Category Archives: Breast Surgeon

Bras After Breast Reconstruction



Whether you are having immediate or delayed breast reconstruction, you will most likely need new bras after your surgery.

Surgical Bra

Immediately after breast reconstruction surgery, you will be placed in a surgical bra.  The surgical bra is similar to a sports bra, but it clasps in the front, so it can be easily taken on and off.  You will need to wear this bra for approximately two to three weeks, or as recommended by your surgeon.  Although it is not super fashionable, it does have many necessary benefits while healing after surgery by providing support and needed compression to help shape the breast. It is important to remember that everyone is different.  Be sure to consult with your surgeon or nurse before transitioning away from the surgical bra.

Bra Fitting after Surgery

Once cleared to wear normal bras, you will need to be professionally measured for your new bra size.  After you have your new size, remember to try before you buy!  All bras fit differently, even if the size is the same, as varying styles and brands are designed to sit differently on your body.  When trying on bras remember to look for the following:

  • Cups—cups should be fitted to the breast without any gapping or bulging.  If your breasts are slightly different in size (remember most women’s are) be sure to fit the bra to the largest breast.
  • Shoulder Straps—straps should fit close to your body, but not so close that they cut in to your shoulders.
  • Band—the band should fit nice and snug around your body, but not too tight.  It also needs to sit at the same level in the front and back.

Once you have found the bra that works for you, why not buy a few!  Make it fun and grab some in exciting colors and patterns!

By: Gary Arishita

What is Nipple-Sparing Mastectomy?

What is Nipple-Sparing Mastectomy?

Nipple-sparing mastectomy preserves the nipple and areola and all the breast skin envelope around it. Only the breast tissue under the skin and nipple-areola is removed. A skin-sparing mastectomy also preserves the breast skin envelope but unlike the nipple-sparing procedure, removes the nipple and areola.

Who is a Candidate?

Nipple-sparing mastectomy is an option for many patients with a small cancer located several centimeters away from the nipple-areola complex. Patients with ductal carcinoma in situ (DCIS) can also be candidates depending on the location and distance from the nipple-areola. Patients who need a significant breast lift for the best cosmetic results are not ideal candidates.

During the surgery, the breast tissue on the underside of the areola is shaved away. In patients that have a known breast cancer, this tissue is sent as a biopsy to pathology to make sure there is no cancer under the nipple or areola. If this biopsy is negative then the area can be preserved. If it is positive for cancer cells, the nipple and areola must be removed.

Patients seeking prophylactic mastectomy and immediate breast reconstruction due to their high risk of breast cancer (eg BRCA+ and other genetic syndromes, strong family history) are the best candidates.

What are the Benefits?

Studies show that nipple-sparing mastectomy does not compromise cancer treatment when performed in appropriate candidates. Preserving the nipple-areola complex adds to the quality of the reconstruction and makes the results even more “natural” and cosmetically pleasing. The patient also avoids the additional steps of nipple reconstruction and tattooing.

What are the Risks?

Patients must be prepared to lose all nipple sensation. In cases where some nipple-areola sensation is preserved or returns over time, the feeling is typically well short of what Mother Nature provided.

Shaving away the breast tissue from the underside of the areola can sometimes compromise the blood supply to the area. If the blood supply is damaged too much by the nipple-sparing mastectomy, part or all of the nipple-areola can die. Thankfully this is very uncommon when the procedure is performed by surgeons experienced with this technique.

At PRMA, we are able to check the blood flow intra-operatively if there is a concern that the nipple-areola may not survive. In the unlikely event the nipple-areola cannot be saved, it is removed to prevent wound healing complications and a new nipple and areola are reconstructed at a later time.

Where will the Scars be?

This depends on the size and shape of the breast, whether a small “lift” is needed, patient preference and surgeon preference. Scars can be placed around part of the areola, extend outwards or downwards from the areola, or be completely away from the areola at the breast crease.

By Minas Chrysopoulo

3D Printing and the Future of Breast Reconstruction

Many news outlets have reported recently on new research being performed just up the road in Austin, TX.  A company called TeVido is conducting research and experimenting with different 3D printing technologies and harvested human cells to create real nipples for breast reconstruction patients.

Crazy cool right?!?  For some added input, I reached out to a couple of the PRMA surgeons to get their thoughts on this new technology.

“3D printing is an emerging technology with tremendous potential.  However, this technology is still in its infancy and its applications within the medical field requires compliance with the same rigorous standards as with any other pharmaceutical or medical device before they are adopted. The current practice of nipple reconstruction using the patient’s own skin is a minimally invasive as well as a tried-and-true method used for many years with high patient satisfaction. In addition, being considered as a broadly accepted and integral component of breast reconstruction, thecurrent methods of nipple reconstruction are covered by insurance whereas experimental methods such as 3D-printed nipples, most likely, are not,” said Dr. Ochoa.

Dr. Arishita added, “Wow, this is a very exciting but a complicated, high tech way of treating a common problem. Women should also know that in some situations, their nipples can be preserved. Patients should ask their surgeon about nipple sparing surgery.

With the many options available today and the always progressing technologies, women have access to advance breast and nipple reconstruction options after cancer.

Although this innovative nipple creation technique is in the beginning stages, clinical trials could start in as little as two years.  What are your thoughts?