Indication for Surgery: BRCA Gene Mutation / Hereditary Breast Cancer Risk

Options For Natural Tissue Reconstruction Surgery After Prophylactic Mastectomy

This page provides you with a well-rounded look at your procedure options in breast reconstruction, as well as your timing options with or after prophylactic mastectomy.

Dr. Joshua L. Levine is a world-renowned, pioneer microsurgeon specializing solely in natural tissue breast reconstruction.

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Introduction

About Prophylactic Mastectomy with Breast Reconstruction

Prophylactic mastectomy with autologous breast reconstruction not only diminishes the risk of cancer but also brings about aesthetic enhancements through advanced procedures.

Choosing Cancer-Preventing Mastectomy

Upon discovering that you have inherited gene mutations such as BRCA1, BRCA2, ATM, PALB2, CHEK2, and PTEN, which elevate the risk of developing breast cancer, the next crucial decision revolves around risk-reducing measures.

A common and effective option is bilateral, risk-reducing, prophylactic mastectomy. This surgical procedure aims to decrease the risk of breast cancer.

After mastectomy, the chance of getting breast cancer is reduced dramatically. Never down to zero, but way below that of the normal population without the mutation.

Choosing Natural Breast Reconstruction After Mastectomy

Following prophylactic mastectomy, you have the opportunity for natural tissue breast reconstruction. Dr. Joshua L. Levine is an advanced, world-renowned microsurgeon, specializing in autologous breast reconstruction. All of Dr. Levine’s procedures are natural tissue, muscle-sparing, and implant-free. This advanced technique not only helps restore a more natural look and feel, but also preserves muscle integrity.

If you are considering natural tissue reconstruction after prophylactic mastectomy, the next thing to consider will be your timing options.

With Dr. Joshua Levine’s advanced techniques, such as stacked combination flaps, or utilizing the delay phenomenon in staged-immediate reconstruction, all women, no matter how thin and no matter what body type, are candidates for natural tissue, muscle-sparing, implant-free breast reconstruction.

Dr. Joshua Levine Breast Reconstruction Surgeon Welcome Text

Timing Options

The Decision of When: Breast Reconstruction after Prophylactic Mastectomy

Dr. Levine will discuss with you which of the following prophylactic breast reconstruction timing options is best for you and your needs.

Immediate Breast Reconstruction

Breast reconstruction is done at the same time as mastectomy.

Staged-Immediate Reconstruction

Breast reconstruction is done separately, generally within two weeks of mastectomy.

Delayed Reconstruction

Breast reconstruction is done at any time after prophylactic mastectomy.

Surgical Delay with DIEP, SIEA, or DCIA Flap

The surgical delay procedure is an invaluable preemptive procedure that increases the reliability and the amount of tissue we can harvest from the abdomen with either a DIEP, SIEA, DCIA Flap procedure. As a result of this preemptive procedure, patients who may have been told that the abdomen is not available as a donor site may now be candidates. After doing this short outpatient procedure approximately one week prior to the free flap breast reconstruction.

Reconstruction Procedures Options

Your Choice Between Natural Tissue and Implants in Breast Reconstruction.

Reconstruction Presents Two Primary Choices

1. Autologous tissue, involving the person’s own natural tissue.
2. Implant-based (saline or silicone)

Autologous Reconstruction Explained:

Autologous procedures prioritize true muscle-sparing techniques, preserving vital muscle structures while utilizing the patient’s own tissues to reconstruct the breasts.

Dr. Levine is a world leading authority and foremost expert on the many perforator flap natural tissue breast reconstruction procedures including DIEP, SIEA, SHaEP, PAP, GAP, LAP and TDAP Flap procedures.

This muscle-sparing approach contributes to a more natural look and feel, avoiding the use of implants and resulting in a breast reconstruction that aligns with the individual’s unique anatomy.

Benefits of Autologous Reconstruction:

Implants vs. Natural Tissue Reconstruction

Many women opt for breast implants because it is a quick and fairly easy operation. However, implants are known to cause significant problems, such as capsular contracture, pain, ruptures, deflations, shifting and infection.

Although these complications can be devastating, perforator flap breast reconstruction is the best remedy. Using your own body tissue without muscle offers a permanent solution to implant failure — the reconstructed breasts behave, look and feel more like a natural breast.

Dr. Levine’s Patients Say:

Below are notes taken by Dr. Levine during patient consultations who are seeking corrective reconstruction after implants.

“Hurts like hell, looks like shit.”
“Stress balls. Feels like a brick. Lead things on my chest. Vulnerable, always aware.”
“No day goes by ever ever ever that I’m not uncomfortable.”
“Imagine living every day with an acorn stuck under your tongue, and you can’t get it out.”
“Feels loose. Pain like something scratching, something has come loose.”
“Never have been pleased cosmetically. Not the slightest bit symmetrical.”
“I don’t want to have any pain. Feels like a rock. Looks horrible. Strangled. Skin looks like mush.”

What Studies Say:

Patient Results

Dr. Levine’s Testimonials and Results

Patient Testimonials

I had a double mastectomy and immediately had capsular contracture stage 4. I lived for 12 years in constant pain and suffering. Replacing the implants was not an option.

At my consultation I immediately knew that I trusted Dr. Levine to do my Diep surgery.

He is highly skilled, kind, caring, answered all my questions and made me feel like I was his only patient.

He performed a 4 flap surgery which I only weigh 115 lbs.

I recovered very well will no issues and very minimal pain.

I look and feel better now than I did before the surgery. Dr Levine changed my life.

He gave me my life back the way I was before my cancer.

It’s been 5 years since my surgeries and there is not a day that goes by that I am not eternally grateful for Levine. He is undoubtedly the best surgeon you will find.

– Patient Testimonial

“Dr. Levine is AMAZING!!! Not only is he surgically one of the best, (an artist at his craft), but he genuinely CARES about his patients and their well-being. 

I would not have been able to be made “whole” again after a double mastectomy if it weren’t for Dr. Levine. 

Every other plastic surgeon (Penn Medicine) told me I wasn’t a candidate for the DIEP (use your own natural tissue) reconstruction. 

They all wanted me to either be flat or do implants. I didn’t want either of those options. 

It wasn’t until I found Dr. Levine that I had my solution. 

 He has pioneered a new technique that harvests more tissue, makes recovery better, and extends beyond what is done elsewhere (using a delay procedure) that gave me my figure back in a way no one else could have. 

 I’m thrilled with my results from Dr. Levine and can now move forward beyond cancer with confidence.

– Patient Testimonial

View Dr. Levine’s Patient Results Gallery

The photographs in this section are of actual patients of Dr. Joshua Levine.

They have undergone various types of natural tissue breast reconstruction (perforator free flaps), i.e. DIEP/SIEA, PAP, GAP, delayed, immediate, with nipple-sparing mastectomy, etc.

Each patient is unique and results may vary.

Dr. Joshua L. Levine, MD, FACS

Advanced Microsurgeon in Natural Tissue Breast Reconstruction

“Dr. Levine is an outstanding Doctor. He is a wonderful human being and a highly skilled surgeon. My results are nothing short of miraculous. There is no one like Doctor Levine. He is an artist and a true professional.”

Dr. Joshua Levine Breast Reconstruction Surgeon Welcome Text

Dr. Joshua L. Levine, MD, FACS
World Leading Authority in Perforator Flap Breast Reconstruction

Based in New York, New Jersey, and Connecticut

Dr. Joshua L. Levine is a world-renowned microsurgeon in natural tissue perforator flap breast reconstruction. He has been pioneering advancements in the field of perforator flap breast reconstruction since the beginning of his career in 2004, and has completed over 1,700 successful reconstruction procedures.

With his advanced techniques in autologous flap breast reconstruction, such as stacked combination flaps, or utilizing the delay phenomenon in staged-immediate reconstruction, all women, no matter how thin and no matter what body type, are candidates for natural tissue, muscle-sparing, implant-free breast reconstruction.

Dr. Levine has developed dedicated natural tissue breast reconstruction centers throughout New York, New Jersey and Connecticut. He works with expert breast surgeons and has personally directed the advanced training of his surgical teams in state-of-the-art procedures at each of the centers.