Find the Right Breast Procedure for You

The goal of breast reconstruction is to restore a woman’s sense of wholeness by constructing a breast with similar shape, symmetry, and softness as the original.

Advances in microsurgery have resulted in less invasive surgical procedures that offer natural-feeling breasts and the potential for the return of sensation. We counsel our patients on all of the options available and emphasize less invasive, more natural restoration options.

Dr. Spiegel specializes in advanced microsurgical procedures, has performed over 1,200 procedures, and has had a hand in creating several techniques to ensure beautiful cosmetic results.

I Have Just Been Diagnosed With Breast Cancer

It is never too early to start researching breast reconstruction. Knowing your options can help you keep a positive outlook during the times ahead, and an optimistic attitude can aid in your recovery.

Talk to Dr. Spiegel about your options and how your treatment plan can accommodate your reconstruction. You will discuss your medical history, lifestyle, etc., and she will help you determine what will work best for your needs.

Please feel free to browse the resources available on our website if you would like to know more. We offer many methods of breast reconstruction, including the DIEP and SIEA flap procedures, direct to implant reconstruction, SGAP and Latissimus flap procedures, and are more than happy to discuss any questions or concerns you may have about your breast reconstruction journey.

I Have Already Had a Mastectomy

The DIEP and SIEA flap are advanced breast reconstruction techniques used after mastectomy in which excess skin and fat are removed from the lower part of the abdomen and are used to reconstruct the breasts. The difference between them is the choice of blood vessels used to nourish the flap tissue.

• In DIEP flap breast reconstruction, advanced microsurgical techniques are used to safely separate the blood vessels contained in the abdominal rectus muscle while preserving the integrity of the muscle.
• In SIEA flap reconstruction, the blood vessels are located in the fatty tissue of the abdomen. This requires less dissection than the DIEP flap due to the depth of the blood vessels.

The DIEP/SIEA techniques can also result in a slimmer abdominal contour (similar to the results of a tummy tuck), which can help many women feel better about their new shape. Direct to implant reconstruction, SGAP and Latissimus flap procedures are also options for reconstruction after you have had a mastectomy.

I Have Already Had Reconstruction and Am Dissatisfied With the Results

If you have already had breast reconstruction surgery but are unhappy with the size, shape, or symmetry of your results, we are able to perform breast augmentation, reduction, or revision surgery (or a combination of surgeries) to help restore your confidence in your new shape. There are also options available such as fat grafting, implant replacement surgery, and the addition of collagen, so that the results of your reconstruction can be closer to what you desire.

• Augmentation: This is usually achieved with the use of implants, either silicone or saline-filled depending on factors such as your individual anatomy and desired results.
• Reduction: Excess fat and tissue are removed, and the breasts are repositioned and reshaped.
• Revision: If implants are causing issues, they can be removed or replaced, and the breast tissue can be excised and reshaped if necessary.

Loss of Volume or Naturally Small Breasts

Breast Augmentation

Breast augmentation is a very popular procedure. Your breasts undergo changes over time due to several factors, including the natural aging process, weight loss, and pregnancy. Additionally, many women are genetically predisposed to have naturally small breasts. Lack of breast volume can cause dissatisfaction with your appearance. Breast augmentation can enhance breast volume and help improve your self-confidence. This procedure is usually done by inserting implants either over the surface of or beneath the chest muscles. Fat grafting can also be used as a standalone procedure or in conjunction with breast implants to add volume to the breasts.

Types of Breast Implants

• Saline breast implants: An outer shell made of silicone is filled with a sterile saline solution. These implants can be pre-filled to the desired size or filled once they are inserted into the body.

• Silicone breast implants: The outer silicone shell is filled with a silicone gel. These are pre-filled and require a longer incision for proper placement. Silicone implants can give a very natural feel to the breasts.

Breast augmentation surgery is a very personal decision, and a consultation with Dr. Spiegel can help you figure out exactly what you need to help you achieve your aesthetic goals.

Sagging Breasts

Breast Lift

Mastopexy, more commonly known as breast lift surgery, is a procedure that lifts and reshapes sagging breasts.

Factors like gravity, weight changes, pregnancy, and menopause can cause breast tissue to weaken and stretch, causing the breasts to soften and sag over time. This can also lead to a loss of breast volume.

• Incisions are made, and excess breast skin is removed. 
• The remaining skin and fat are moved to a higher position on the chest, along with the nipple-areola complex. 
• The nipples usually remain attached to the breast tissue during a breast lift in order to maintain sensation.

Because every breast surgery is different, an in-depth consultation will allow you and Dr. Spiegel to decide what steps are necessary to get the results you are looking for.

Overly Large Breasts

Breast Reduction

Breast reduction surgery is performed to reshape and reduce the size of the breasts by removing excess skin and tissue.

Overly large breasts can cause several issues, including:

• Chronic pain: The weight can cause pain in the shoulders, neck, and back.
• Nerve problems: Large breasts can cause your shoulders to roll forward and make it hard to have good posture. Poor posture can result in pain and numbness in the upper extremities and the shoulders.
• Skin problems: It can be difficult to keep the area under the breasts dry, leading to yeast infections, rashes, chafing from poorly fitted bras, and other issues.
• Emotional issues: Overly large breasts can attract attention that may make you feel uncomfortable. They can also make it difficult to find appropriate clothing options, especially items like bathing suits or blouses.

During a breast reduction, skin, fat, and glandular tissue are removed. The areolas and nipples are repositioned and usually remain attached to the nerves and blood vessels. In some cases, however, the nipple-areolar complex may need to be removed completely and repositioned.

Because there are many ways to perform a breast reduction, Dr. Spiegel will discuss the right placement and type of incision, the amount of tissue to be removed, and other factors with you during your consultation.