Hybrid Breast Reconstruction

Hybrid Breast Reconstruction

After a breast cancer diagnosis, many patients seek breast reconstruction to reflect their restored health. Breast reconstruction can be a critical step in moving forward, but how do you know which type of procedure is the right choice for you? In some situations, a combination of reconstruction techniques, also known as hybrid breast reconstruction, may provide the most aesthetically pleasing outcome, so you once again feel and look like you. Hybrid breast reconstruction is not a common choice, but it is one that Austin Plastic & Reconstructive Surgery has been offering patients for years.

Our plastic surgeons specialize in breast reconstruction with natural-looking and beautiful results for women in the Austin area and across the country, helping them to restore confidence in their appearance after a breast cancer diagnosis and treatment. Our surgeons' goal is for every patient to feel educated on the reconstructive techniques available, so you can make the best decision for you.

What is Hybrid Breast Reconstruction?

Hybrid breast reconstruction combines a flap procedure (such as DIEP flap) with implants to create a fuller, more natural upper body contour. The addition of implants with a flap provides more fullness than flaps alone. The technique of placing implants underneath the body’s own tissue results in a look and feel more like a natural breast. These procedures are individually customized to the unique needs and aesthetic goals of each patient, requiring substantial experience and skill on the part of the board-certified plastic surgeon to achieve an optimal outcome. Our reconstructive plastic surgeons have the expertise in this specialized technique to provide superior results for our patients.

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Contact Austin Plastic & Reconstructive Surgery to set up a consultation to learn more about hybrid breast reconstruction in Austin, TX. Call (512) 815-0123 or send a message online.

Is a Hybrid Reconstruction Right for Me?

There are different reasons why your surgeon may recommend a hybrid breast reconstruction approach. For example, some women may only have a small amount of fat in areas like the buttocks, abdomen or thighs. In these cases, your surgeon may use the available excess tissue in combination with a small implant to create the fullness and projection a patient desires. In this way, your surgeon can provide a natural-looking outcome without compromising on the breast size the patient may want. Studies, including one published in PRS Global Open in 2017, have shown that this hybrid approach offers excellent results for the right patients.

Implant Options

Our surgeons prefer silicone (versus saline) implants for our reconstruction patients because they look and feel more like natural breast tissue. With various sizes available, your surgeon will help you determine the appropriate size for your body proportions and desired results. Keep in mind that when you are combining the implants with a flap technique, you will be able to select smaller implants that will reduce your risk for some complications after surgery. When the smaller implants are combined with a patient’s own tissue, your surgeon can typically achieve the desired fullness and projection.

Other implant variations involve the outer shell of the implant (smooth or textured), implant shape (round or teardrop) and profile (projection versus width). The profile refers to how the breast will project from the chest wall and will be determined by the width of your chest and the look you desire. Your surgeon will walk through all your choices with you so that you are comfortable with your surgical plan when the day of your surgery arrives.

Austin Plastic & Reconstructive Surgery

  • Known for natural-looking aesthetic results in breast reconstruction and cosmetic surgery.
  • Elected by peers for inclusion in Texas Monthly's Texas Super Doctors®: Rising Stars listing.
  • Reconstructed over 6,000 patients, including more than 2,500 DIEP flap reconstructions.
  • 4.9-star average rating over hundreds of reviews for reconstructive and cosmetic surgery.
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Photo to use for APRS block

Flap Options

Flaps are skin and fat (and rarely, muscle) taken from one area of the body used to replace the breast tissue removed during a mastectomy. Flaps can be taken from different areas of the body, depending on where the best donor tissue may be located. Austin Plastic & Reconstructive Surgery offers the following flap options:

  • DIEP Flap – fat and skin taken from excess lower abdominal tissue, which creates a flatter abdomen contour
  • GAP Flap – fat and skin removed from the upper or lower buttock region
  • PAP Flap – fat and skin taken from the posterior and inner thigh
  • Latissimus Dorsi (LD) Flap – skin, fat and muscle from the upper back rotated to the front to create the breast mound

Your surgeon will review your options at your consultation and help you choose the best approach for your reconstruction surgery.

When to Perform Hybrid Reconstruction

Hybrid breast reconstruction can be performed at the same time as your mastectomy (immediate reconstruction) or some time afterward (delayed reconstruction). Many women can have their reconstruction at the same time as their initial breast surgery, so be sure to meet with your entire surgical team before your mastectomy to find out if that is a possibility. If you opt for delayed reconstruction, there is no timeframe as to when the surgery needs to be completed to ensure success.

Some women may require a staged approach to their reconstruction. During the first stage, an expander is placed in the breast tissue to create a space for the implant. The expander is like a balloon which can be gradually filled with a sterile saline solution. As more fluid goes into the expander, the space for the implant becomes larger until you are ready to have the implant placed in the breast pocket. At that time, your surgeon can often do both the implant placement and the flap procedure in the same surgery to create your final results. Expanders can be placed during your mastectomy or at a later time.

Can Hybrid Breast Reconstruction be Combined with Other Procedures?

You may discuss a larger treatment plan with your doctor when you consult with them about your breast reconstruction. In this situation, our primary focus is to restore the most natural appearance of your breasts. Depending on the extent of your hybrid procedure, we will want all of your body's healing energy to focus on this area alone. If your treatment plan involves a flap graft with tissue taken from your abdominal area, your surgical outcome may look similar to having a tummy tuck. The details of each procedure are carefully planned to ensure optimal recovery. If you are interested in other procedures, please bring up your desires during your consultation. We are happy to listen to your goals and accommodate them if at all possible.

How Long Does it Take to Fully Recover from Hybrid Breast Reconstruction?

Your surgical recovery may depend on the timing of your reconstructive procedures. Generally, breast reconstruction patients are advised to follow certain activity restrictions for six to eight weeks to enable their bodies to heal and regenerate new tissue in the breast area as well as the donor area for the flap. Heavy lifting must be avoided for up to 12 weeks after surgery. While the first four months of recovery is the most intense, it can take up to a full year for smaller aspects of healing to occur. For example, it can take that long for surgical scars to mature and for skin and tissue to fully settle.

Is There a Way to Preview What the Procedure Results Will Look Like?

It is understandable to want to have the best possible idea of what to expect from your breast reconstruction process. Your doctor and our experienced team are with you every step of the way. During your consultation and pre-surgical planning, you can expect your doctor to provide concise information, including prospective outcomes. Our surgeons have performed thousands of breast reconstruction procedures, many of them include DIEP flaps. Their before and after gallery may be immensely informative as you navigate your treatment process.

Is the Procedure Painful or Uncomfortable?

The procedure itself is performed with anesthesia that blunts neurotransmission from the body to the brain. Basically, you cannot register pain when under the effects of anesthesia. After your surgery, you can expect swelling, tightness, bruising, and soreness in your surgical sites. The donor site may also temporarily lose some degree of sensation. As your blood supply and nerve endings are restored, your normal sensation should return. It can take several weeks to several months for all sensations to self-correct, but your comfort should improve significantly within your first six weeks of recovery.

Is There Noticeable Scarring After Hybrid Breast Reconstruction?

Scarring is an inevitable part of having surgery. Your doctor will discuss where incisions will be made and what to expect in terms of scar location and size. She will also provide information regarding how to promote optimal wound healing and, when the time comes, may also provide or recommend a formal plan to help reduce the appearance of your scars. From the consultation through your planning, surgery, and recovery stages, we are here to support your most satisfying reconstruction journey!

About the Surgery

Hybrid breast reconstruction is performed under general anesthesia, and your surgeon will also administer a long-lasting pain blocking medication to reduce your discomfort after surgery. Incision placement will vary, based on the type of flap used and the size of the implants. Our surgeons focus on techniques to place incisions in hidden areas to minimize visible post-operative scarring, such as the inframammary fold (fold of the breast).

If done in two stages, you will typically not stay overnight in the hospital after implant placement surgery. If this procedure is done at the same time as your mastectomy, you may stay in the hospital overnight. After you go home, you will spend time resting and recuperating so that your breasts have plenty of time to heal. It is helpful to have a family member or friend with you for the first day or two so you can focus on your recovery. While the actual surgical process and recovery time will vary based on how this procedure is performed, most women are back to their regular activities within about four weeks after their operation.

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Download Our Breast Reconstruction Post-Operative Care Guides

We've compiled detailed post-operative care instructions to best equip our breast reconstruction patients throughout their recovery process. To ensure the best and safest recovery, your plan encompasses appropriate prescriptions and clear directions towards maintaining your comfort to get you back to normal life and activity as soon as possible. Individual patients respond uniquely, and the type of procedure may differ, but these basic guidelines will help you along your journey.

Finding the Best Fit for You

There are numerous options in aesthetic breast reconstruction today, but not every approach will work the best for you. Our reconstructive plastic surgeons and our all-women team are committed to helping our reconstruction patients achieve optimal results. Your surgeon will spend ample time with you throughout the process, starting with thoroughly getting to know you and understanding your concerns, so together you can form a surgical plan that fits with your needs, aesthetic goals and lifestyle. When you work with Austin Plastic & Reconstructive Surgery, you will receive superior care and attention, as well as a safe and successful surgical experience. To learn more about your choices in breast reconstruction, contact Austin Plastic & Reconstructive Surgery today at (512) 815-0123.

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