Premier breast cancer surgeon, Dr. Dennis Holmes, with locations in Beverly Hills, Santa Monica, Glendale, and Los Angeles, California, works with the area’s leading plastic surgeons to plan breast reconstruction, either using the patient’s natural tissues, via saline or silicone implants, or a combination of the two.
Dr. Holmes works with plastic surgeons to plan the best choice of reconstruction for each woman. In most cases, breast reconstruction can be started, and often even completed, at the time of the mastectomy. This is known as an immediate reconstruction. In some cases, reconstruction must be deferred, an approach known as delayed reconstruction. The appropriate type and timing of reconstruction are an individual decision, based on the patient’s body size, the amount of preserved breast tissue, overall physical health, cancer stage, and desired breast size. Dr. Holmes and the plastic surgeon work together to create the best-individualized game plan.
Tissue flap reconstruction uses tissue, muscle and/or fat from other parts of the body to create a natural-looking and feeling breast. Various tissue flap reconstruction options exist. Some of the most common are:
Saline and silicone implant reconstruction are widely used today for women who do not desire tissue flap reconstruction. The implant is usually inserted behind the pectoralis major chest muscle, not directly under the skin. To create an adequate space behind the muscle for placement of the implant, the plastic surgeon might first insert a temporary, empty implant (called a tissue expander) that is injected with saline over several weeks until the overlying skin and muscle have been adequately expanded to accommodate a full-size saline or silicone implant. The need for a tissue expander and the time it takes to fill it is determined by the size of the final breast size desired by the patient. Some patient may undergo implant reconstruction at the time of mastectomy without the need of a tissue expander. This is called an immediate implant reconstruction.
Women with breast cancer may choose contralateral prophylactic mastectomy (CPM) or preventive removal of the unaffected breast to maintain breast symmetry, to eliminate the need for annual mammograms, or due to anxiety about the future risk of cancer in the opposite breast. You can calculate your personal risk of contralateral breast cancer (CBC) by visiting the following link: https://cbc-predictor-utd.shinyapps.io/CBCRisk. CPM is usually covered by insurance. A 20-year risk of CBC of 5% or less is considered LOW.
"He treated my daughter who had stage one breast cancer. He put us at ease and calmed our fears , he was the perfect surgeon for our situation."
"He has to be one of the most incredible doctor that I've been blessed to have on my survival team. He's saved my life! I'm a proud 28 yr B C survivor."
"Dr. Holmes is kind, professional, and has a lot of patience answering every question you might have."
"Great and SMART staff. Great place with ZERO infection rate. I was back to work after surgery way sooner then expected! Awesome place great center."
“Thank you so much for being caring and patient with me during this hard transition. I really appreciate your professionalism and dedication.”
“God Bless you, your mind, and your hands, so you may continue to help all women with breast cancer! We thank you for everything that you have done!"
"This week I celebrated my 55th birthday. I cannot be thankful enough for your help in giving me another chance to enjoy waking up each day."