What to Know About Breast Reconstruction

Breast reconstruction refers to surgery performed to correct acquired or congenital disorders of the breast or chest.   Most people define breast reconstruction as recreating the breast after mastectomy for breast cancer.  However, breast reconstruction can be performed for a multitude of different indications. 

Breast reconstruction can also refer to the reconstruction of the breast or chest for congenital disorders of the breast including Poland syndrome in men and women, pectus deformity in men and women, and extra nipples in men and women.

Breast reconstruction can be performed after massive weight loss, after trauma or work injury, and for revision of cosmetic surgery. 

All causes of breast loss in men and women take a heavy toll on a patient’s body confidence. For this reason, breast reconstruction can be an integral part of treatment for many men and women even when the patient has associated functional problems. Fortunately, many reconstructive options are available by board-certified plastic and reconstructive surgeon like Dr. Azouz in Dallas. 

Here’s what to know about your options for breast reconstruction and how Dr. Azouz can help.

What is Breast Reconstruction?

Breast reconstruction is a procedure that aims to restore the shape, look, and feel of the breasts after they’ve been partially or fully removed during mastectomy, from trauma, or for a patient who is born without a breast. There are a few different ways that breast reconstruction can be achieved. In some cases, breast reconstruction includes surgical techniques to rebuild and recreate the nipples, areolas, and breasts mounds. Breast reconstruction surgery with Dallas-based board-certified plastic surgeon Dr. Azouz can occur at the same time as mastectomy, or months to years later. 

Indications for Breast Reconstruction

  • Post-mastectomy
  • After trauma or work injury
  • Poland syndrome
  • Chest wall deformity (Pectus)
  • Breast/chest asymmetry 
  • Extra nipples (Polythelia)
  •  To revise cosmetic breast surgery
  • Gender confirmation surgery
  • Gynecomastia (male breasts)

How Does Breast Reconstruction with Implants Work?

Breast reconstruction with implants can occur in two different ways:

  1. Using tissue expanders that are placed under the skin. The tissue expanders are inflated and gradually stretch tissues to accommodate implants which are placed later in a different surgical procedure. 
  2. Breast implants are placed above, in the place of or below the pectoralis musculature.

Implants can be customized according to your desired goals. Breast implants come in a variety of shapes and sizes. Breast implants with or without tissue expanders are a good option for women who have undergone a mastectomy and would like to regain their feminine shape.  Pectoral implants are a good option in men who want the appearance of bigger pectoral muscles or who are missing a pectoral muscle (Poland syndrome).  

Dr. Azouz is known for his ability to perform directly to implant breast reconstruction in men and women with a drainless minimally invasive technique.

How Does Breast Reconstruction with a Tissue Flap Work?


Breast reconstruction with a tissue flap is also called autologous tissue grafting or flap reconstruction. This surgical procedure uses a section of tissue or muscle taken from another area of the body (either with or without the connected blood vessels) to create a natural breast mound out of the skin, muscle, and fatty tissue. Areas where flaps can be taken from include:

·           The abdomen (DIEP flap) which does not include muscle

·           The latissimus dorsi (LD flap), or the middle and side of the back

·           The lower abdomen (TRAM flap) which does include muscle

Additionally, some women can opt for fat grafting from areas around the thighs or buttocks if they’ve previously undergone major abdominal surgery (or don’t have enough tissue in the torso for reconstruction). For some women, a combination of tissue flaps and implants is the most effective reconstruction technique.

How Does Nipple and Areola Reconstruction Work?

After recovery from breast reconstruction, many women and men opt for nipple and areola reconstruction. This can be performed by grafting small pieces of skin to the breast mound in combination with medical tattooing. The goal of nipple and areola reconstruction surgery is to create a more natural-looking breast, nipple, and areola. Some mastectomies can be performed while sparing the nipple and areola, preventing the need for nipple reconstruction at a later time.

Schedule an appointment

The best way to achieve life-changing and confidence-boosting reconstruction results is by partnering with an experienced reconstructive breast surgeon. To meet with board-certified Dallas Plastic surgeons Dr. David Azouz and Dr. Solomon Azouz, we invite you to contact our office or call 972 702 8888.

The Pros and Cons of Areola Reconstruction

The areola and nipples can often be disproportionate to the breasts, whether this is due to changes in the size of the breasts, pregnancy, and breastfeeding, or genetic factors. Many patients have other abnormalities of the areola and nipples, including gynecomastia in men or inverted nipples. Fortunately, all of these can be resolved through a relatively simple cosmetic procedure. Before you choose to move forward with an areola reconstruction, however, it’s important to understand the pros and cons of the procedure.

Who Can Benefit from Areola Reconstruction Surgery?

Primarily, areola reconstruction surgery serves to change the shape or reduce the size of the areola. It is commonly performed alongside a breast reduction or breast lift, but may also be chosen as an independent procedure.

Candidates often include those who have had a previous breast surgery, which can impact the areola negatively. Areola reduction is also commonly performed on patients who have increased areola size after breastfeeding. Men suffering from gynecomastia may also be candidates for areola or nipple reduction surgery.

Finally, some patients choose a procedure to repair their inverted nipples, which may be the result of scarring or genetic factors. The steps of this procedure differ from a standard areola or nipple reconstruction, but inverted nipple repair is still an available option for patients.

How is Areola Reconstruction Performed?

In a typical areola reconstruction, the procedure is performed by making an incision around the areola and removing excess skin and tissue. Any resulting scarring is well hidden in the border of the areola.

Repairing inverted nipples is completed by making small, hidden incisions to remove scar tissue or other connective tissues holding the nipple in an inverted position.

Are There Risks for Areola Reconstruction?

Like any surgery, there are some risks for areola reconstruction. However, complications are not common.

Some possible complications include bleeding, infection, nerve damage, loss of sensation, and scarring. For some, the ability to breastfeed can also be effected, so most surgeons recommend waiting until you no longer wish to have children before having the procedure.

Dr. Azouz will thoroughly review your health to determine whether you’re a safe candidate for the surgery and explain steps for your recovery period so that you can best avoid any complications from areola reconstruction.

What is Recovery Like?

During the first few days after areola reconstruction, you can expect some swelling and discomfort, though pain can be managed with medication. Serious physical activity should be avoided as you heal. Dr. Azouz will monitor your healing during follow-up appointments and advise when you can return to exercising and performing other strenuous activity. Patients should also be careful to protect the breasts for several months after the procedure, including wearing a supportive sports bra when exercising or playing sports.

Schedule a Consultation with Dr. Azouz

If you’re interested in areola reconstruction, schedule a consultation with Dr. Azouz at Azouz Plastic and Cosmetic Surgery in Dallas, TX. Call (972) 702-8888 or request an appointment online.