Aesthetic breast reconstruction is a cosmetic surgery performed to restore the breast(s) to an attractive appearance in shape and size following a lumpectomy or mastectomy after cancer (or for high risk breast cancer patients). The reconstruction can be done with a diep flap, implant, or other methods depending on the outcome you are looking to achieve.
Advanced options in reconstructive surgery make it easier for breast cancer patients to feel complete and have breasts that look and feel natural. This surgery can include a few procedures and different stages that may be done at the same time as your breast cancer treatment or delayed until the treatment is complete.
New Orleans, LA plastic surgeon Dr. Jules Walters creates an individualized surgical plan with compassion as we help you and your cancer team to restore your appearance and confidence. We work with leading breast oncologic surgeons in the area and are intimately involved from the beginning to help plan the best treatment option for your reconstruction. We also perform advanced Vectra 3D imaging to help us in the planning stages to achieve the best outcome for your newly reconstructed breasts.
Diep Flap Breast Reconstruction
DIEP flap breast reconstruction uses the skin and fat from the lower abdomen in order to shape the new breast. Because muscle tissue is spared in DIEP flap breast reconstruction, the procedure is not as invasive as older methods, and it involves a recovery period similar to a tummy tuck. The DIEP acronym stands for deep inferior epigastric artery perforator and is the most advanced reconstruction performed worldwide. What makes a DIEP flap different with Dr. Walters is low, hidden abdominal incisions, and abdominal results that resemble cosmetic tummy tucks.
Dr. Jules Walters has many years of experience with DIEP flap breast reconstruction for patients in the New Orleans area. This technique is more popular compared to the other methods of breast reconstruction. Dr. Walters and his team will determine if the DIEP flap method would be most beneficial or if another breast reconstruction technique would best achieve your aesthetic goals.
Using implants is another way to reconstruct the shape of your breasts. There are different types of implants and Dr. Walters can help you determine the type of implant and method that would make the most sense for your specific situation.
Aesthetic breast reconstruction is an extremely personalized surgery. Each patient will be required to have an in-depth consultation appointment with Dr. Walters to create their surgical plan from their concerns, needs, and appropriate techniques. If you are planning to have breast reconstruction surgery, it's vital that you are emotionally prepared for reconstruction and understand realistic expectations for results. While Dr. Walters aims to give you an attractive, natural appearance, your reconstructed breast(s) may not have the same sensations, look, or feel as your original breast(s). You should get approval from your oncology team to undergo reconstruction surgery and talk to Dr. Walters regarding other factors that may impact your recovery.
Breast Reconstruction Reviews
"Excellence in all! - I truly had the best experience and results I could hope for from Dr. Walters! My new reconstructed breast almost matched the first go-around, which is difficult to achieve. I had a DIEP flap with an easy to hide abdominal scar. Not all surgeons are able to do them so low, a testimony to his surgical and planning talent. Additionally, his bedside manner is excellent; he really helped me put..."- B. / RealSelf / May 21, 2018
"After my bout with cancer, I needed breast reconstruction. I was referred by a friend to Koobehi. Dr. Walters did an AMAZING job! My husband said once I saw the results for the first time, he could see the glow on my face that I was very pleased with the results! The ENTIRE STAFF were AMAZING , as well!"- D.W. / Google / Sep 06, 2019
"I was diagnosised in 2018 with TNBC. I had a bilateral masectomy. I completed my treatment in June of 2019. I decided to have implants put in, I thought that would be the least evasive way to go. Boy was I wrong. I got capsular contraction on the cancer side and the implant was tight in my chest and hard. I breast were not symetrical. Every time I lifted my arm it felt like my skin and muscle were ripping from my bones. I had pain in my knees, ankles, legs and feet. The other breast was not round like a normal breast, it had a square look to it. I was very disappointed with the way they looked and felt. Very unnatural. I decided I had to get these implants taken out. Thank God I was able to meet with Dr. Walters. I am only 4 weeks post-op for the DIEP flap procedure. As soon as I had those implants removed my pain instantly went away. I feel wonderful. AND my breast look amazing!!! They look and feel natural. All of the ladies in the office are exetremely nice and helpful. I had my prodecure at Ochsner Baptist and the nurses in ICU where very caring. I highly recommend Dr. Walters. I felt so bad for so long and was embarassed by the way I look. Now I can't stop talking about my breast. Can't wait to see the final outcome."- A.M. / Google / Jul 31, 2020
"Excellent doctor and excellent staff. My breast reconstruction went perfectly. I am more than happy with the results. Dr. Walters is a real professional and his staff is warm and compassionate. I would recommend Dr. Walters to anyone. He is an excellent plastic surgeon!!!"- B.D. / Google / Sep 18, 2020
"After consulting with multiple plastic surgeons, I chose Dr. Walters as my surgeon for many reasons. Dr. Walters was the only doctor who recommended the most modern, state of the art procedure for my breast reconstruction after my prophylactic double mastectomy. He patiently pursued privileges to work at St. Tammany Parish Hospital so that he could work alongside my breast surgeon. Throughout the entire process, he took great care to clearly communicate with me and to make sure that I fully understood all my options and what to expect while recovering. Although my surgery was prophylactic in nature, he took care to perfect my breasts as if was a cosmetic case. I have no visible scars, and my breasts look natural and beautiful. Throughout the entire process, Dr. Walters displayed authentic concern for my recovery, such to the extent that he called me multiple times to check on my progress. Additionally, he shared his cell phone number with me, which is exceptional for most doctors. Dr. Walters exceeded my expectations in all areas, and I would recommend him without hesitation! On a side note, during each of my procedures, each and every nurse who cared for me during my hospital stays explained they had never seen a doctor so incredibly meticulous in his work. Each claimed Dr. Walters would be their surgeon of choice. Dr. Walters staff were just as wonderful to work with. Throughout the entire experience, Dr. Walters and his staff were not only professional, but each cared for my happiness and well-being. If you or anyone you know is looking for a surgeon, I encourage you to visit with Dr. Walters. I am so happy I did!"- N.B. / Google / May 03, 2020
Dr. Walters uses a number of incision techniques to limit scarring, as well as reconstructive methods to create a natural-looking breast. Many of these advanced techniques are explained below.
Women undergoing breast reconstruction surgery are also often worried about how their breasts will feel after treatment and if they will have sensation restored.
Breast Neurotization with ReSensation™
Dr. Walters is committed to providing patients with optimal breast reconstruction outcomes, which is why he is one of a few select U.S. board-certified plastic surgeons now performing breast neurotization with ReSensation™. This is a revolutionary, highly-advanced surgical technique that gives breast cancer survivors the opportunity to not only look like themselves again but to actually feel normal at the same time.
During a mastectomy, breast tissue is removed, often times severing the nerves that provide feeling to the breast, skin, and nipple. This often results in numbness or a loss of feeling or sensation in the breast area that many times does not return. With ReSensation, Dr. Walters provides patients with the possibility of restoring sensation to the breasts as part of the flap reconstruction surgery method. The technique uses allograft nerve tissue to reconnect the nerves in the flap with those in the chest wall. Over time, this guides regrowth of nerve fibers and can potentially restore sensation to the breast. The return of breast sensation and feeling is discussed in detail during the initial consultation. ReSensation is explained to help give women some reassurance that Dr. Walters does everything possible during surgery to help restore feeling back to the breasts.
HIDDEN SCAR TECHNIQUE
There are a variety of surgical techniques available to reconstruct the breasts, mainly utilizing either implants or autologous tissue (flap surgery). Dr. Walters uses the SPY Elite system, imaging technology used during breast reconstruction, to guide him to the most healthy tissue for the best results possible. There are also multiple factors that Dr. Walters looks at when deciding on the technique that will give you your best results. A few of these factors are your specific cancer diagnosis, when the reconstruction is performed, whether you will use implants or natural tissue, and if nipple reconstruction or nipple-sparing is a part of the treatment plan. Scars certainly do matter, and Dr. Walters closely works with the breast oncologic surgeon in deciding the incisions utilized for your breast cancer surgery. Dr. Jules Walters is the FIRST plastic surgeon in the New Orleans area to be a Hidden Scar Breast Reconstruction provider.
Hidden Scar Breast Reconstruction Surgery
This method is an advanced approach to reshaping your breast after a mastectomy procedure. During Hidden Scar Mastectomy and Hidden Scar Breast Reconstruction procedures, the breast surgeon and Dr. Walters will work together to hide your scars. As a result, you have little to no visible reminder of the surgery, your cancer, or your risk of cancer.
In a Hidden Scar Breast Reconstruction procedure, Dr. Walters will reshape your breast to have the natural look and feel that you desire while hiding all of your scars. Your surgeon will use the same incision in the natural crease beneath your breast (inframammary fold) that your breast surgeon used to perform the Hidden Scar Mastectomy procedure. If Dr. Walters and your breast surgeon cannot keep your incision in the natural crease beneath your breast, then a vertical incision or anchor type incision is utlized (all incisions used in cosmetic breast surgery). Horizontal scars on the breast commonly used in reconstructions by other surgeons are not utilized by Dr. Jules Walters. These principles make up the concepts of Aesthetic Breast Reconstruction offered by Dr. Walters.
ALTERNATIVE FLAP TECHNIQUES WE OFFER:
Another flap is the profunda artery perforator flap (PAP). This method uses skin and fat from your inner thigh to create your breast(s). The incisions in your thigh will resemble a cosmetic thigh lift.
The GAP (gluteal artery perforator) technique uses skin and fat from the buttocks (either lower buttocks or from the hip area) to reconstruct the breast. This is performed when there is not enough fat or skin in the abdominal or thigh area to be used.
Hybrid Stacked Flap
This muscle-sparing technique takes flaps from different sections of your body for breast reconstruction, typically used for women who don't have adequate donor tissue in a single area of their body. A hybrid stacked flap can also be utilized with a small breast implant at the same time to give the flap more projection.
Please click on the video below to open the player in a new window:
Although flap procedures are a common and highly successful method for breast reconstruction surgery, you may want to rebuild your breast(s) with implants utilizing the most ADVANCED TECHNIQUES. This technique places a tissue expander above the pectoralis muscle (prepectoral technique) and then gradually fills it with air or saline solution over the next few weeks to stretch the skin naturally. In certain patients, Dr. Walters will perform a Direct-to-Implant technique (DTI) in the prepectoral position, where the breast implant is placed immediately instead of requiring an additional tissue expander step.
ADVANTAGES OF PREPECTORAL IMPLANT RECONSTRUCTION:
Because the chest muscle isn’t cut:
- Potentially shorter recovery time
- Potentially less pain or side effects caused by cutting the chest muscle
Because the implant is placed over the muscle:
- Surgeon has greater control of shape and form of the breast
- Flexing your chest muscle will not make the breast implants move in unpleasant, unnatural ways
- No Animation Deformity
Surgical breast reconstruction is done in several steps. In all phases (like the flap creation, tissue expansion, or implant placement), general anesthesia is always used. Flap surgeries usually require a 3 day stay in the hospital whereas implant or tissue expander placement requires just an overnight stay. Flap surgeries usually involve a 2-4 week recovery where implant reconstruction is much less. A second stage reconstructive surgery, which is outpatient), is usually performed 3-4 months after your first surgery where the final shaping of your breast(s) is performed. Fat grafting is utilized in almost all second stage surgeries. You can further improve the look of your breasts by having areola and nipple reconstruction if you were not able to have a nipple sparing mastectomy. There are several procedures to restore the nipple-areola complex so that it appears more attractive, including 3D nipple tattooing if an additional surgical procedure is not desired. In time, the reconstructed breast(s) should appear more normal so you can feel whole again. Regular check-ups with breast exams with both your breast cancer surgeon and Dr. Walters are important and highly recommended for long-term health.
Plan Your Procedure
Reclaim Your Self-Confidence
Although the process of breast reconstruction can take time, it's probably one of the top beneficial surgeries for our New Orleans, LA patients. Remember it's not just breast reconstruction in our practice; it is Aesthetic Breast Reconstruction. We aim to help improve the physical and emotional impact of breast cancer treatment while also allowing you to boost your figure and self-confidence. If you have breast cancer or have a high risk of developing breast cancer, we encourage you to contact our New Orleans or Metairie, LA office and make an appointment with Dr. Jules Walters.
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