Christopher Williams, M.D.

Placing a breast implant is the most common way to reconstruct a breast after mastectomy or lumpectomy. An implant can restore the shape of your breast and help alleviate the emotional discomfort commonly experienced after breast cancer surgery. Implant reconstruction is one of the two main breast reconstruction options available. To learn if implant reconstruction is the ideal strategy for your needs, call 303-706-1100 to schedule a private consultation with our board-certified plastic and reconstructive surgeons. The Breast Center Park Meadows Cosmetic Surgery serves patients from Lone Tree and Denver, Colorado as well as across the nation. What is Implant Breast Reconstruction? There are two types of breast implants that can be used for implant-based reconstruction: Silicone breast implants Saline breast implants This is a procedure that uses a saline or silicone device to reshape the breast after cancer surgery. Our surgeons will work with you to select the implant size, shape, projection, and style that will best meet your needs. Saline implants have two basic components: an outer shell made of silicone polymer and an inner fluid made of a saltwater solution. This solution is similar to fluid naturally present in your body. One advantage of saline implants is that they have a flexible fill volume, so our surgeons can adjust them during the procedure. Silicone breast implants contain a silicone gel contained in a silicone shell, and closely resemble the look and feel of breast tissue once placed. Women who prefer silicone breast implants favor the natural appearance they provide. These implants are not prone to rippling or wrinkling, as can sometimes be the case with saline implants. Our surgeons most often recommend silicone gel implants because they provide patients with the most natural look and feel. With silicone implants, the recreated breasts move much more like normal breast tissue does. What are the Benefits of Breast Reconstruction Using Implants? Implant reconstruction benefits Implant reconstruction has numerous advantages that make it an appealing choice, including that it: Is widely available and something many surgeons are trained to perform Is a relatively short procedure Is highly customizable Limits surgery to the chest, as opposed to other areas of the body Generally involves a shorter recovery than other reconstruction methods Allows you to change your mind and pursue autologous reconstruction later Is ideal if you do not have enough excess tissue for autologous reconstruction As with all surgical procedures, implant reconstruction comes with a few considerations that you must weigh when deciding if it is the appropriate solution. One thing to be aware of is that breast implants are not lifetime devices. They will likely need to be replaced at some point down the road, typically after 10 to 15 years. Am I a Candidate For Implant-Based Breast Reconstruction? Saline breast implants for reconstruction Breast reconstruction using implants is an appropriate option for many women. However, since implant reconstruction candidacy depends on so many individualized factors, you will need to meet with our surgeons to find out if it is right for you. You may be a candidate for this procedure if you are interested in enhancing the fullness, contour, and femininity of your breast shape after undergoing one of the following surgical breast cancer treatments: Mastectomy Double mastectomy Prophylactic mastectomy Lumpectomy It is important to know that the nature of your cancer treatment may affect your candidacy for implants and the results that implants can offer. For example, radiation therapy performed before or after implant placement results in significantly higher reconstruction complication rates. For that reason, many surgeons view autologous reconstruction as the ideal method in the case of radiation. Stages of Implant Reconstruction Implant reconstruction can be performed at any time after your breast cancer surgery. Reconstruction timing is split into three categories: immediate (also known as single-stage or direct-to-implant), staged, and delayed. Immediate reconstruction is done immediately after your mastectomy; you will wake up with a new breast mound and skip the tissue expansion process. Staged reconstruction begins at the time of mastectomy and is completed at a later date. Delayed reconstruction is done months or years after mastectomy surgery. Many patients undergo staged reconstruction, which is completed in three phases: First stage: A tissue expander is placed beneath the skin to create space for an implant. Our surgeons will fill the expander will a sterile saline solution to gradually increase the size of the breast pocket over time.

Minor procedures are almost always necessary after breast reconstruction surgery to achieve the most natural-looking, aesthetically pleasing result. These secondary surgeries and techniques are a normal part of the overall breast reconstruction process here at The Breast Center Park Meadows Cosmetic Surgery. Our board-certified plastic surgeons also use many of these same methods to improve an unsatisfactory reconstruction performed elsewhere. Pursuing revision procedures and techniques doesn’t mean that something has gone wrong with your reconstruction. Rather, these are optional adjustments done to provide the best-possible breast shape, contour, volume, and appearance. Our surgeons are committed to achieving your goals for reconstruction through revision. To learn more about breast revision and shaping procedures, call 303-706-1100 to schedule a consultation. We serve patients from Denver and Lone Tree, Colorado, and across the country. Breast Shaping Surgeries The term breast shaping refers to procedures and techniques that help achieve ideal breast shape and size after reconstruction. Our surgeons can use these methods to adjust one or both reconstructed breasts, as well as the non-cancer breast in women who choose to undergo a unilateral (one-sided) breast reconstruction. Breast shaping adjustments commonly include: Breast lift Breast reduction Liposuction Fat grafting Placing a breast implant Fat Grafting Dr. Jeremy Williams and Dr. Christopher Williams often use fat grafting to provide optimal reconstructive results. With this method, fat from elsewhere on your body is used to shape your breast contours and enhance breast symmetry. Fat grafting can help soften the edges around the implant, if needed, and can also fill contour defects that may appear during the settling process. When fat grafting is used for breast shaping surgeries, the patient’s own fat is harvested by liposuction techniques from donor areas such as the abdomen, flanks, and thighs. Fat grafting is usually an outpatient procedure and often takes place at our state-licensed, The Joint Commission-accredited facility Park Meadows Outpatient Surgery. VIEW OUR BEFORE AND AFTER GALLERY OF BREAST RECONSTRUCTION REVISION USING FAT GRAFTING. Nipple Reconstruction Patient review of breast shaping For the increasing number of women who receive a nipple-sparing mastectomy, nipple reconstruction won’t be a concern. However, you may have undergone a mastectomy that involved removing the nipple. In that case, reconstructing it is a relatively simple process that can help you feel complete and improve your satisfaction with your results. Nipple reconstruction often follows implant-based or autologous tissue-based breast reconstruction. One of the main techniques involves using your own tissue to create a mound that looks like a nipple. Oftentimes, this tissue comes from the reconstructed breast itself. The nipple will not have sensitivity like your nipples did before, but many women feel better about their final breast reconstruction results when they have a visible nipple. Schedule Your Consultation Areola Pigmentation Areola pigmentation, sometimes called "nipple tattooing," is often the final step of the breast reconstruction process. It involves carefully and methodically recreating the appearance of the nipple-areola complex by placing medical-grade pigments under the skin with tattooing instruments. Nipple tattooing is completed no sooner than three months after nipple reconstruction to allow the latest incisions to heal properly. Our physicians and nurses have specialized training for this tattooing procedure. We offer a wide spectrum of shades and colors to create the result you desire. Areola pigmentation is done under local anesthesia, meaning you can drive yourself to and from our practice for your appointment. As with any tattoo, the pigments will tend to fade with time, and acquiring the precise shade may require more than one pigmentation (tattoo) procedure. This final phase of reconstruction often serves to transform the reconstruction into a breast that is truly your breast. This enables many survivors to lay their cancer burden down and move forward in life with restored femininity. Call Dr. Williams For Breast Shaping In Park Meadows! Find out which of these procedures and techniques may be right for you by scheduling a consultation at 303-706-1100. You can also request an appointment by submitting an online contact form, and we’ll get back to you at our earliest convenience. The Breast Center Park Meadows Cosmetic Surgery serves patients from Denver and Lone Tree, Colorado, and across the country.

Nipple-sparing mastectomies are becoming increasingly common. Still, there are plenty of women who are not candidates for this type of breast cancer surgery. If you belong to that group, you may choose to get nipple tattoos as the final stage of your breast reconstruction. We are proud to offer several surgeries and treatments to enhance reconstruction results. Schedule a consultation at 303-706-1100 to learn more about achieving your cosmetic goals. The Breast Center Park Meadows Cosmetic Surgery serves Denver, Lone Tree, and nearby areas of Colorado. Many patients also travel from across the country for our expertise. What Is Nipple Tattooing? Nipple tattooing is a way to recreate the appearance of your nipple and areola. The process is similar to getting a tattoo anywhere else on your body. In this case, the difference is that it involves the application of medical-grade pigments to the center of your reconstructed breast. One of the biggest advantages of nipple tattooing is that it is very customizable. You can work with our team to choose details such as the color, size, and placement of your nipple tattoos. What Are the Common Reasons for Nipple Tattooing? There are a few different reasons to get a nipple tattoo. To begin with, it is a relatively simple treatment that has a high degree of satisfaction among patients. And unlike some secondary surgeries after breast reconstruction, it does not add any new scars to the breast. It can also be repeated as necessary to achieve the desired outcome and maintain the best possible results. Is Nipple Tattooing Typically Done Post-Reconstruction? Nipple tattooing is almost always done after breast reconstruction. It is uncommon to perform it at the time of implant-based or autologous procedures. Instead, most surgeons recommend waiting at least four months after reconstruction is finished to see the results of that surgery. For patients who have undergone nipple reconstruction, there is also a waiting period. It is generally recommended to complete areola pigmentation no sooner than three months after nipple reconstruction. That will allow the latest incisions to heal well before doing a tattoo. Who Is a Candidate for Areola Pigmentation? You may be a candidate for nipple tattooing if you had breast reconstruction with a tissue flap or implant. It can also be done if you had subsequent breast shaping surgeries such as fat grafting. However, areola pigmentation may not be right for everyone, including women who have damaged breast skin after radiation. It also may not work for those with overly thin breast skin due to mastectomy surgery. Our board-certified plastic and reconstructive surgeons will gladly evaluate your candidacy and determine if nipple tattooing is an appropriate treatment for you. Schedule Your Consultation Is Nipple Tattooing Painful? After mastectomy and reconstruction, most women lose sensation in their breast area. That means that it is common to feel little to no pain when getting a nipple tattoo. After the treatment, pain should be minimal and can typically be controlled with over-the-counter pain medications. How Long Does It Take for the Tattoo Area To Heal? It can take up to three weeks for a nipple tattoo to heal completely. At first, your tattoo will look red and irritated. The color may also look much darker than what you anticipated. These things are a normal part of the healing process. Please be patient as the color will gradually get lighter. Nipple tattoo aftercare is relatively simple and straightforward. You will need to keep the area moist with a triple antibiotic ointment for at least five days. Expect some peeling to occur. You may resume most regular activities, including eating, drinking, and exercising immediately following your procedure. However, please refrain from soaking in water for three weeks. How Long Will the Nipple Tattoo Last? Nipple tattoos should last for many years without noticeable fading. But keep in mind that there are many different factors at play. These include the color of the tattoo and how well you care for it over time. Because every situation is slightly different, It is difficult to predict exactly how long your areola pigmentation will last before the color degrades or gets blurry. Fortunately, you will have the opportunity to touch up your tattoo if you ever decide that you want to enhance its appearance. Schedule Your Areola Pigmentation Consultation in Lone Tree Whether you had breast reconstruction performed at our practice or elsewhere, our staff will gladly determine if you are a candidate for enhancing your results through areola pigmentation. Call 303-706-1100 to schedule a consultation with our board-certified plastic and reconstructive surgeons. The Breast Center Park Meadows Cosmetic Surgery serves Denver, Lone Tree, and nearby areas of Colorado, as well as across the country.

Autologous breast reconstruction uses your own tissue (most commonly fat, skin, and sometimes muscle) that is taken from a different area of your body to re-create your breast. This breast reconstruction technique is capable of achieving more natural-looking and durable results than reconstruction with implants alone. For most patients, complete restoration of the breast is possible in just a few stages, most of which will take place right here at our on-site surgical center. There are many options available today for autologous breast reconstruction. After performing an examination, our experienced Colorado breast reconstruction surgeons can help you determine the best method for your needs. To learn more about this reconstruction technique, please call The Breast Center Park Meadows Cosmetic Surgery at 303-706-1100 today. We proudly serve patients from Denver, Lone Tree, and nearby areas in Colorado. What is Autologous Reconstruction? In autologous breast reconstruction, skin, fat, and sometimes muscle tissue is taken from one area of the body in the form of a flap and then relocated to the chest, carrying its own blood supply. This tissue is used to create a new breast that often looks and feels natural. There are two forms of flaps used today in breast reconstruction — Pedicled and Free Flaps. A Pedicled Flap is a flap that has been rotated or moved from its original location to reconstruct a defect nearby, without losing that blood supply. A Free Flap is a flap whose blood supply is cut to move the tissue a longer distance for relocation. Free flaps are newer techniques, developed about 20 years ago, and since have become frequently used in breast reconstruction. Our board-certified plastic surgeons are among the few in the nation who have the microsurgical training to perform free flaps and reconnect the blood vessels. Autologous Breast Reconstruction Techniques Benefits of DIEP flap infographic At our practice, DIEP flap is the preferred method of autologous reconstruction. It is a muscle-sparing procedure that uses excess tissue from the lower belly, thus giving the added benefit of a slimmer abdominal area. While we prefer DIEP flap, there may be cases when another method would be more appropriate for you. Our surgeons have received training for these procedures, but we will often refer you to another physician for surgery. Other available autologous breast reconstruction procedures include the: SGAP Flap: This procedure uses tissue from the buttock area, and can be a good option for women who do not have enough excess abdominal tissue to accommodate a DIEP Flap. TUG Flap: The TUG Flap is a method that uses skin and fat from the inner thigh region, relocating this tissue to the chest wall to reconstruct the breast. TRAM Flap and Free TRAM Flap: These flap procedures utilize skin and fat in the abdominal area, but they take the rectus abdominis muscle as well. Even if only a small portion of the muscle is repositioned to the new breast, it can create abdominal weakness. Latissimus Flap: The Latissimus Flap is a technique which uses the skin, fat, and a part or all of the latissimus muscle from one side of the back. This can be a good option for patients with limited donor sites, such as the abdomen or buttock. It is also a good choice for patients with damage to one breast from radiation. Our board-certified surgeons will discuss your options in detail and recommend the procedure that best meets your needs and expectations. Perforator-Based Microsurgical Breast Reconstruction Perforator-based microsurgical breast reconstruction is the most state-of-the-art method currently used in autologous breast reconstruction. This method uses techniques that spare your muscles and nerves, aiming to limit damage to the donor site by harvesting only the artery and veins (i.e., the blood vessels that “perforate” your muscles). This technique leaves your muscles in place, instead of having them taken with the flap and causing more significant damage. Because this method requires so much extra time and effort, very few plastic surgeons use it – but we do whenever possible, for the benefit of our patients. DIEP flaps, SGAP flaps, and TUG flaps are all examples of perforator-based flaps.

There are several different types of mastectomy or breast cancer surgery. Most involve removing the nipple and areola. Therefore, women often rely on secondary surgeries and techniques after breast reconstruction to achieve the most natural-looking outcome. For them, nipple reconstruction surgery can be an important final step in their breast reconstruction journey. Of course, the choice is entirely up to you. Are you interested in exploring your options for nipple reconstruction? Call 303-706-1100 today to schedule a consultation at The Breast Center Park Meadows Cosmetic Surgery. We serve patients from Denver and Lone Tree, Colorado and across the country. What Is Nipple Reconstruction? Nipple reconstruction surgery is typically an outpatient procedure. It often uses the skin from your reconstructed breast or elsewhere on your body to rebuild an elevated nipple. To add color and create the appearance of an areola, the reconstructed nipple can be tattooed later. The most significant benefit of getting your nipple reconstructed is that it will project outward. You may find that this gives your reconstructed breasts a more natural appearance in and out of clothing. That can go a long way to increase your overall satisfaction with your results. Who Is a Candidate for Nipple Reconstruction? You may be a candidate for nipple reconstruction if you have had breast reconstruction with implants or a tissue flap. However, it depends on your health and breast tissue condition. Some factors that may impact your ability to get nipple reconstruction include: Skin damage due to radiation treatments Skin thickness after mastectomy and reconstruction Chest lymphedema A history of infections in the breast area Nipple reconstruction is ideal for those who want their nipples to have physical dimension. Some patients prefer it if their nipples do not show through their clothes and enjoy the freedom that comes with not wearing a bra. If you identify with the latter, tattooing may be a better option. Is Nipple Reconstruction Painful? Nipple reconstruction is a minor procedure that is usually performed under local anesthesia. You may notice a slight pinch as the numbing medicine is injected into the treatment area. Once it takes effect, you should not feel much pain or tenderness during the procedure. Keep in mind that you may have little to no sensation in your breasts after mastectomy and reconstruction. How Do I Prepare for Nipple Reconstruction? You will receive a specific set of pre-operative guidelines before nipple reconstruction surgery. Those guidelines will include information about: Eating and drinking before your procedure Medications to take or avoid What to wear to your surgery We often recommend waiting at least four months after breast reconstruction to get this surgery. Doing so will allow your breasts to heal and settle into their final appearance. If you are pursuing fat grafting and other shaping procedures, it is generally best to wait until those are complete. How Is Nipple Reconstruction Performed? Nipple reconstruction can be performed in several different ways. The most common techniques include: Skin flap: By folding and suturing together flaps of skin from your reconstructed breast, this approach creates a small elevated mound. Sometimes, additional skin, fat, or fillers are used to achieve better nipple projection. Skin graft: If there is not enough tissue to create flaps on the skin, a skin graft may be appropriate. It involves taking skin from another area of the body, such as the abdomen or thigh, and manipulating it to form a new nipple. Nipple sharing: If you had a unilateral mastectomy and the nipple on the unaffected breast is big enough, a portion of it can be used to build a new nipple. This technique results in a nipple that matches the other in terms of size and color. Our surgeons may also place something called a Biodesign Nipple Reconstruction Cylinder. This tissue repair cylinder creates a scaffolding within the nipple to promote long-term volume and projection. The body gradually turns the material into natural tissue. How Long Does the Nipple Take To Heal After Reconstruction? Nipple reconstruction comes with a relatively short and easy recovery. Our surgeons will provide aftercare instructions and activity restrictions. You will need to wear a protective dressing until your follow-up visit a week after surgery. Avoid wearing tight bras and shirts that apply pressure. It can take between four to six months for your new nipples to settle. At that point, you can choose to have tattoos applied to the reconstructed nipples and areola area. This step will add color and create a more realistic look. What Should I Expect From My Results? Nipple reconstruction has a high patient satisfaction rate. This is evidenced by a multi-center study on nipple reconstruction with the Biodesign Nipple Reconstruction Cylinder.

Finding the right time for your breast reconstruction can be a complex decision. It involves weighing factors that are unique to your situation and having collaborative conversations with your medical team. In the end, you’ll come together to choose one of three strategies: immediate breast reconstruction, delayed breast reconstruction, or hybrid immediate-delayed breast reconstruction, also known as a “staged” approach. At The Breast Center Park Meadows Cosmetic Surgery, our board-certified plastic and reconstructive surgeons consider it a privilege to guide you through your options. While the final decision regarding when to start your breast reconstruction may not be made at your consultation, this initial meeting is a great place to start. Call 303-706-1100 to schedule an educational, unhurried breast reconstruction consultation. We proudly serve patients from Denver and Lone Tree, Colorado, as well as across the country. When Should I Have My Breast Reconstruction? Some women begin reconstruction on the same day as their mastectomy, while others wait due to personal preferences or the specifics of their cancer treatment. The right timing for you will depend on a host of different factors, including: Your current health The details of your cancer Your decision to pursue a prophylactic mastectomy or lumpectomy, if applicable Your plans for chemotherapy or radiation therapy Your goals and preferences Your readiness to think about reconstruction Feedback from your breast oncologic surgeon Feedback from your radiation oncologist Our surgeons will spend time explaining the benefits and considerations associated with your different timing options. They will make sure to relate everything to your unique situation, including the surgical steps, recovery, and results you may be able to expect. By giving you a complete picture of your options, our surgeons hope to make it easier for you to choose what’s best for you. Immediate Breast Reconstruction Immediate breast reconstruction is when the primary breast reconstruction surgery is completed the same day as your mastectomy. It is also known as a one-stage reconstruction. Newly diagnosed breast cancer patients may be candidates for this approach. This type of breast reconstruction can be performed with either implants or using an autologous tissue approach. If implants are used, the procedure is referred to as direct-to-implant reconstruction. After the general surgeon completes the mastectomy, our plastic surgeons step in to either place an implant in the breast pocket or take the skin and fat from the donor site and create the new breasts. The advantages of immediate breast reconstruction include: Preserving more native skin from the breast Providing a slightly better cosmetic result in many cases Working in a breast that has minimal or no scar tissue Waking up with a breast mound Convenience of combining the mastectomy and the primary stage of the reconstruction Avoiding the use of tissue expanders Some disadvantages of immediate breast reconstruction include: The reconstruction could be adversely affected by postoperative chemotherapy and radiation therapy It may be too much information for you to absorb in a short time, and you may feel overwhelmed by your options It may present some difficulties for women with larger breasts It may not be the right option for locally advanced breast cancers Delayed Breast Reconstruction Woman planning her breast reconstruction in Lone TreeThe term delayed reconstruction refers to breast reconstruction that is performed when a patient has already had their mastectomy at an earlier date. The mastectomy could have been carried out months, years, or decades prior to reconstruction. There are almost always techniques that can be considered for patients pursuing delayed reconstruction. In some cases, tissue expanders and implants can be used. Frequently, however, you may need to consider using an autologous tissue reconstruction in which skin, fat, and sometimes muscle is moved from a distant site to the chest to build the breast. Benefits of a delayed reconstruction strategy include: The timing of surgery can be optimized for your health status Chemotherapy and radiation therapy is already done Likely a lower infection rate than immediate breast reconstruction You can consider your options carefully, and there is no rush to decide on a technique Disadvantages of delayed breast reconstruction include: There is usually less native breast skin preserved to make a breast Often harder to get a superior cosmetic result You require at least one extra operation since the reconstruction was not combined with the mastectomy