Breast Reconstruction – Stage I

Orange county breast reconstruction specialist, Dr. Farbod Esmailian discusses the first stage of breast reconstruction after mastectomy. Breast cancer is unfortunately common, occuring in 1 out of every 9 women. It is one of the most common cancers in women. It is more common the older the patient, however, with better and more aggressive screening, we are discovering breast cancer in even younger women. Patients that are referred to me have already been diagnosed and are under the care of a general surgeon who has planned a mastectomy. Orange County breast reconstruction generally begins when the mastectomy ends. Immediate breast reconstruction is when the general surgeon or breast surgeon works with the plastic surgeon in cohort. The Orange County breast reconstruction is begun when the mastectomy is complete. At the same time, the Stage I of breast reconstruction is begun with placement of a tissue expander and acellular dermis. A breast tissue expander is a temporary implant that has an integrated port which can be accessed thru the skin to fill with saline. The tissue expander is placed behind the pectoralis muscle and the acellular dermis (Alloderm) is placed along the inframammary crease to provide added tissue coverage, and to stabilize the breast fold which is commonly weakened from the mastectomy. The implant is therefore completely covered and “nested” behind the muscle and the acellular dermis. A drain tube is placed and the skin is closed. Depending on the situation, the expander is filled a certain amount in the operating room to provide some fullness to the breast. Patients generally stay in the hospital one night for a one sided Orange County breast reconstruction and two nights if a bilateral breast reconstruction is performed. The expansions are then begun about 2-4 weeks from the time of surgery. The expansions are performed in the office as simple as placing a needle thru the skin (which is numb) and accessing the port to fill the tissue expander. Tissue expanders are filled on a weekly schedule to achieve the fullness and breast size desired. Once this has been accomplished the next step is removal and placement of permanent implants, Stage II. Orange County breast reconstruction performed by Dr. Farbod Esmailian, breast surgery specialist, is perfomed in his Los Alamitos plastic surgery office. You may contact us at 562.655.8071 for any further questions.


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