Actual Patient of Dr Turowski – Miss Illinois 2018 “I love the results of my breast augmentation and having no scars on my breasts!”

Miss Polonia USA 2018 (Miss Poland in the USA) : “I love what Dr Turowski magically created – beautiful breasts without ANY scars on the breasts. I feel so confident and pretty!”

Miss Polonia USA 2018 (Miss Poland USA) : “I feel confident, sexy and do not have any scars on my breasts – endoscopic surgery is the way to go!”

Miss Illinois 2019 before & after breast augmentation

With axillary breast augmentation you do not have to worry to expose underboob area – there are no scars on the breasts!

Our patient who is a body building champion enjoys her new body shape after axillary breast augmentation

Breast Augmentation Chicago a Personal Story by Dr Gregory Turowski

Breast enhancement is an art. Although it is quite simple for an average plastic surgeon to place a breast implant through a large cut incision – leaving a conspicuous (sometimes ugly) scar and causing a breast bump rather than beautifully shaped breasts, this is not what women desire. Most women dream of beautifully and naturally shaped breasts without visible scars. While the size of the breasts is a uniquely personal decision, the shape, feel, symmetry and lack of visible scars is not. These details are really up to the surgeon.

This is why Dr. Turowski has been perfecting his breast augmentation procedure since 1996. From the beginning, he was looking for the most natural, scarless approach. Although most plastic surgeons discard and avoid the endoscopic armpit (axillary) approach because they find it difficult to achieve predictable results, this seems to be the preferred technique for truly experienced and skilled surgeons.

This in an example of the axillary (armpit) incision for breast implants, Dr turowski’s preffered method.

Throughout his career, Dr. Turowski has successfully performed THOUSANDS of breast augmentations combining the armpit endoscopic technique with saline implants. One reason for this is that, until last year, silicone implants still presented some challenges. While saline implants are inserted as empty bags which are rolled and filled with saline after insertion into the woman’s body, silicone implants come pre-filled and have to be squeezed through a very small incision and a tunnel from the woman’s armpit to her breast pocket. Therefore, Dr. Turowski’s preferred incision for silicone implants used to be periareolar (still better than inframmary – under the breast scar).

This issue finally improved in 2012 when a special funnel (Keller funnel) was created to expedite touch-less silicone implant placement. Through this ingenious method, silicone implants can now be placed effortlessly through a minimal, usually invisible armpit incision, which creates beautiful and natural looking breasts without ANY breast scars. Moreover, the Keller funnel avoids any contact between an implant and the armpit skin, which could potentially lower the incidence of capsular contractures.

As a result, Dr. Turowski now performs most of these surgeries (silicone and saline) through a minimally invasive armpit incision (although other techniques are obviously available upon request). Typically, women are back to their daily activities, with minimal swelling and bruising, within 48 hours of surgery.

Another recent development in breast implants is an addition of the Sientra and Inamed shaped form stable implants . These cohesive “gummy bear” implants might be helpful in some cases and Dr. Turowski discusses all of these options during personal consultations.

Exciting new implant choice MOTIVA

Less invasive, quicker recovery, possibility of local anesthesia, armpit approach still possible!

Advantages of Motiva Breast Implants

When considering breast augmentation, choosing the right implants is crucial for achieving your desired results. Motiva breast implants stand out in the market for several compelling reasons. Here’s a closer look at the advantages that make Motiva the preferred choice for many patients.

Learn more…

Videos about Breast augmentation *

What types of implants are being used for breast augmentation?

How to choose the right breast implant size?

How will my breasts look right after the procedure?

Will my breasts become less sensitive after breast augmentation?

Can I combine breast augmentation with any other procedures?

What kind of scars can I expect?

Breast augmentation FAQ

What kinds of implants are used for breast augmentation?

Actual patient of Dr Turowski *

First introduced in 1962, since 1992 until 2007, silicone breast implants had been available for research purposes only ( Dr. Turowski was a part of this research effort). However, the last chapter of the silicone breast implants saga was closed in November 2007, when (after 14 years of deliberations and research) the FDA decided that the medical evidence was sufficiently positive enough to let these devices back on the market. The studies have failed to find a link between silicone implants and cancer, connective tissue disorders or other diseases.Science has prevailed. US women now have the same options as others around the world had for years.
Breasts augmentations have grown in popularity despite media controversy. Last year over 300,000 women had their breast enlarged in the United States, a 40% increase since 2000. Until 2007, most procedures utilized the saline or salt water solution, rather than silicone, implant. However, since silicone breast implants have been officially re-approved for primary breast augmentations, this situation has completely changed. Currently, in Dr. Turowski’s practice, 9 out 10 women choose silicone implants over saline implants. This follows the worldwide trends, which show that over 90% of breast enlargement procedures utilize silicone rather than saline implants. The advantage is clear: silicone feels softer and looks more natural.

Now some regulatory issues: the FDA is allowing silicone devices for women who are at least 22. The only exception is for women with inborn anomalies such as asymmetry, tubular breasts and some other conditions (if you are not sure if you are a candidate for silicone implants, please schedule a consultation with one of our surgeons to discuss your situation). Saline implants are still widely used, and for some patients, maybe a more desirable choice. Saline implants are still associated with a very high satisfaction rate.

Implants are not considered lifetime devices and some patients will need at least one additional surgery to remove and replace implants. MRI studies may be recommended post surgeries. Manufacturers of implants offer life time warranty on these devices and defray costs of replacements for 10 years.

How is breast enlargement done?

The procedure consists of creating a pocket under the breast tissue and pectoralis muscle and placing a soft, natural-feeling implant underneath the breast and the pectoral muscle. Our surgeons perform all augmentations in the submuscular position. In rare cases, the exact position of the implants (subglandular or submuscular) can only be recommended by the plastic surgeon after the clinical evaluation of the patient. There are a variety of implant designs and your plastic surgeon will review the potential advantages of certain designs during a consultation.

What kind of scars can I expect?

Since the saline implants are inserted deflated and are later injected with saline when inside the body, the incision can be kept to a minimal size (usually shorter than an inch). Moreover, although incisions are small, every attempt is made to hide them either in the arm pit or under the areola, where they can be barely noticeable on the border of lighter and darker skin. The axillary (armpit) approach requires minimally invasive endoscopic video techniques which are readily available to our plastic surgeons. Silicone implants are fully inflated before insertion and therefore the incision has to be slightly larger. However, scars resulting from these surgeries are still usually barely noticebable if made around the areola or in the armpit. We usually try to stay away from the under the breast (inframmary) insertion sites since the healing in this area is quite unpredictable and may lead to conspicous scarring. Since its introduction, the Keller funnel armpit approach is the best technique to hide scars from both saline and silicone implants.

Am I going to loose nipple sensation?

Minimally invasive techniques utilized by our plastic surgeons very infrequently result in nipple sensation alteration. Nipple sensation loss is extremely uncommon and is independent of the incision site chosen. The nipples may actually be hypersensitive (e.g. more sensitive) for some time after surgery. Under the breast incision has been shown to cause most nipple sensation loss (one more reason to avoid it)

What kind of anesthesia is used for breast augmentation?

With current advanced anesthesia techniques, the best and safest way to perform breast augmentation is to do the procedures under deep intravenous sedation with patients totally unaware of the ongoing surgical action. This allows for pain-free surgical procedure while permitting avoidance of risky chest wall injections for local pain control. Postoperative nausea is minimized using this approach and there are no complaints of postoperative sore throats and hoarseness, which is usually typical for general anesthesia and tracheal intubations. We also routinely utilize OnQ pain pumps which inject local anesthetic directly into the implant pocket during the first several hours after sugery.

How long does the procedure take?

Although the surgical time for breast augmentation may vary depending on a particular patient’s situation, surgery generally requires less than one hour of anesthesia time.

Do I have to stay in the hospital?

Breast augmentation is typically an outpatient procedure (patient returns home after she is recovered from anesthesia) and we perform it in our AAAHC accredited surgery suite. However, to accommodate some patients’ social needs, an overnight stay in a hotel and nursing support can be arranged.

What is the typical recovery?

After surgery, the patient is wrapped in a compressive dressing. The following morning the dressing is removed and she is placed in a soft bra. The discomfort after breast augmentation can be significant. Therefore, our plastic surgeons use the revolutionary On-Q pain control system “pain pump.” This disposable device, which is placed during surgery, delivers local anesthetic directly to the operative site, providing over 24 hrs of pain relief. The device is then easily removed during the postoperative visit day after surgery . Routine activities can usually be resumed within a few days. Sports and exercises can be resumed within a few weeks.

Breast Augmentation – Vectra 3D Visualization *

Experience the same results as those mentioned here.

Actual patients of dr Turowski

Breast Augmentation Chicago – Testimonials *

*Individual results may vary and there are no guarantees that you will experience the same results as those mentioned here.

Advantages of Motiva Breast Implants

When considering breast augmentation, choosing the right implants is crucial for achieving your desired results. Motiva breast implants stand out in the market for several compelling reasons. Here’s a closer look at the advantages that make Motiva the preferred choice for many patients:

1. Advanced Technology

Motiva breast implants utilize state-of-the-art technology, including the exclusive SmoothSilk surface design that minimizes the risk of complications and enhances overall comfort. This innovative design promotes a natural feel and movement, closely mimicking the characteristics of natural breast tissue.

2. Variety of Options

Motiva offers a wide range of sizes, shapes, and profiles, allowing patients to customize their breast augmentation to fit their unique body types and aesthetic goals. Whether you desire a subtle enhancement or a more dramatic transformation, Motiva provides tailored solutions to meet your specific needs.

3. Safety and Durability

Safety is paramount in any surgical procedure. Motiva breast implants are made from high-quality silicone gel that is both safe and durable. The implants are designed to resist rupture and leakage, providing peace of mind for patients. Additionally, the implants come with a comprehensive warranty, underscoring the manufacturer’s commitment to quality and safety.

4. Natural Appearance

One of the most significant advantages of Motiva implants is their ability to provide a natural look and feel. The implants are designed to mimic the movement and softness of natural breast tissue, resulting in a more aesthetically pleasing outcome. Patients can enjoy a fuller bust without compromising on a natural appearance.

5. Minimally Invasive Options

Motiva also offers options for minimally invasive procedures, which can lead to reduced recovery times and less scarring. Advanced surgical techniques combined with the design of the implants allow for a more efficient and comfortable experience for patients. Surgical Technique: Dr Turowski can use various techniques to place Motiva implants, including inframammary (under the breast fold) and periareolar (around the nipple) incisions. However most popular method for him is endoscopicThese methods can help minimize visible scarring and enhance cosmetic outcomes.

6. Local Anesthesia Option

One of the standout features of Motiva breast augmentation is the possibility of performing the procedure under local anesthesia. This option can greatly reduce anxiety for patients, as they remain awake and aware during the surgery while feeling little to no discomfort. Local anesthesia often leads to a quicker recovery and allows patients to return home the same day, enhancing their overall experience.

7. Enhanced Recovery

With Motiva implants, many patients report a quicker recovery time compared to traditional implants. The lightweight design and smooth surface promote healing, allowing patients to return to their daily activities sooner.

8. Patient Satisfaction

Numerous studies and testimonials reflect high levels of patient satisfaction with Motiva breast implants. Many women have shared positive experiences regarding the comfort, appearance, and overall results of their augmentation procedures.

Conclusion

Choosing Motiva breast implants means opting for advanced technology, safety, and a natural look. With a range of personalized options, including the ability to perform the procedure under local anesthesia, and a commitment to patient satisfaction, Motiva stands out as a leading choice for breast augmentation. Consult with your surgeon to discover how Motiva implants can help you achieve your aesthetic goals.

Patient testimonial

 

Miss Missouri 2020 *

This procedure is designed to reshape and elevate the sagging or drooping breast (as a result of weight loss, natural aging process, congenital deformity or changes following pregnancy and breast feeding). Mastopexy may be combined with a small breast reduction or augmentation procedure.

Breast lift / Mastopexy FAQ

Why do the breasts sag?

 

Actual patient of Dr Turowski *

Generally, breasts sag because the skin envelope became larger than the breast content (breast tissue itself). It might be a result of skin stretching or loss of breast volume. It frequently follows weight loss, maybe a result of pregnancy and breast feeding or natural aging process. Occasionally, it may occur early in life as a result of poor skin elasticity.

How is the breast lift performed?

There are many techniques designed to correct breast ptosis (sagginess). All of these procedures attempt to correct excess amount of skin and reshape the breast to a more desirable, youthful appearance. Depending on the preoperative shape of the breast more or less incisions may be required. During the procedure, the nipples are elevated to the appropriate level and the skin is repositioned around the breast. The nipples remain attached to the breast tissue so the nipples’ sensation is usually preserved. Most mastopexies can be performed through the concentric (circular) or vertical (“lollipop”) technique. In some cases minor reduction may be performed. Often it is desirable to insert an implant for added projection and upper pole fullness.

 

Actual patient of Dr Turowski *

How long will the procedure take?

Depending on the technique used the procedure takes approximately 2 to 2.5 hrs.

What kind of anesthesia is used for breast lifting?

The best and safe way to perform breast lifting is to perform the procedures under general anesthesia with patient totally unaware of the ongoing surgical procedure. In some cases IV sedation may be preferable.

Do I have to stay in the hospital?

Breast lifting is typically an outpatient procedure (patient returns home after she is recovered from anesthesia). However, to accommodate some patients’ needs an overnight stay and nursing support can be arranged.

What is the typical recovery?

After surgery, the patient is placed in a supportive bra and routine activities can usually be resumed within few days. There is usually a minimal discomfort in the first couple days after the procedure, well controlled with oral medications. Sports and exercises can be resumed within few weeks.

Actual patient of Dr Turowski. *

Breast lift (mastopexy) Chicago – testimonials *

*Individual results may vary and there are no guarantees that you will experience the same results as those mentioned here.

These procedures are designed to reduce size of the breasts. Large breasts are frequently associated with upper back/neck pain, shoulder grooving, under breast skin irritation. Therefore, most of these procedures are potentially covered by health insurance. Each patient has to be individually approved by her insurance company.

There are several techniques of breast reduction procedure. Generally they are either conventional inverted “T” techniques or vertical “lollipop” type surgery. Both are great ways to reduce breasts and have advantages and disadvantages. Our plastic surgeons utilizes both techniques for breast reduction. The choice which technique is used depends mostly on the size/shape of patient’s breasts and her desires for size change. This is usually discussed in detail during a personal consultation.

Breast reduction FAQ

Who is a candidate for breast reduction?

Anyone who is in good general health is a good candidate. There is no age limit, however the procedure should be avoided in girls less than 18 years old. There are exceptions in younger girls with so called “gigantomastia” who are seriously troubled by extremely large breasts, but these cases have to evaluated on individual basis. There is no upper age limit, and the procedure can be safely performed in medically stable older women.

How is breast reduction performed?

There are several techniques of breast reduction procedure. Generally they are either conventional inverted “T” techniques or vertical “lollipop” type surgery. Both are great ways to reduce breasts and have advantages and disadvantages. Our plastic surgeons utilizes both techniques for breast reduction. The choice which technique is used depends mostly on the size/shape of patient’s breasts and her desires for the size change. This is usually discussed in detail during a personal consultation. The procedure can be performed under general anesthesia or IV sedation and typically is done on the uotpatient basis

What is the typical recovery?

Breast reduction is typically an outpatient procedure (patient returns home after he is recovered from anesthesia). However, to accommodate some patients’ needs an overnight stay and nursing support can be arranged. After the procedure, the patient is placed in elastic, compressive bra. The bra can be removed after 2 days, when the routine activities can be resumed. The sports bra should be worn for three weeks after the procedure. There is usually minimal discomfort in the first couple days after the procedure, well controlled with oral medications. Sports and exercises can be resumed within few weeks.

*Individual results may vary and there are no guarantees that you will experience the same results as those mentioned here.

Correction of breast asymmetry Chicago – Testimonials*

*Individual results may vary and there are no guarantees that you will experience the same results as those mentioned here.

Occasionally, the size of a man’s breast is larger than desired. If you are self-conscious about the appearance of your breasts, various procedures have been designed to correct this imperfection. Most contemporary procedures involve ultrasonic liposuction for shape correction. Utilizing this advanced liposuction technique helps avoid unsightly scarring from surgical excisions.

Chicago Gynecomastia Surgery: A Solution to Male Breast Enlargement

Large breasts, while considered by many an asset in a woman, can be truly an embarrassment for a man.

Male breast enlargement, or gynecomastia, is a fairly common condition, affecting 40% to 60% of males. Millions of men and boys know the feeling of looking in a mirror or down at their bodies and seeing enlarged breasts where a flatter, more masculine chest would normally be.

Some of the factors that can cause male breast enlargement are:

Obesity:

As the body increases in weight the fat gets stored in various locations, including the chest. Additionally, the excess fat leads to the production of estrogen, which causes growth of more breast tissue.

Aging:

As a man grows older, the disruption in the balance of his hormones can cause the breasts to grow larger.

Alcohol Abuse:

If alcohol is abused to the extent of causing liver damage, a hormone imbalance can be created causing gynecomastia.

Cancer:

Certain types of cancer including lung cancer and testicular cancer can cause hormone imbalances resulting in male breast enlargement.

Prescription Drug Side Effects:

Many prescription medications have gynecomastia listed as a potential side effect. These include such drugs as amphetamines, antidepressants, blood pressure drugs, ulcer medications and antipsychotics.

Heredity:

Hereditary disorders such as Klinefelter’s Syndrome can cause breast enlargement in males.

Puberty:

During puberty, some boys will develop enlarged breasts due to the increased production of hormones that occur at that period of life. Most of the situation resolves itself without interference.

Steroid Usage:

The abuse of anabolic steroids by bodybuilders can cause the development of male breast enlargement. Once inside the body, these steroids can be chemically changed into estrogen, causing the growth of not only muscle tissue but breast tissue as well.

How do you know if you have Gynecomastia?

The symptoms are not difficult to see, which is why it is such a problem for those afflicted with male breast enlargement. Gynecomastia is characterized by excess localized fat, increased glandular tissue development and sometimes, excess breast skin. Any of these can be present in either one or both breasts.

How is Gynecomastia Correction Surgery Performed?

Dr. Turowski can perform gynecomastia surgery at his Chicago cosmetic surgery center on an outpatient basis. He will go over the entire surgical procedure with you in the days prior to the procedure.

First you will be prepped for surgery, including the administration of either general or local anesthetic. Dr. Turowski will proceed to remove excess fat​ and, breast tissue ​through a minimally invasive approach through a minimal access at the border of the colored areoloa skin. In most cases these access sites are barely detectable.

Interestingly for most case of gynecomastia skin resection is nor required . The exact procedure will be based on a thorough examination and consultation done at the New Horizons Center for Cosmetic Surgery in Chicago.

With a gynecomastia procedure, Dr. Gregory Turowski of New Horizons Center for Cosmetic Surgery can reduce the size of enlarged male breasts, returning to them a flatter, more masculine look.

Recovering from Surgery

Every surgery has a recovery process and it is essential that you follow the instruction given you by Dr. Turowski during your period of recovery.

After your surgery, Dr. Turowski will place a foam pad on your chest covered by a compression vest. The pad is normally left on for a week and the compression vest for about
​2​ weeks. The compression vest minimizes swelling and supports your new chest contour as it heals. Any bruising from the procedure will go away in from ​2-4 weeks.

Be sure to ask Dr. Turowski specific questions about what you can expect during your individual recovery period and for a list of the “dos and don’t” you must adhere to following surgery.

Getting a Consultation

Where women will usually freely discuss concerns over breast development and size with friends, men are unlikely to do so. This is one reason getting a consultation with Dr. Turowski is so important.

If you are a male with enlarged breasts causing you emotional discomfort or impairing your confidence or self esteem, you should talk to Dr. Gregory Turowski at the New Horizons Center for Cosmetic Surgery in Chicago. Dr. Turowski, MD, Ph.D., F.A.C.S is one of few double board-certified plastic surgeons specializing in plastic and cosmetic face and body surgery. With a European background, and years of training at Harvard and Yale, he’s the doctor you want to see for a decision regarding gynecomastia and male breast reduction surgery.

Come to the Chicago Cosmetic Surgery Clinic for a Consultation with Dr. Turowski about your Male Breast Enlargement

Gynecomastia can be treated and usually fully resolved with cosmetic surgery here in Chicago. Even if you don’t live right in the Chicago area, it’s worth it to take a few days and come to New Horizons Center for Cosmetic Surgery in Chicago and talk to Dr. Gregory Turowski. He can help guide you into the right decision regarding gynecomastia
​procedure.

The goal of your gynecomastia

​procedure will be to give you a flatter chest and relieve both mental and physical stress this condition can cause.

Male breast reduction FAQ

What is gynecomastia?

This is a medical name for the enlarged male breasts (from Greek language “woman-like breasts”). Sometimes it may be associated with male/female hormonal imbalances. In most cases, however, it is a common, benign condition consisting of breast fibrous tissue enlargement and extra fat deposition.

Who is a candidate?

Anyone who is in good general health is a good candidate. There is no age limit, although, patients with elastic, firm skin have the best chance to avoid skin excisions. Although temporary breast enlargement is common in teenage males, prolonged enlargement may lead to significant emotional distress. Therefore, correction of gynecomastia may be indicated in this age group.

How is male breast reduction performed?

The recent development of ultrasonic liposuction almost entirely eliminated the need for skin excision in cases of male breast enlargement and thus the creation of unsightly scars typical for surgical breast excisions. Excess amount of breast tissue and fat is removed through minute, well hidden incisions, allowing the skin envelope to conform to the new shape of breasts. The nipples are preserved. In some extreme cases skin excision might need to be performed but is then usually limited to circular, non-conspicuous incision around the nipple. The procedure can be performed under general anesthesia or IV sedation.

What is the typical recovery?

Correction of gynecomastia is typically an outpatient procedure (patient returns home after he is recovered from anesthesia). However, to accommodate some patients’ needs an overnight stay and nursing support can be arranged. After the procedure, the patient is placed in an elastic, compressive, spandex-like garment. The garment can be removed after 3 days, when the routine activities can be resumed. The garment should be worn for two weeks after the procedure. The garment is non-conspicuous and easily hidden under regular clothes. There is usually minimal discomfort in the first couple days after the procedure, well controlled with oral medications. Sports and exercises can be resumed within few weeks.

*Individual results may vary and there are no guarantees that you will experience the same results as those mentioned here.

Revision breast surgery Chicago – Testimonials *

*Individual results may vary and there are no guarantees that you will experience the same results as those mentioned here.

• Some women experience complications such as leakage, rupture, or capsular contracture, where the scar tissue around the implant tightens, leading to discomfort and changes in breast shape. These are typically treated by releasing scars and replacing implants with a fresh set.
• Some simply got older and do not want to replace implants anymore
•  Others may face health issues that they believe are related to their implants, often referred to as “breast implant illness,” which can include symptoms like fatigue, joint pain, and autoimmune responses. Although there is no scientific proof that implants can cause these diseases and symptoms some women feel better after implant removal

 The procedure itself involves the careful removal of the implants and, if necessary, any scar tissue. What is proven is that “en-block” or the entire capsule removal is not necessary and can be harmful to breasts and cause unnecessary scarring. As a matter of fact surgeons who recommend these procedures are considered unethical by the American Society of Plastic Surgeons 

Dr Turowski may also recommend a breast lift or other reconstructive procedures simultaneously to enhance the aesthetic result. Recovery times can vary, but many patients can return to normal activities within a few weeks, though full recovery may take longer, especially if additional procedures were performed.

Emotional and psychological aspects are also important to consider. Many women report feeling a sense of relief after explant surgery, particularly if they had been experiencing discomfort or health concerns related to their implants. It can also be a transformative experience, allowing women to embrace their natural bodies or pursue a different aesthetic.  Consulting with a knowledgeable surgeon like Dr Turowski is essential to ensure that all options are thoroughly discussed, and that the patient feels supported throughout the process.

Inverted nipple correction Chicago – Testimonials *

*Individual results may vary and there are no guarantees that you will experience the same results as those mentioned here.

*Individual results may vary and there are no guarantees that you will experience the same results as those mentioned here.

We understand that the diagnosis of breast cancer often presents an emotional and physical strain on you and your family, and we want you to know that we will work in concert with your team of physicians to provide the highest quality of care available in a compassionate manner. You can be assured that our priorities are aligned with you and your cancer doctors, with the top priority to cure your cancer.

Although you may have already been referred to, or have seen another plastic surgeon for a consultation regarding breast reconstruction, you should consider a second opinion from a plastic surgeon specializing in this type of surgery. The decision-making process and overall surgical experience that is vital for the success of these highly complex surgeries are of upmost importance. Therefore, it is important to become fully informed and make an educated decision:

• When considering your choices in breast reconstruction, you should weigh the pros and cons of having surgery performed at a large teaching institution, where you may be operated on by a surgeon-in-training under the supervision of an attending surgeon. This is in contrast to a private hospital, where all your surgery and care will be performed personally by very experienced attending surgeons.
• Smaller institutions that specialize in breast cancer treatment usually offer a more personalized approach to care and yet have the same high standards offered by its larger counterparts.
• At a consultation, you should be able to view multiple postoperative photographs of actual patients, who have undergone similar procedures in all stages of the reconstructive process.
• If desired, you should be able to contact previous patients who have underwent similar procedures to hear real stories of their recovery and healing process.

The goal of reconstructive surgery is to restore what has been removed by various approaches based on your preferences and appropriateness of the surgery. During your consultation, we will discuss in detail the available options for breast reconstruction, taking into consideration your medical history, need for adjunctive treatments such as chemotherapy and radiation, and personal preferences. Based on this information, we tailor a plan and coordinate surgery with your breast surgeon. If you do not have a breast surgeon, we will be able to refer you to several surgeons specializing in breast cancer surgery. This is of paramount importance, since the final results of an immediate breast reconstruction depend greatly on the teamwork of the breast cancer surgeon and plastic surgeon. It is our goal to provide you with as much information as possible to assist in making an informed decision about breast reconstruction.

Many decisions need to be made to decide which reconstructive option is most appropriate for you. Most breast reconstruction can be performed at the time of the mastectomy, or in other words – immediate breast reconstruction. However, there are rare circumstances where a delayed breast reconstruction may be recommended, depending on if you will require other treatments after the mastectomy. If the reconstructive surgery was not performed during the initial mastectomy surgery, depending on circumstances, delayed breast reconstruction can usually be performed as soon as several weeks after the original surgery. We have also performed breast reconstructions as late as 30 years after the initial mastectomy. Barring any coexisting major medical problems, the age of the patient is usually not a limiting factor.

The reconstructive options available differ in their approach, amount of time for the initial surgery, length of hospitalization and recovery time, and need for future procedures. In general, breast reconstruction, from creation of a breast mound to nipple and areola reconstruction, requires staged procedures, although the subsequent procedures usually are minor outpatient or in-office surgeries with significantly shorter recovery times. To provide our patients an exceptional experience and for their convenience, most of these secondary procedures can be performed in our private fully- accredited state-of-the-art surgery center.

Breast reconstruction options

Broadly speaking, breast reconstruction can be divided into implant-based reconstruction or autologous (your own tissue) reconstruction. However, there are reconstructions, such as the latissimus dorsi flap from your back, that incorporates both your own tissue with an implant to create a breast of appropriate volume based on your preferences or to match the other remaining breast.

Breast reconstruction – FAQ

Who is a candidate?

Any woman who is going to have or has had a unilateral or bilateral mastectomy is a candidate for breast reconstruction. Occasionally, breast reconstruction is also necessary to correct post-lumpectomy changes in breast shape or size.

Should my reconstruction be immediate or delayed?

In most situations an immediate breast reconstruction (done at the time of the mastectomy) is appropriate. The advantage of this approach is that you wake up from the surgery with a new breast, or the beginnings of a new breast, already in place. In addition, when the breast reconstruction is performed immediately, the soft tissue envelope is not allowed to heal and contract, which often enhances the eventual reconstructive result. There are some instances where Dr Turowski will recommend a delayed reconstruction, but this decision is made on an individualized basis.

Where are the scars after breast reconstruction?

This depends on the type of reconstruction performed. With a tissue expander/implant based reconstruction, the scar created from the mastectomy provides access for the breast reconstruction. With a latissimus dorsi flap reconstruction, there is an additional scar on your back. With a TRAM flap reconstruction, there is an additional scar on your lower abdomen, analogous to that created during an abdominoplasty or “tummy tuck”.

Will the reconstructed breast be symmetric to the existing breast?

In cases of unilateral reconstruction, every attempt is made to create a balanced, natural appearing reconstructed breast. This may require staged surgeries. In addition, Dr Turowski may recommend a surgery on the contralateral breast (such as a breast augmentation, reduction, or lift) to make matching the reconstructed breast easier or making overall improvement in your appearance. In cases of bilateral reconstruction, symmetry is often obtained because the same reconstructive technique is applied to both breasts.

Will the reconstructed breast have sensation?

A reconstructed breast usually does not have normal sensation that existed before the surgery, but most women find that some sensation returns after several months.

What is the recovery after breast reconstruction?

This depends on the type of reconstruction. After a tissue expander/implant reconstruction, you can expect the stay in the hospital for 24-48 hours. For a latissimus dorsi flap reconstruction, hospitalization ranges from 2-3 days. After a TRAM flap, you can expect a 3-5 day hospital stay.

Pain medications are typically required for 1-2 weeks, and activity is gradually increased over a several week period of time. Occasionally, we recommend physical therapy after breast reconstruction to regain mobility and strength.

What is done for restoring the nipple and areola?

The final stage of breast restoration takes place after the breast mound is created. Initially the nipple is reconstructed using local tissue, and then medical tattooing is performed to restore the color of the areola. Both of these are performed as minor office procedures.

Can breast cancer recur after breast reconstruction?

In rare instances, breast cancer can recur after a lumpectomy or mastectomy with or without reconstruction. Modern techniques, such as mammogram, ultrasound, and MRI, allow detection of breast cancer recurrences even in the setting of a reconstructed breast. Your team of physicians will monitor you for recurrences with the appropriate tests after your mastectomy and reconstruction. Several studies showed no difference in recurrence detection or patient survivals in patient with or without reconstructions..

Does insurance cover breast reconstruction?

Insurance companies and managed care organizations are now required to pay for breast reconstruction for women who have had a mastectomy. Health care plans are also required to pay for surgery to make the opposite natural breast match the reconstructed breast. The Women’s Health and Cancer Rights Act of 1997, which ensures these rights, states that:

“A group health plan, and a health insurance issuer providing health insurance coverage in connection with a group health plan, that provides medical and surgical benefits with respect to a mastectomy shall ensure that, in a case in which a mastectomy patient elects breast reconstruction, coverage is provided for:

1. All stages of reconstruction of the breast on which the mastectomy has been performed; and
2. Surgery and reconstruction of the other breast to produce a symmetrical appearance;

in the manner determined by the attending physician and the patient to be appropriate, and consistent with any fee schedule contained in the plan.”

This law is also observed by Medicare and Medicaid. However, you should still check with your insurance company ahead of time – most companies require that you obtain authorization in advance about any surgery that is not an emergency. Also, not all insurance companies cover nipple tattooing, so ask about this procedure if you think you would like to have it done. If you do not have insurance, you should talk with your doctor about the cost of the breast reconstruction surgery and office visits.

Implant-based reconstruction

A breast implant is a round or teardrop-shaped shell, filled with saline (salt-water) or silicone gel. The implant is placed behind the pectoralis major chest muscle in a manner similar to what occurs during breast augmentation surgery.

In a select group of women, implants may be placed as a one-stage process, where a permanent implant is used at the time of the mastectomy. However, most women require a two-stage process, using a tissue expander before the permanent implant is placed.

A tissue expander is an implant with a valve/port that can be filled with saline to stretch the remaining chest skin and soft tissues to make room for the breast implant. The tissue expander is placed under the pectoralis major muscle at the time of your mastectomy. After the incisions have healed, a small valve/port is accessed and saline is injected into the expander during several office visits, usually over a 6-8 week period of time. This gradual stretching creates more skin and soft tissue, not unlike how the skin of the abdomen stretches during a pregnancy. The tissue expander is filled until it is slightly larger than the desired size to assure that the skin and soft tissue can accommodate the permanent implant. At a second surgery, the tissue expander is replaced with a permanent saline or silicone implant.

The advantage of this type of reconstruction is that the initial surgery is shorter, on average adding only 1-2 hours to the mastectomy surgery and typically requiring only a single day of hospitalization. Since this technique does not involve removal of tissue from another site of your body, it does not create any additional scars or potential donor-site morbidity (see below for more details).

The disadvantage of this approach is that it typically involves a tissue expander, which requires at least 2 surgical stages and multiple visits to our office during the expansion process. There are instances where this may be more challenging for the patient than a recovery from a latissimus dorsi flap reconstruction (see below). In addition, an implant does not have the same shape and feel of a natural breast, so that it may make matching the opposite breast more difficult (for patients only having a unilateral or one-sided mastectomy). As opposed to other types of reconstruction this type of surgery may produce a higher risk of early complications when performed as immediate breast reconstruction. In the short-term, the implant can become infected or malpositioned, which may require surgery to correct these problems. In the longer-term, implants may eventually require subsequent procedures to replace them due to capsular contracture, rupture, or malposition.

Autologous tissue reconstructions

Breast reconstruction can be performed without implants, using a flap of your own tissue. A flap entails a combination of skin, fat, and/or muscle that is taken from one portion of your body and moved to your chest to create a breast. The advantages of using your own tissues are that it typically has a more natural shape and feel of a native breast, and that it typically avoids the use of an implant. It also offers immediate reconstruction of the breast shape that usually requires only minor adjustments during secondary procedures. The disadvantages of this approach are that it requires a longer surgery and recovery time, and creates an additional scar on your body, with the potential for donor-site morbidity. The main autologous reconstructions use tissues from the back or abdomen and are described below.

Latissimus Dorsi Flap

A latissimus dorsi flap involves taking the skin, fat, and latissimus dorsi muscle from your back (in the area below your scapula or shoulder blade) and tunneling it through the axilla or armpit to create a breast. Sometimes it is possible to use this flap without implants in order to achieve the desired size. However, this technique often is used in conjunction with a tissue expander or implant to reconstruct the breast.

Why use a latissimus flap if you are going to use an implant anyway? There are several reasons. Using a latissimus flap with an implant typically has a more natural shape and feel than an implant alone. One way to describe this effect is for you to imagine putting an implant under a bed sheet. With only a thin sheet over the implant, all of the contours of the implant are visible and the implant can be readily felt. On the other hand, if the implant is placed under a thick comforter, the implant is there only to provide volume, and is not as visible or palpable. The former analogy describes an implant-only based reconstruction, while the latter analogy describes the latissimus flap with implant reconstruction. In addition, placing the skin, fat, and muscle over an implant may reduce complications relating to infection and radiation therapy.

Therefore, the advantages of the latissimus flap are that it decreases some of the risks of using an implant, it typically is easier to match the opposite breast with this approach, and it replaces deficient skin and soft tissue which may be missing or damaged after the mastectomy and/or radiation treatments. In cases of immediate breast reconstruction, the patient emerges from the mastectomy and reconstructive surgery almost completely restored to a natural (or sometimes better) size and shape as compared to having a mound of tissue present if an expander is utilized. After the initial surgery, there often is no additional expansion necessary. Therefore the recovery period is usually surprisingly easier than for an expander/implant reconstruction, because there is no need for the sometimes-painful injections and stretching associated with the expansion process. We utilize this technique in all age groups (young and old) with tremendous success. We believe it is optimal for women looking for a relatively quick recovery and very satisfactory results without the disadvantages of prolonged expansion and problems of implant exposure.

The disadvantages of this approach are that it requires a longer surgery, and it results in an additional scar on your back where the flap is obtained (although this scar is usually well hidden by your bra). The loss of muscle function is usually well compensated by the other muscles of the shoulder and back.

TRAM Flap

The TRAM flap stands for a Transverse Rectus Abdominus Myocutaneous Flap. Put simply, it uses your abdominal skin and fat based on blood vessels that travel through the rectus abdominus muscle (sometimes known as your six-pack muscle). There are many variations of this type of flap which indicates the method by which Dr Turowski move the abdominal tissue up to the chest to create the breast. In a peddled TRAM, the tissue is moved to the chest by a subcutaneous tunnel in the lower portion of your breast. In a free TRAM, the abdominal tissue is transferred to the chest by using microsurgical techniques to reconnect the blood vessels that provide nourishment to the tissues.

The advantages of the TRAM are that it removes abdominal tissue to reconstruct the breast, which improves your abdominal contour after surgery (similar to an abdominoplasty or tummy tuck). In addition, it avoids the use of an implant, has a more natural look and feel, and is durable.

The disadvantages of this approach are that it requires a longer surgery with a longer recovery time than for both an implant-based or latissimus flap reconstruction, it creates a scar across your lower abdomen (similar to the scar after a tummy tuck), it may result in some abdominal muscle weakness, and it is possible to develop bulging or a hernia at the site where the flap is taken from.

DIEP and SIEA Flap

The DIEP and SIEA flaps stand for the Deep Inferior Epigastric Perforator and Superficial Inferior Epigastic Artery flaps, respectively. These flaps fall under the category of perforator flaps, which are advanced microsurgical procedures that attempt to spare the abdominal muscles. The advantage of using these flaps is that it spares the abdominal wall fascia and muscles, and may reduce the incidence of weakness, hernia/bulging, and post-operative pain. The disadvantages of the DIEP and SIEA flaps are that is a significantly longer operative procedure, and has the risk of problems with the microsurgical connections of the blood vessels.

Surgery on the other breast

In some patients who are receiving a unilateral mastectomy, to achieve optimal results we may recommend surgery on the contralateral or opposite breast in order to make the breasts more symmetric. This may involve a breast reduction, breast lift, or breast augmentation. Fortunately, these procedures are covered under insurance under the Women’s Health and Cancer Rights Act of 1998.

Nipple and areolar reconstruction

After the breast mound is created with a flap and/or implant, the nipple and areola are reconstructed in a subsequent outpatient or office procedure. The nipple is made by surgically rearranging a small portion of the skin and fat of your reconstructed breast, and the areola is tattooed in a separate procedure.

Bilateral breast reconstruction

In some circumstances, bilateral breast removal or mastectomy may be recommended by your oncologist or breast surgeon. This may either be for treatment of a bilateral breast cancer or as a prophylactic measure in high-risk patients. Breast reconstruction in this circumstance often allows Dr Turowski more control over the reconstruction and to achieve outstanding and symmetrical results. We have utilized bilateral implant reconstructions, bilateral TRAM flaps, and bilateral latissimus dorsi flaps with great success.

Breast reconstruction – Testimonials *

Patient Reviews & Recommendations

RealSelf Patient Reviews of Gregory Turowski, MD, PhD, FACS

*Individual results may vary and there are no guarantees that you will experience the same results as those mentioned here.