San Francisco Breast Reconstruction

Board Certified Plastic Surgeons Dr. Gabriel M. Kind and Dr. David S. Chang

Voted Castle Connolly Top Doctors

Autologous reconstruction

We have performed over 1100 microsurgical flaps for breast reconstruction with greater than 99% success rate.  In addition to the DIEP flap, we are experienced in the SIEA, TUG, PAP, GAP and stacked flaps. We also perform the APEX procedure when needed, to avoid excessive muscle trauma.

Implant Reconstruction

We have extensive experience in implant reconstruction.  We use the latest implants and offer pre-pectoral reconstruction and direct-to-implant reconstruction.  

Lumpectomy defects and revision reconstruction

 We have experience in oncoplastic reconstruction at the time of lumpectomy. Or, if you have had a lumpectomy and have asymmetry or have an unsatisfactory reconstruction, you may benefit from a consultation to discuss the reconstructive options.

Autologous Reconstruction

 

Autologous breast reconstruction involves microsurgery to transfer tissue from another part of the body to the breast in order to restore the breast mound.  The most common tissue used is the lower abdominal fat (aka DIEP flap).  The tissue is transferred without loss of muscle function. Dr. Kind and Dr. Chang use a microscope when reconnecting the artery and vein from the abdominal tissue to an artery and vein in the chest.  Other areas of the body that can be used to make a breast are the inner thighs (TUG or PAP flap). We also perform nerve repair to the flaps (Resensation) which may improve return of sensation.

 
DIEP flap breast reconstruction

This patient had immediate bilateral breast reconstruction with DIEP flaps at the time of her mastectomies.

Nipple sparing mastectomy and bilateral DIEP flaps.

A postop patient after nipple sparing mastectomies and bilateral DIEP flaps.

Implant Reconstruction

Breast reconstruction with implants is the most common method of reconstruction in the United States.  Most commonly, patients choose silicone implants, however, saline implants are also an option.  All breast implants are FDA approved and are safe. Dr. Kind and Dr. Chang perform two stage expander-implant reconstruction, and direct-to-implant (DTI) reconstructions at the time of mastectomy in select patients. There are pros and cons to implant reconstruction. It is best to learn about the options and decide on a plan that is best for you.

implant breast reconstruction

This patient had bilateral skin and nipple sparing mastectomies and a two-staged expander to implant reconstruction with pre-pectoral silicone implants and dermal allograft.

 

Lumpectomy and revision reconstruction.

 

Many patients choose breast conservation to treat their cancer.  This may result in asymmetry of the breasts.  There are many treatment options to address asymmetric breasts depending on a patient's goals.  If you are going to have breast conservation (lumpectomy or partial mastectomy), you may benefit from a consultation to discuss options for reconstruction at the same time as your cancer surgery.

If you have an unsatisfactory result after reconstruction, you may benefit from a fresh approach.  Dr. Kind and Dr. Chang have extensive experience treating breast asymmetry and revising reconstructions.

 

 

68-year-old woman with left breast cancer, before lumpectomy.

oncolplastic breast reconstruction, lumpectomy

After lumpectomy, oncoplastic reconstruction of left breast and right breast reduction for symmetry.