Candidates for breast reconstruction surgery in Beverly Hills, Santa Monica, and the greater Los Angeles area might have:

• Undergone a mastectomy or lumpectomy to treat breast cancer
• Undergone a prophylactic mastectomy due to an inherited genetic mutation (in the BRCA1 or BRCA2 gene) that predisposes them to breast cancer
• Congenital breast deformities they would like corrected
• Breast reconstruction after explantation due to BII (Breast Implant Illnesses)

While breast reconstruction after mastectomy is most common, transgender patients can also be candidates for breast reconstruction surgery. This procedure can allow them to affirm their authentic selves and have their appearance more closely match their identity.

48 year old female with history of left breast cancer. She underwent left breast cancer lumpectomy and radiation.

Patient was unhappy with the lumpectomy deformity that cause significant breast asymmetry and pain.

• Left breast lumpectomy defect reconstruction with DIEP flap – using tissue from the abdomen.
• Right breast augmentation for symmetry

Following your surgery, Dr. Goldberg and her team will provide you with detailed post-care instructions. If you have any questions regarding your recovery period, you can reach the team directly at the contact detail they provide.

After surgery, gauze or bandages will be applied to your incisions. This will minimize swelling and give additional support to the reconstructed breast(s) during your healing process. A thin tube may be placed under the skin to drain any excess fluid as you heal.

Most patients will remain in the hospital for 1 to 3 days depending on the reconstructive techniques. On average, patients may return to work at 4 weeks after a breast reconstruction.

Patients might experience discomfort and swelling in the treated area for several days after their reconstructive procedure. Pain medication can alleviate discomfort and make swelling, irritation, and bruising manageable.

Dr. Goldberg will provide clear instructions on caring for your breasts following surgery, taking medications, and looking for specific concerns. The breast reconstruction recovery process will continue for several weeks while swelling decreases and the breast shape and position settle. Patients should continue to follow recovery instructions and attend follow-up appointments.

Direct-to-implant (DTI) breast reconstruction is a modern technique that completes mastectomy and breast reconstruction in one surgery. This technique involves Dr. Golberg installing a silicone gel breast implant immediately after a breast cancer surgeon performs a mastectomy to remove the breast tissue. It is common for Dr. Goldberg to use mesh products (acellular dermal matrix) to support the tissue’s regenerative process.

DTI breast reconstruction is an ideal option for those who can have mastectomies that spare the nipple and those in the early stages of breast cancer. DTI breast reconstruction is especially advantageous for a faster return to a natural body image. This is because the procedure offers simplicity and avoids multiple surgeries and recovery periods.

The prepectoral breast reconstruction technique can be used for 1-stage or 2-stage implant reconstruction. Traditionally, implant reconstruction involves placing the implant or tissue expander completely under the chest muscle (submuscular placement) or partially under the muscle and partially under an acellular dermal matrix (dual-plane placement). This can lead to significant pain after surgery and animation deformities.

Dr. Golberg positions the implants under the mastectomy skin flap but above the muscle, and she uses an acellular dermal matrix mesh to support the implant. This preserves the function of the pectoralis major muscle and chest wall to reduce postoperative pain.

The profunda artery perforator (PAP) flap is one of the most groundbreaking breast reconstruction techniques used today. It uses skin and fat tissue from your inner thigh and the profunda artery perforator blood vessel. State-of-the-art microsurgery rebuilds the breast by reattaching the blood vessel and thigh tissue to the chest.

The PAP flap is ideal for patients who do not have enough abdominal fat for a DIEP flap. Patients who wish to have a completely natural breast reconstruction without using an implant are also good candidates for a PAP flap.

As one of the leading surgeons in reconstructive surgery, Dr. Goldberg was one of the first to offer the PAP flap to patients in Los Angeles, California. Now, it has become one of the most popular breast reconstruction procedures in her practice.

An SGAP flap uses the superior gluteal artery perforator blood vessel and skin and fat from the upper buttocks and hips to reconstruct the breast. Dr. Goldberg uses microsurgery to meticulously reattach the blood vessels of the flap to blood vessels in your chest to promote survival of the skin and fat tissue.

The SGAP flap method is great for patients who desire a tighter, more lifted butt, as the skin and fat are removed similar to how a buttock lift is done. Good candidates for an SGAP flap are women who don’t have adequate abdominal tissue for a TRAM, DIEP, or SIEA flap. The SGAP flap leaves an inconspicuous scar near the top of your buttocks that can be easily covered by a swimsuit or underwear.

For some patients, 1-stage (immediate) breast reconstruction is performed at the same time as their mastectomy. However, a delayed breast reconstruction can be performed weeks, months, or even years after mastectomy or lumpectomy.

Patients may desire delayed reconstruction because of a medical condition, their current stage of breast cancer, or their personal lifestyle choice. Patients who undergo delayed breast reconstruction have the advantage of having additional cancer therapy without disrupting the already reconstructed breast(s).

No matter how long you wait to consider reconstructive care, it is never too late to seek breast reconstruction. Dr. Goldberg believes that every woman should have the opportunity to receive breast reconstruction that satisfies her aesthetic goals and encourages her emotional well-being.

Dr. Goldberg offers breast reconstruction revision for patients who are unsatisfied with their initial breast reconstruction results. Patients may find that their breast shape, volume, or symmetry has become distorted due to breast implant or tissue flap complications.

Revision breast reconstruction may also include a capsulectomy, implant replacement, and/or additional techniques to resolve breast reconstruction complications. Revision breast reconstruction can create more attractive, satisfactory, and harmonious results than your initial reconstruction.

68 year old female who presented to Dr. Goldberg for a breast reconstruction revision.

Patient was unhappy with the lumpectomy deformity that cause significant breast asymmetry and pain.

Left breast implant removal. The pectoralis major muscle was placed back down on the chest. Dr. Goldberg performed a latissimus dorsi myocutaneous flap to provide new healthy tissue and placement of a new implant – Hybrid reconstruction (latissimus dorsi myocutaneous flap plus an implant).

The patient is happy and her pain resolved.