What is Goldilocks Breast Reconstruction?

 

Traditionally Goldilocks Breast Reconstruction was used to describe a type of breast reconstruction where the skin and fat left after a mastectomy was rearranged in such a way to create a breast.  The tissue from the lateral breast and chest wall can also be recruited to provide additional volume. This technique works well in women with large breasts who want smaller breasts postoperatively and fits the adage of “not too big, not too small, but just right” – Goldilocks and the Three Bears story.

 

There are multiple applications of Goldilocks Reconstruction:

  • The reconstruction can be performed in the traditional aspect, rearranging the patient’s own tissues to create a new, smaller breast.  If desired, the patient can undergo one or more episodes of fat grafting to enhance the size or shape of the breast.
  • The reconstruction can be performed in combination with a tissue expander and/or implant for women with large, droopy breasts desiring better breast shape with a more youthful and “perky” appearance.
  • The reconstruction can be performed in patients who do not want reconstruction but want to limit or prevent the concavity that can be caused by a mastectomy.

 

This surgery is done at the same time as the mastectomy.  The surgery usually takes 1.5-2 hours depending on whether you are having single or double mastectomies.  This is in addition to the time it takes to complete the mastectomy. Patients are usually hospitalized for one night after a mastectomy with Goldilocks Reconstruction.

 

During the consultation I will evaluate your specific case and present all the options that are available to you.  We are committed to helping you close the loop on breast cancer and have confidence to move forward. Call today to schedule your consultation. 248-524-0620.

 

Dr. Sarah Elswick, MD

Plastic, Reconstructive and Aesthetic Surgery 

What is direct to implant breast reconstruction surgery?

Knowing your surgery options for breast reconstruction is critical for making the right decision.  This week I want to talk about direct to implant reconstruction. In direct to implant surgery the permanent implant is placed at the time of mastectomy, avoiding the need for a tissue expander.  This surgery is also referred to as “single stage” breast reconstruction. I prefer, however, not use this term due to the fact that many women still require a revisional surgery to optimize breast shape, scars, or symmetry.

Candidates for direct to implant reconstruction include women with small to moderate size breasts that want to have the same breast size or smaller breast size post-operatively.  Large implants can cause strain on the breast skin after the mastectomy which may lead to implant failure. As the reconstructive surgeon I would closely with your breast surgeon to ensure you receive the best treatment available.  The reconstructive

 surgery usually takes 1-1.5 hours depending on whether you are having single or double mastectomies.  

 

During the consultation I will evaluate your specific case and present all the options that are available to you.  We are committed to helping you close the loop on breast cancer and have confidence to move forward. Call today to schedule your consultation. 248-524-0620.

 

Dr. Sarah Elswick, MD

Plastic, Reconstructive and Aesthetic Surgery

 

What is a tissue expander?

Intro to series, Breast reconstruction surgery has several different approaches.  Due to this and the complexities of the surgery patients typically have lots of questions and may feel overwhelmed.  Dr. Elswick would like to offer a blog series on answering several of these questions to help patients increase their knowledge and make informed decisions.  She is passionate about breast reconstruction surgery and works one on one with her patients to ensure every question is thoroughly answered before moving forward.  

 

We have several questions already in mind to answer but welcome additional ones from you. Our first question is: 

 

What is a tissue expander?

 

A tissue expander is one of the more commonly used devices in breast reconstruction.  A tissue expander is a temporary “spacer”, similar to a balloon, which allows the plastic surgeon to preserve the volume and shape of the breast.  It is shaped like a breast and has a “tear drop” appearance when viewed from the side. The outer shell of the tissue expander is made of silicone.  

 

There are different sizes of tissue expanders, so it can be individualized to fit your body and reconstructive goals.  Unlike a breast implant, a tissue expander has a port that is connected to the inside cavity. The port is identified with a magnet and accessed through your skin so the expander can be filled post-operatively with either air or fluid.  A tissue expander is used as a temporary device to help create a nice pocket to hold the final implant while also expanding or stretching the breast skin to create the desired post-operative size and shape. When the tissue expander fills are complete and the skin and incisions have healed, the tissue expander is removed and replaced with a permanent implant (three to six months after your expander surgery or radiation).

 

Attached is a photo of a tissue expander. During your consultation, I will have one available for you to physically see and touch to help you better understand the device.  Please call my office located in Troy, Michigan to set up your consultation. 248-524-0620. Together we can restore your body and confidence. 

 

Sarah M. Elswick, MD 

Reconstructive, Plastic and Aesthetic Surgery