La Jolla Reconstructive Surgery – Breast Reconstruction, Trauma and Physical Irregularities

It is our sincere pleasure to have helped hundreds of patients at our La Jolla clinic who have had mastectomies rediscover their inner and outer beauty through breast reconstruction. Of all the things we do here at SK Clinic in La Jolla, near San Diego, there is a true sense that we are contributing in a very real way to the renewal of the total person. We help them overcome both a physical and emotional loss and have a sense of being “‘whole” again.

• Breast Reconstruction
• Congenital Deformities and Trauma Reconstruction

 Breast Reconstruction

At SK Clinic of La Jolla, outside of San Diego, we use four specific approaches to breast reconstruction, the results of which can be remarkable. Each procedure is discussed thoroughly with you and then the procedure is completely individualized to meet your needs and desires. All procedures are performed at the hospital by Dr. Krant or Dr. Apostolides.

The first option at SK Clinic of La Jolla for breast reconstruction involves a prosthetic expander, which is inserted under the skin and chest muscles. This can be done at the time of the mastectomy or any time thereafter. Over a period of months, saline solution is easily injected into the expander and the overlying skin and muscles stretches and adapts. With this approach, the patient can help decide what final size she wants. Once the tissue is fully stretched and expanded to the desired size, the expander is removed and a permanent saline or gel implant is placed within the space that was expanded. The result is natural appearing breasts that are symmetrical and compatible.

The second breast reconstruction option is the latissimus dorsi flap. In this alternative reconstructive procedure, we move both skin and muscle from the back and transfer it to the front of the chest to recreate tissue that was lost. The bra line discretely masks the scar line created on the back. This procedure is particularly favored in cases where a mastectomy or radiation treatment has left insufficient tissue in the breast area. However, in this procedure a permanent implant or expander is typically required to add volume to the breast mound. Even though we do remove muscle from the back, function is not lost as other back muscles compensate to allow you to enjoy all your normal activities. This procedure can sometimes be done immediately after mastectomy or can be delayed to any time afterward.

SK Clinic of La Jolla, San Diego offers a third breast reconstruction procedure that involves using abdominal tissue to reconstruct the breast mound. This procedure, commonly known as a TRAM (Transverse Rectus Abdominis Myocutoneous) flap procedure, offers two resulting benefits. First, only existing tissue is used to recreate the breast mound, eliminating the need for an implant. Second, the resulting elimination of tissue and fat in the abdominal area provides a similar cosmetic outcome as an abdominoplasty or tummy tuck. The abdominal musculature is tightened and you still can perform all functions. The procedure may be performed immediately after mastectomy or may be delayed. It can be performed as a pedicle flap or as a microscopic “free” flap, a decision that will be determined by Dr. Krant or Dr. Apostolides.

The fourth option is the DIEP flap. This is one of the newest and most advanced reconstructive techniques that we now offer.  The DIEP flap stands for “Deep Inferior Epigastric Perforator” Flap.  It is a technique of taking the excess skin and fat from the abdomen, as you would in a tummy tuck, based on a small blood vessel that feeds blood to the tissue.  We then reconnect those blood vessels to an artery and vein in the breast effectively replacing the breast tissue removed with a mastectomy.  The result is a tummy tuck of the abdomen, with your abdominal muscles spared (unlike the more traditional TRAM procedure) and a reconstructed breast.  This can be performed for a single breast or both breasts.  This new method allows a woman to replace her breast tissue with similar tissue for a functional and aesthetic reconstruction.  Additionally, the patient benefits from a tummy tuck of the abdomen without any ill effect on the musculature.  You and your surgeon can decide which procedure is right for you. Along with various other flaps and implant based reconstruction, we are bringing the latest advances in breast cancer reconstruction to SK Clinic and San Diego.

With all breast reconstruction procedures, consideration is given to nipple and areola reconstruction as well. It is the patient’s decision whether or not to pursue this procedure, which will essentially make the reconstructed “mound” into a reconstructed “breast.” The results create a very natural appearing nipple and areola.

These procedures can be performed at the time of mastectomy, immediately allowing the patient to awaken with a breast “mound.” This offers a great psychological and emotional benefit. Breast reconstruction can also be performed at a later date, often dictated by the patient’s medical condition, or if the mastectomy was performed months or years earlier. The procedure is coordinated with our general surgeon, oncologist and radiation therapist. In either way, the breast mound can be effectively reconstructed to produce a natural, pleasing breast shape and form.

Contact SK Clinic in La Jolla, San Diego to learn more about breast reconstruction.

 Congenital Deformities and Trauma Reconstruction

Plastic surgeons perform an estimated one million reconstructive procedures annually. Reconstructive surgery benefits people of all ages and helps solve a wide range of issues resulting from congenital deformities (birth defects) and trauma (injury, disease, and aging). Dr. Stephen Krant and Dr. John Apostolides of SK Clinic in La Jolla perform masterful reconstructive surgery and are renowned for beautiful, meticulous work.

Typical cases of congenital deformities that are treated with reconstructive surgery are birthmarks, cleft-lip deformities, missing or extra fingers, malformed ears, and irregular breast growth. Trauma cases that plastic surgeons work to resolve include burns, lacerations, injuries from auto accidents, and irregularities resulting from diseases such as cancer. Procedures vary according to the purpose of the reconstructive surgery and are customized to meet the needs of the individual. Please contact our La Jolla office today to consult with Dr. Krant or Dr. Apostolides about the best way to proceed with your situation.