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The Center for Plastic Surgery at Sentara Martha Jefferson


Women most often seek breast reconstruction surgery after breast cancer diagnosis and mastectomy, though reconstruction may be required due to trauma, congenital defects, or other reasons as well.

Post Mastectomy Reduction

Post-mastectomy reconstruction may be performed at the time of the mastectomy or may be delayed, and there are several methods available.

Breast Implant with Tissue Expander

Reconstruction using an implant and a tissue expander requires a staged approach. Often, mastectomy surgery doesn’t leave enough tissue to adequately cover a new implant.  Instead, a tissue expander is put in place, and slowly increased in volume through a series of in-office expansions until you’ve reached your desired size.   At that point, the tissue expander is replaced with a permanent implant.


A TRAM flap breast reconstruction uses your own abdominal tissues to construct a new breast.  During a TRAM (for Transverse Rectus Abdominus Myocutaneous) flap procedure, the breast is reconstructed from muscle, skin, and fat.  Although the TRAM procedure can mean a longer operation and a longer recovery period, it may be the best option for women who’ve undergone radiation therapy and who are not good candidates for tissue expansion.  It may also offer more symmetrical results for some patients, depending on body type and other variables.

Latissimus Flap

The latissimus dorsi flap method of breast reconstruction has been in use for more than 30 years.  Like the TRAM flap, the latissimus flap uses tissue from your body to reconstruct the breast.  This method, commonly combined with a tissue expander and breast implant, offers additional options with regard to the appearance of the reconstructed breast.  Very thin patients with small breasts can sometimes achieve their desired result using the latissimus flap alone, with no implants necessary.

Nipple Reconstruction

Women may require nipple reconstruction as part of breast reconstruction, or for other reasons such as trauma or infection.  Dr. Showalter and Dr. Vastine are able to create a new nipple during reconstruction surgery.  Once the new nipple is healed, pigment is added in an in-office procedure to obtain the most natural-looking result possible.


Correction of Asymmetry

While all women have some degree of breast asymmetry, those with a noticeable difference may choose to have corrective surgery. Our doctors will describe which breast surgery techniques are appropriate during a personal consultation.

Breast Implant Removal or Exchange

Occasionally, women who have had cosmetic breast augmentation will require the removal of implants or an exchange for new implants. This may happen for a variety of reasons, including implant rupture, scar tissue formation, breast cancer diagnosis, or simply the desire for a different size implant. Our surgeons have a great deal of experience in this area and will be able to help you through the whole process.

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© 2018 The Center for Plastic Surgery at Sentara Martha Jefferson
595 Martha Jefferson Drive, Suite 280
Charlottesville, VA 22911
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