, CT, and MRI, to detect and diagnose breast cancer. These doctors interpret imaging results and take biopsies, as needed, to help confirm a diagnosis and plan treatment.
Nurses and Nurse Coordinators (RNs)
Nurses and nurse coordinators are registered nurses who coordinate your care with your breast cancer team. They guide you from your first contact through follow-up care and help you find counseling, financial, and other support services.
Care Coordinators
Care coordinators provide you with information and assistance before and during your appointment.
- Medical Assistants: Medical assistants work with our team to help provide care. They may prepare you for an examination, assist your doctor, or take your vital signs before your appointment.
- Patient Care Coordinators: Our patient care coordinators help you with scheduling appointments and accessing your lab results. They are your first line of contact before you see your provider and guide you during your breast cancer care.
- Patient Access Representatives: Patient access representatives can answer all your questions about health insurance coverage, help you apply for health insurance, and refer you to our financial counselors.
Research Coordinators
Doctors at Stanford Medicine Cancer Center participate in research efforts to advance the understanding of breast cancer and its treatment. Research coordinators help screen candidates for possible participation in clinical research trials.
Cancer Care Services
Your cancer care includes services that focus on breast reconstruction surgery and follow-up care. Our support programs are available to you throughout the diagnosis and treatment process. We work with you to prevent complications after surgery and address your physical and mental health. Contact our Cancer Care Services for your personal support plan.
We make access to care as simple as possible. We anticipate what you need and provide support when you need it. Our network of locations puts our services within your reach. User-friendly digital health tools help you stay connected with your care team. We accept most insurance plans and offer discounted transportation, short-stay options, and international travel and translation services. We help make sense of the details, so you can make decisions that are right for you.
Breast reconstruction care is convenient and easy to access at Stanford Health Care. Our Bay Area facilities are your gateway to world-class care.