Breast Reconstruction in Toronto
You don't have to just 'survive' breast cancer, you can live a normal life after breast cancer
Reconstructive Surgery
Reconstructive Surgery deals with reconstructing shape and function which may be abnormal due to inborn errors, injury, or disease. The aim of reconstructive surgery is to allow patients to look and function as normally as possible.
Dr. Jugenburg has sub-specialization in cancer reconstruction, and has trained at the world-renowned Memorial Sloan-Kettering Cancer Centre in Manhattan. Upon returning to Toronto, Dr. Jugenburg has worked at the Toronto General Hospital and Mt. Sinai Hospital in Toronto, providing some of the most sophisticated care to his patients. Currently, Dr. Jugenburg practices out of the Humber River Regional Hospital in Toronto offering patients implant-based breast reconstruction, pedicled flap reconstruction, and new advances in reconstructive surgery such as single stage implant reconstruction procedures.
“I’m finally able to wear what I want and simply feel comfortable in my skin. Having the surgery done has caused me to feel beautiful, attractive and content again. It has absolutely changed my life for the better.”
(Dr. Jugenburg’s patient after completion of her reconstructive surgeries)
Breast cancer is one of the most common types of cancer that women get. There are various subtypes of breast cancer, and various forms of treatment. Some patients may undergo only a lumpectomy (removal of the tumor alone), while others need to have the entire breast removed (mastectomy). After this breast surgery reconstruction can be done. There are also those women who have a known family history or are known to have a BRCA gene mutation, and these women may choose to have their breasts removed (prophylactic mastectomy) to minimize their risk of developing breast cancer..
Please note prior to any Breast Reconstruction Consultation, we need a referral letter from your doctor. Please ask them to simply fax a referral to 647-436-6969
What Can You Expect Following Breast Reconstruction?
Although breast reconstruction can rebuild your breast, the results are highly variable:
- A reconstructed breast will not have the same sensation and feel as the breast it replaces.
- Visible incision lines will always be present on the breast, whether from reconstruction or mastectomy.
- Certain surgical techniques will leave incision lines at the donor site, commonly located in less exposed areas of the body such as the back, abdomen or buttocks.
- A note about symmetry: If only one breast is affected, it alone may be reconstructed. In addition, a breast lift, breast reduction or breast augmentation may be recommended for the opposite breast to improve symmetry of the size and position of both breasts.
This patient had breast cancer on both sides, requiring both breasts to be removed. She underwent reconstruction of both breasts with implants, and nipple reconstruction 3 months later. She is now 8 months after her reconstruction
Living Pink Breast Cancer Fundraiser
Breast Reconstruction Advocacy
Dr. Jugenburg is actively involved in promoting breast cancer reconstruction. Only 9% of Canadian breast cancer patients undergo breast reconstruction. Dr. Jugenburg would like this number to increase dramatically. Women shouldn’t just survive breast cancer. With breast reconstruction you can go on living, not just surviving.
Dr. Jugenburg attended a breast cancer awareness and fundraiser event (LivingPink at Crystal Beach) where he spoke about breast reconstruction. Dr. Jugenburg has also organized the Breast Reconstruction Awareness Day at the Humber River Regional Hospital and for 2012 he will be running an awareness campaign at his Royal York Hotel clinic. Dr. Jugenburg actively supports Breast Cancer Research, as all our consultation fees are donated to Breast Cancer Foundation
Nipple Reconstruction
Once the breast has been recreated (the breast mound), women can choose to have the nipple and areola reconstructed as well. This usually takes place some time after the breast mound re-creation in order to allow the newly reconstructed breast to settle in before the nipple/areola are planned. The nipple is created by using the existing breast tissue and wrapping it together into a small ball of tissues. The areola is recreated by either using a skin graft, a tattoo or both.
Creating Symmetry
In cases where only one breast is reconstructed, the other (natural) breast has to be adjusted to create symmetry. This can mean a reduction, a lift, or augmentation of the normal breast. These are called Balancing Procedures.
Breast Cancer Reconstruction Using Breast Implants
Breast Cancer Reconstruction using implants is an option for women who either do not have sufficient excess skin and fat that can be used for breast cancer reconstruction, or who wish to avoid the prolonged recovery and risks associated with complicated breast reconstruction using flaps. Benefits of implant reconstruction are quicker simpler surgery, shorter recovery, minimal risks.
Breast Cancer Reconstruction Using Your Own Tissues
Some women wish to use their own tissues for breast reconstruction. This option avoids the need for implants. To be eligible for this option, you should have sufficient excess skin and fat (ideally on your belly) that can be used to recreate your pre-cancer breast. These procedures are more extensive than implant breast reconstructions and have a longer recovery period.
Using Alloderm In Breast Reconstruction
Alloderm is an exciting new technology that allows Dr. Martin to offer a one stage implant breast reconstruction, as compared to the traditional technique that required two surgeries spaced several months apart. Alloderm is a substance that acts as a muscle substitute to provide coverage over the implant.
Single Stage Implant Breast Reconstruction
New breast implants designed specifically for breast reconstruction now have the ability to expand (like a tissue expander) and then can be left in place and do not need to be replaced by an actual breast implant (unlike a tissue expander) thus avoiding the need for a second surgery.
TRAM Flap Breast Reconstruction
TRAM flap stands for Transverse Rectus Abdominis Myocutaneous flap, which in other words means the belly skin and fat is taken along with the rectus muscle (the sixpack muscle) and is moved into the breast area to reconstruct the breast. It’s a bit of a 2-for-1 deal as you get a breast reconstruction and a tummy tuck. It does have a downside, however, which is the need to take the rectus muscle. This weakens the abdominal wall and creates a risk of hernia or abdominal bulge and weakness.
DIEP Flap Breast Reconstruction
DIEP flap stands for Deep Inferior Epigastric Perforator flap, and is a variation of the TRAM flap which does not sacrifice the rectus muscle while still using the abdominal skin and flap. This is a ‘microsurgical’ procedure which carries the risk of total flap failure. It requires a specialized surgery setup and surgical microscope. This is in effect a transplant of tissue from the abdomen to the breast.
Latissimus Dorsi Flap Breast Reconstruction
Latissimus Dorsi is the back muscle that gives you the V shape on your posterior. It is used together with an implant to provide healthy muscle and skin used to cover the implant breast reconstruction. Dr. Martin uses this option in patients who had radiation therapy to their breasts because it allows him to use healthy, non-irradiated skin and muscle to cover the chest.
Gluteal Flap Breast Reconstruction
A gluetal flap, which use tissue from the buttocks, is probably the most surgically complicated breast reconstruction option and has several limitations. This is the flap of last resort for many breast reconstruction surgeons.
Microsurgery
Microsurgery is a sub-specialty of Reconstructive Surgery which incorporates the use of a microscope in order to facilitate repair on a microscopic level. Replanting amputated body parts and transplanting healthy tissues to reconstruct wounds requires that these tissues have their blood vessels repaired to reinstate healthy blood flow into these amputated or transplanted body parts. Since these blood vessels can be one millimeter or less in diameter, the use of a microscope and exceptionally steady hands are essential for any successful surgery.
FOR MORE INFORMATION ABOUT BREAST CANCER RECONSTRUCTION SCHEDULE YOUR CONSULTATION AT 416-834-6640 or email us at info@torontosurgery.ca
Before and After Pictures
Before and after pictures illustrate what can be done. Dr. Jugenburg will meet with you and examine you before recommending which type of breast reconstruction is ideal for you. Click HERE to see our patient gallery to learn more about what you can expect from a breast reconstruction.
This patient has pre-surgical markings from breast reconstruction using a DIEP flap by Dr. Martin Jugenburg.
After breast reconstruction by DIEP flaps shows fresh healing scars, good breast shape and size.
Dr. Jugenburg's Breast Reconstruction work has also been featured in the Elevate Magazine (click on the image to the right to read the story)
Dr. Martin Jugenburg
Toronto Cosmetic Surgery Institute
100 Front St West, Toronto, ON, M5J1E3
416-834-6640