Dr. Bidic and Dr. Gundlapalli specialize in breast reconstruction for New Jersey women who have undergone mastectomy to treat or prevent breast cancer. The disfigurement of a mastectomy can be emotionally devastating, but modern breast reconstruction techniques help women to be whole again. If you have undergone or are planning on having a mastectomy, our surgeons can help restore your breasts, your femininity, and your self-esteem.
"My experience with breast reconstruction might be different than many as I came to
Dr Gundlapalli as a patient dealing with Triple Negative Stage 4 Breast Cancer. I had been previously told that surgery was not going to be an option for me as it was too late. Due to a full response to chemo, my team met and decided that I was given the option to have a Double Mastectomy. I jumped at the chance as I was looking forward to getting any areas that had former tumors taken out of me and therefore hopefully giving me the best chance of no future breast cancer recurrence. I was nervous about reconstruction and had considered going flat as I truly have never been a fan of bras and I have heard complaints about reconstruction from other women that had undergone mastectomies. I had told my Surgical Oncologist that I was so unsure what to do and had concerns. She recommended I meet with the only doctor she will partner with for reconstruction, Dr. Gundlapalli and see how I felt after meeting with him. I met with Dr G and he sat with me and took the time to explain all of my options in detail. He showed me images, talked to me in depth about every option and outcome and answered all of my questions. We spent a great deal of time together that first appointment and I felt that Dr. Gundlapalli truly understood how I felt, what I wanted and my concerns. There was no pressure and the decision to have reconstructive surgery or not was fully my decision alone to make. On May 1, 2021, I had a Double Mastectomy with axillary dissection removing 20 lymph nodes. I went Direct to Implant Reconstruction, as I was a candidate for that and it worked out with my skin and blood flow etc to be an option. After my surgery Dr. G and his staff were by my side and supportive through the whole healing process. I am truly happy with the results of my surgery. I have been asked many times if I am going to get nipple tattoos and it strikes me as an interesting question when I get asked that, to be honest I dont really pay attention to the fact that I dont have nipples. Dr G did such an incredible job that my incision site truly was so very well done that I dont even notice my scars, they dont bother me. They have become a part of who I am, accepted and whole. Dr. G is not only incredibly talented at what he does, he is also truly a caring human being. These are the qualities that make his work exceptional and my mind able to be accepting and happy with my breasts after having a double mastectomy with reconstruction. "
A Consultation That's All About You
Our cosmetic surgeons are sensitive to the unique emotional and cosmetic needs of women requiring breast reconstruction. During a consultation, the surgeon usually spends about 45 minutes to an hour to make sure he understands your goals, concerns, and individual breast reconstruction needs. He will patiently guide you through the process and your decisions to ensure that you feel satisfied with your results. And the American Surgical Arts medical team will provide respectful, compassionate, and experienced support throughout your care.
Your Breast Reconstruction Procedure
For breast reconstruction after a mastectomy, the breast surgeon will discuss a number of options with you. These include immediate versus delayed reconstruction of one or both breasts, using your own skin and fat versus using implants, creating new nipple mounds or not, tattooing new areolas (pigmented areas around the nipple) or not.
Immediate or Delayed Breast Reconstruction
New Jersey breast reconstruction specialist Dr. Bidic and Dr. Gundlapalli can begin the reconstruction process immediately after a mastectomy as part of the same operation. This is called immediate reconstruction. If reconstruction is performed at a later time, often after chemotherapy or radiation treatment, then this is called delayed reconstruction. Studies have shown that women who undergo immediate breast reconstruction undergo less psychological stress than those who undergo delayed reconstruction.
Skin Options or Flaps
We offer advanced flap procedures for breast reconstruction such as:
Latissimus dorsi flap / DIEP flap / TRAM flap
These techniques use a flap of tissue from another area of the body, such as the abdomen or back, to reconstruct the breast. The transplanted tissue either remains attached or is detached and reattached to blood vessels near the area of reconstruction.
To make room for an implant, temporary, saline-filled implants called tissue expanders are inserted.
These are gradually filled over several months, expanding the tissue to accommodate a long-term silicone or saline implant. Dr. Bidic and Dr. Gundlapalli offer many kinds of breast implants at our Mullica Hill practice.
- Direct-to-implant: For women who have a B-cup breast or smaller, are happy with their breast shape, and are within a certain weight group, the surgeon offers a direct-to-implant reconstruction option. This is a one-step surgery for the patient that adds only 45 minutes per side to the mastectomy operation. Dr. Bidic is one of the few plastic surgeons in the United States who offers this procedure. The results have been phenomenal.
- Matching procedures: If only a one-sided mastectomy is performed, the surgeon will attempt to have your insurance cover a matching procedure on the non-cancer breast. He can perform a breast lift (mastopexy), breast reduction, or breast augmentation based on the dimensions of the breast reconstruction previously performed.
Through liposuction, the doctor can harvest fat from other areas to enhance the results of breast reconstruction. It is usually done in conjunction with nipple reconstructions or matching procedures.
All breast cancer reconstructive procedures mentioned above are covered by health insurance. The surgeons and staff will support you to help you understand your rights and options regarding health insurance for breast reconstruction.
Advanced 3D imaging lets you see the possibilities.
We use VECTRA to help evaluate your needs and better assess the expectations that are possible with surgery. You and the surgeon will be able to review the 3D outcomes for the same procedure you seek.
Who Is a Candidate for Breast Reconstruction?
You may be an ideal candidate for breast reconstruction surgery if you:
- Have missing breast tissue due to trauma or a mastectomy
- Are in good overall health
- Are not currently receiving radiation or chemotherapy
- Don’t smoke or can quit smoking
While it is possible to have breast reconstruction surgery at the same time as your breast cancer procedure, some patients may find it better to delay their reconstructive surgery. If you are currently undergoing chemotherapy or radiation therapy, you may have to wait to have the procedure. However, Dr. Bidic will help you figure out the best timing of your breast reconstruction.
What Are the Benefits of Breast Reconstruction?
The most notable benefit of breast reconstruction surgery is the positive impact it can have on your wellbeing. Many women who undergo a mastectomy or trauma find that they regain their femininity after a breast reconstruction, leading to more self-confidence and physical comfort. In addition, Dr. Bidic can tailor your procedure to your specific needs.
What Is the Recovery Process Like After Breast Reconstruction?
The recovery process for breast reconstruction will depend on the technique utilized in the surgery. If you receive a flap-based procedure, you will most likely spend the first few days of recovery in the hospital so Dr. Bidic can monitor you. For those receiving an implant-based reconstruction, it is possible to go home the same day of surgery in many cases.
After the first few days, patients may experience some swelling, soreness, and bruising around their breasts. This can be managed with pain medications as recommended by Dr. Bidic. About 1-2 weeks after surgery, most patients find that they can return to work and other non-strenuous activities. Patients who have physically demanding jobs or exercise vigorously will have to wait a minimum of six weeks before continuing those activities. To ensure your recovery process goes smoothly, Dr. Bidic will provide you with detailed post-operative instructions to follow.
How Long Will It Take to See My Results After Breast Reconstruction?
While some changes in your breast shape will be immediately noticeable after surgery, it may take several months for you to see your final results. Scars may take 12 months or more to fade to a lighter color depending on your recovery.
What Are the Risks of a Breast Reconstruction Procedure?
Any type of surgery carries some sort of risk for the patient. Although most complications aren’t common, possible risks include:
- Blood clots
- Fluid build-up
- Changes in nipple sensation
- Problems with anesthesia
- Capsular contracture
Before your procedure, Dr. Bidic will thoroughly examine your medical history for anything that may cause complications. If you smoke, Dr. Bidic may ask you to quit smoking sometime before your surgery since nicotine can interfere with healing and recovery.
Does Breast Reconstruction Surgery Require Anesthesia?
Since breast reconstruction is an invasive procedure, it requires anesthesia to be administered. If you have any questions about the use of anesthesia, make sure to schedule a consultation with Dr. Bidic.
Can Breast Reduction Correct Breast Asymmetry?
Breast asymmetry is not uncommon in all women, but it is even more prevalent in those with overly large natural breasts. Often when the hormones trigger breast growth during puberty, in women who develop very large breasts any difference in the starting point of the signals between breasts can create asymmetry.
Breast reduction surgery with Dr. Bidic and Dr. Gundlapalli, both of whom are double board-certified plastic surgeons, is a great way to not only reduce the size, weight, and burden of your breasts but also to make them symmetrical. With the removal of excess sagging skin and fatty tissue, it is not difficult for our team to make your smaller breasts symmetrical.
Is There Anything I can do to Make my Scars Less Visible?
The best advice for managing or attempting to minimize the appearance of your scars is to leave the silicone wound dressings in place until your American Surgical Arts surgeon removes them at your follow-up. Also, wearing your surgical bra and then your support bra at all times during the first 4-6 weeks is critical. This eliminates any pressure on the incisions, which keeps the scars as narrow as possible. It also helps eliminate some of the redness.
Keep your scars out of the sun. Healing skin is extra sensitive, plus sun exposure makes scars darken. A product called bioCorneum+ SPF 30 is a good topical silicone treatment that doubles as a sunscreen. It creates an invisible protective layer over the scar. This keeps it clean, supported, and shielded from UV rays.
Our medical aestheticians can recommend topical scar-minimizing treatments that keep the area moisturized and help to minimize the appearance of the scars. SkinMedica makes one such product called Scar Recovery Gel with Centelline.
Lightly massaging your scars can help them heal more smoothly. But you cannot do this too early and put stress on your incisions. Ask your surgeon when massage could be appropriate, along with the proper technique.
Are the Results of my Breast Reduction Permanent?
Our American Surgical Arts patients are thrilled with the results of their reduction surgery, and these results are permanent. The excess, sagging skin and heavy breast tissue that are removed are gone for good. Your breasts will be higher, shapelier, and completely proportional to the rest of your figure, and they will stay that way. Of course, you can have some sagging as you age, but it will be minimal because you’ve already removed much of the tissue that would have sagged. As long as you maintain a healthy weight, you should enjoy your new smaller breasts for the rest of your life.
How Small can I go With Breast Reduction Surgery?
How much you’d like Dr. Gundlapalli or Dr. Bidic to reduce your breasts is completely your decision; there isn’t a limit. Most of our patients from across southwestern New Jersey opt to keep their breasts proportional with the rest of their figure. They want to reduce the burden and weight of their breasts, rather than focus on a specific size decrease. The goal is to make your breasts proportional, alleviating their negative impact on your life.
Some patients coming to us for this surgery are so sick of their oversized breasts that they talk about radically decreasing their size. They’ve spent a life dealing with their breasts and want to be done with them. But you also don’t want to regret downsizing your breasts too much at some point down the road. After all, your body shape will change dramatically with this procedure. It’s a welcome change, but it will be an adjustment.
When you meet with Dr. Gundlapalli or Dr. Bidic for your consultation, the two of your will discuss your goals and see how much you’d like to decrease your breasts. Most of our patients opt to reduce their breasts by one to two cup sizes.
Is There an Age Restriction for Having Breast Reduction?
The one criterion is that the patient’s breasts have finished growing and developing. This may be the case when a young woman is only in her mid-teens. It can be tempting for a young woman who is already tired of her overly large breasts to want to do something about them now, but it’s best to wait just a bit. Beyond the size issue, maturity also comes into play. It’s best that the young woman having reduction be confident and happy in making this decision on her own. At American Surgical Arts, we require our patients to be at least 18 years old to have this procedure.
There is not an upper age limit.
Will my Nipple Lose Sensation?
In breast reduction, it’s usually necessary to relocate the nipple/areola complex to a higher position on the breast because of the removal of excess tissue. This can affect the nerves in the nipples, and this can impact sensation. Dr. Bidic and Dr. Gundlapalli make every effort to mitigate this, and most patients regain full sensation as their nerves adjust to the changes.
Will a Breast Reduction Make me Look Thinner?
Most of our patients at American Surgical Arts feel their breast reduction made them feel thinner. While Dr. Gundlapalli or Dr. Bidic will remove a few pounds of fatty tissue with this procedure, this isn’t about weight loss; it’s about removing sagging, excess skin and fatty breast tissue.
Still, not having very large, sagging breasts will make you appear thinner. Part of that could be the clothes you will now be able to wear. Most women with overly large natural breasts seek to hide them, so they wear loose-fitting clothing. They’re tired of the attention their breasts receive and they keep them covered. But after having reduction, you can now buy clothes that complement your new smaller chest. This will make you appear thinner.
Many of our breast reduction patients are so thrilled to be rid of their outsized breasts that they really change their lives. They join exercise classes and generally become more physically active because now they can…without pain.
All of this contributes to you feeling and looking thinner. How great is that? These are great procedures for women tired of the burden of their overly large natural breasts!
Read what our patients are saying!
" Dr. Gundlapalli has truly changed my life. When I entered his office, I was a nervous wreck. As a woman who suffers from arthritis, it was compounded by my overly large chest. It took me years to even work up the courage to meet a doctor about a potential breast reduction, but when I found Dr. G, I was instantly comfortable. He explained the whole procedure in full detail, answered all of my questions patiently and kindly, and his compassion for my situation was apparent. The procedure was flawless, and it was worth the few days of pain for the results I’ve achieved. I am free from all of the pain and restrictive clothing to which I was once bound. His talents have made such a profound difference in my daily life, and I cannot thank him enough! "
Will the Results of My Breast Reconstruction Look Natural?
The goal of breast cancer treatment is to eliminate cancerous cells from your body, which may involve removing part or nearly all of your natural breast tissue. In that initial stage of care, the focus is your health and longevity, not your appearance. When we plan your breast reconstruction, the goal is to help you reclaim full confidence in your appearance. The results are more for you than for anyone else, and Dr. Bidic and Dr. Gundlapalli will spend a great deal of time listening to and talking with you about your options.
Our doctors specialize in breast reconstruction and have considerable training and experience that they bring to every case. When you consult with them about your reconstruction process, you can expect to engage in meaningful conversation about your desired outcome and the options that will be best suited to your preferences and goals. During your course of treatment, your doctor can discuss their expectations regarding your final cosmetic outcome, including how long it may take for your breasts to soften and settle into the most natural appearance.
How to Prepare for a Breast Reconstruction Procedure?
There are several steps that you can take before your breast reconstruction that will help you recover well and enjoy the best possible cosmetic outcome. You'll begin preparing for your procedure weeks or months beforehand. A general guideline includes:
- Engage in a healthy exercise routine. This isn't for weight loss but for good cardiovascular health. Engaging in light strength training a few days a week and walking several days a week is a great way to prepare your body for surgical recovery.
- Avoid smoking and nicotine. Beginning six weeks before surgery, it is imperative to avoid these substances. Doing so restores your body's optimal healing capabilities in time for surgery. It also reduces surgical and post-operative risks such as poor wound healing.
- Consider your medications and supplements. Certain substances, including vitamin E and aspirin, thin the blood. Beginning three weeks before surgery, it's important to avoid all substances that do this. Your doctor may also advise you to begin taking a multivitamin with iron.
- Plan for your recovery period. In addition to taking time off work, it's beneficial to also arrange to have someone take care of the house, the kids, the pets, and any work projects that cannot be tied up ahead of time. Also, prepare a comfortable, quiet space in your home where you can rest for much of the day without feeling isolated. Finally, recovery prep may involve making meals that can be heated easily or arranging a meal-train sign-up for friends and family to provide meals.
Will I Require Drains for My Breast Reconstruction Procedure?
It's very important that fluid does not accumulate around the surgical site after mastectomy or breast reconstruction. Historically, these more complex plastic surgery procedures have required drains. The fluid may be measured at least once a day to ensure that drainage is decreasing as expected. Trust that, if you do need drains, your doctor will be motivated to remove them as soon as it is safe to do so. Also, if it is expected that you'll need drains, you will be fully informed well ahead of time regarding what to expect, how to care for them, and when to contact the office.
How Soon After a Breast Reconstruction Can I Shower?
If your breast reconstruction requires a short hospital stay, your nurse may help you shower before you are discharged. They can ensure that your incisions are well-protected and also help you see how you need to handle drains and bulbs if necessary. Usually, it's possible to shower 24 to 48 hours after the breast reconstruction procedure, and, after that, you can shower once every day if you would like. Your aftercare instructions only have restrictions around submerging the surgical area.