Breast Surgery


The Division of Plastic & Reconstructive Surgery is comprised of Board-Certified Plastic Surgeons who are specifically trained in microsurgery and breast reconstruction techniques.

 


 

The Division of Plastic & Reconstructive Surgery is comprised of Board-Certified Plastic Surgeons who are specifically trained in microsurgery and breast reconstruction techniques. We are part of a multidisciplinary team affiliated with the UCHealth Breast Centers on the Anschutz Medical Campus, Cherry Creek, Children’s Hospital Colorado and Highlands Ranch Specialty Care Center. 
Meet our surgeons.

 


This list describes a few of the breast surgeries we offer. To learn more about what surgery techniques we offer, please 
schedule a consult with your Plastic & Reconstructive Surgeon.  

 Breast Procedures


 

Breast Reduction

Breast reduction is a surgical procedure that removes excess breast tissue in women or men. In women, this is referred to as reduction mammoplasty and is performed to relieve back, neck or shoulder pain in women with large breasts. For men, the procedure is better known as gynecomastia surgery and is intended to  remove breast tissue in order to  flatten the chest.     

Cosmetic Procedures

When a breast surgery is not covered by medical insurance, it is often referred to as cosmetic. We offer self-pay cosmetic breast procedures like breast implants or breast lifts. Click here to be directed to our  cosmetic clinic

Gender-Affirming Breast Surgery 

For patients who are undergoing gender transformation, we offer male to female, and female to male breast surgeries. For more information, please click the links above for our patient education brochures.

Revision Surgery

If you have undergone breast surgery and are no longer satisfied with the results, our surgeons can help you understand what your options are for modifying your results. 

 

 

Breast Cancer Reconstruction


 

 For more information on cancer related procedures, please visit the Cancer Center breast website



Autologous Tissue Reconstruction

Autologous breasts reconstruction consists of moving tissue (flap) from one part of your body to reconstruct the breasts. Flap tissue can be taken from the abdomen, back, thigh or buttocks. There are two types of flaps that may be used, which are classified according to the attachment of the blood vessels.

1. Pedicled flap: the artery and vein remain attached to the tissue that will be transferred.

2. Free flap: the artery and vein are disconnected with the tissue from the donor site and reconnected in the chest.

DIEP Flap Reconstruction

Deep Inferior Epigastric Perforator (DIEP) Flap is a surgical procedure in which the breast is reconstructed using tissue from the patient's own body. The procedure involves the transfer of the patient’s abdominal skin, fat, and blood vessels to the breast area. This approach provides significant benefits to the patient, including a natural-looking breast, maintained core strength, and a quicker recovery than traditional procedures.  

Implant Based Reconstruction

There are breast reconstruction options that offer a satisfactory cosmetic outcome without having to take tissue from another part of the body. There are many options surrounding the type of implant you may choose including fill, size, shape, and profile. Despite previous controversy regarding silicone implants, they are FDA approved for breast reconstruction.

Latissimus Flap Reconstruction

This procedure takes the skin, fat, muscle and blood vessels from your back and moves them to your chest to create a breast. 

Nipple Reconstruction

Nipple reconstruction is a surgical procedure to  rebuild the nipple and areola, typically on a reconstructed breast. Nipple reconstruction helps give the nipple a more natural color and appearance. If you are not a candidate for nipple reconstruction, you can opt to have tattooing done to give the appearance of a nipple.

Nipple Tattooing

The areola (colored portion around the nipple) is reconstructed with tattoo or a skin graft from the groin, thigh, or other areas.  Areolar tattooing is typically painless because your reconstructed breasts do not have sensation, and may be performed in the office.  Tattooing may need to be re-applied after a few years. A skin graft may be taken from your inner thigh or lower waist. The skin from this area has a tendency to heal darker when taken as a skin graft. A skin graft would require you to return to the operating room.

Oncoplastic Reconstruction

If you are considering lumpectomy for treatment of your breast cancer,  oncoplastic  reconstruction may be  an option. Done at the same time as your lumpectomy, t his surgery can preserve the appearance of the affected breast , and provide balance and symmetry with tissue rearrangement on the  unaffected  breast.  We encourage you to schedule a visit with the plastic surgeon prior to  receiving  radiation treatment  as your options for reconstruction are more limited after radiation therapy.

Symmetry Reconstruction

If you are considering lumpectomy for treatment of your breast cancer, there are procedures that can be done to improve the appearance of both the breast receiving treatment and the unaffected breast. Liposuction or fat grafting, breast reduction, breast lift or breast augmentation may be performed. We encourage you to schedule a visit with the plastic surgeon prior to receiving radiation treatment as your options for reconstruction are more limited after radiation therapy.


TAP Flap Reconstruction
TRAM Flap Reconstruction

Depending on the size and availability of blood vessels, a flap may be created using skin, subcutaneous tissue and a small portion of muscle with or without fascia. Most of the muscle is spared, and otherwise the dissection is very similar to the DIEP flap. The vessels supplying the flap are disconnected from the abdomen like a DIEP flap and reconnected to the blood vessels of the chest wall to provide blood flow to the flap that will be used to create the new breast. There will be a scar from hip bone to hip bone and another scar around the bellybutton.


 


Autologous Tissue Reconstruction

Your plastic surgeon may offer you breast reconstruction using your own tissue (autologous reconstruction).  Autologous breasts reconstruction consists of moving tissue (or flap) from one part of your body to reconstruct the breasts.  There are two types of flaps that may be used, which are classified according to the attachment of the blood vessels.

The main benefits of autologous reconstruction are that in the majority of cases you do not need an implant, and the reconstructed breasts have a similar shape and feel of your native breasts. Another benefit is that the donor site will have a better contour since redundant tissue is removed. Disadvantages are that they are technically difficult, and there is a very small risk that the reconstruction fails (the tissue that was used to recreate the breasts does not survive).

 

Deep Inferior Epigastric Perforator (DIEP) Free Flap

Breast reconstruction using tissue from the abdomen provides one of the most natural results of all breast reconstruction options.  DIEP flap consists of dissecting the abdominal tissue and the related blood vessels, moving the tissue to the chest, and reconnecting the blood vessels of the flap to the blood vessels of the chest wall to provide blood flow to the flap that will be used to create the new breast. There is a small amount of abdominal muscle and fascia that is opened at the time of harvesting to gain access to the vessels, but the muscle and fascia are preserved and closed after the harvest of the flap to minimize the risk of weakness and hernias in the abdominal wall. There will be a scar from hip bone to hip bone and another scar around the bellybutton.

Superficial Inferior Epigastric Artery (SIEA) Free Flap

The free flap consists of abdominal skin, subcutaneous tissue and the associated superficial inferior epigastric artery and vein, and its perforators. Similar to the DIEP, the SIEA flap consists of dissecting the abdominal tissue and related blood vessels, moving the tissue to the chest and reconnecting the blood vessels of the flap to the blood vessels of the chest wall to provide blood flow to the flap that will be used to create the new breast. The SIEA free flap is not common as the caliber of these vessels is often too small. However, this option is used when these vessels are of adequate caliber because harvest of this flap does not require incision to the abdominal wall fascia and muscle. A decision to use this flap is usually made in the operating room. There will be a scar from hip bone to hip bone and another scar around the bellybutton.

Muscle Sparing TRAM (ms-TRAM) Free Flap

Depending on the size and availability of blood vessels, a flap may be created using skin, subcutaneous tissue and a small portion of muscle with or without fascia. Most of the muscle is spared, and otherwise the dissection is very similar to the DIEP flap. The vessels supplying the flap are disconnected from the abdomen like a DIEP flap and reconnected to the blood vessels of the chest wall to provide blood flow to the flap that will be used to create the new breast. There will be a scar from hip bone to hip bone and another scar around the bellybutton.

Latissimus Dorsi Myocutaneous Pedicled Flap

The latissimus dorsi myocutaneous flap is a flap from the back that is used for breast reconstruction. The latissimus dorsi muscle, along with the skin and fat that cover the muscle are elevated and moved to the front of your chest with the artery and vein still attached. Most women do not have enough fatty tissue on the back to re-create a breast so a tissue expander or an implant will also be used. The orientation of the scar is horizontally or slightly oblique on your back (the same side as the reconstructed breast). Your surgeon will usually attempt to hide the scar where your bra strap would typically lay. 

Transverse Upper Gracilis (TUG) Free Flap

Patients that desire autologous breast reconstruction but do not have adequate tissue from their abdomen may elect to use tissue from the inner thigh. The tissue consists of skin, fat and muscle and the underlying blood vessels in the region. The blood supply is from the gracilis muscle vessels that originate from the medial femoral circumflex system. The flap is dissected from the underlying tissue with its associated blood vessels and reconnected to the blood supply in the chest in order to provide blood flow to the flap that will be used to create the new breast. The gracilis muscle is located in the upper inner thigh. It starts at your pubic bone and ends along the inside of your upper leg. The gracilis muscle helps you bring your leg toward your body, but it is commonly used for various procedures and there is minimal functional loss from removing it.  The main difference with the DUG flap is the orientation of the final scar. The orientation of the scar is horizontally in your upper inner thigh, and most surgeons will usually hide it in the crease of your thigh and buttocks.

Diagonal Upper Gracilis (DUG) Free Flap

Similar to the TUG flap, the DUG flap uses a patient’s own tissue from the inner thigh to create a new breast after a mastectomy. The free flap consists of skin, fat, and muscle along with the accompanying blood vessels. The blood supply is from the gracilis muscle vessels that originate from the medial femoral circumflex system. The flap is dissected from the underlying tissue with its associated blood vessels and reconnected to the blood supply in the chest in order to provide blood flow to the flap that will be used to create the new breast. There is minimal functional loss from removing the gracilis muscle. The main difference with the TUG flap is the orientation of the final scar. The orientation of the scar is diagonally in your upper inner thigh.

Profunda Artery Perforator (PAP) Free Flap

Patients that desire autologous breast reconstruction but do not have adequate tissue from their abdomen may elect to use tissue from the inner thigh.  The tissue consists of skin and fat from the upper medial and posterior thigh. The blood supply is from the profundal femoris vessels. The flaps are dissected from the underlying tissue with their associated blood vessels and reconnected to the blood supply in the chest to provide blood flow to the flap that will be used to create the new breast. There is no muscle taken with this flap. The orientation of the scar is horizontally in your upper inner thigh, and most surgeons will usually hide it in the crease of your thigh and buttocks.

Superior Gluteal Artery Perforator (SGAP) Free Flap

Patients that do not have adequate tissue from their abdomen to perform autologous breast reconstruction may elect to use tissue from the buttock. The tissue consists of fat taken from the buttock region including the skin, fatty tissue and the underlying blood vessels. Flap is taken from the upper portion of the buttock which is supplied by the superior gluteal vessels. The flap is dissected from the underlying tissue with its associated blood vessels and reconnected to the blood supply in the chest to provide blood flow to the flap that will be used to create the new breast. The scar will be placed on the lower back just above the upper buttock.

 

Inferior Gluteal Artery Perforator (IGAP) Free Flap

Patients that do not have adequate tissue from their abdomen to perform autologous breast reconstruction may elect to use tissue from the buttock. The tissue consists of fat taken from the buttock region including the skin, fatty tissue and the underlying blood vessels. Flap is taken from the lower portion of the buttock which is supplied by the inferior gluteal vessels. The flap is dissected from the underlying tissue with its associated blood vessels and reconnected to the blood supply in the chest to provide blood flow to the flap that will be used to create the new breast. The scar will be placed on the bottom crease of your buttock.  

Diane-OConnor-Thompson-Breast-Center-Anschutz-OHAM


UCHealth Plastic & Reconstructive Clinic - Anschutz Medical Campus

Address: 1635 Aurora Court Anschutz Outpatient Pavilion, 3rd floor Aurora, CO 80045

Phone: 720.848.0800


UCHealth Plastic & Reconstructive Surgery - Cherry Creek

Address: 100 Cook Street Suite 210 Denver, CO 80206

Phone: 720.516.9428


CU Plastic Surgery - Cosmetic Clinic

Address: 12348 E. Montview Blvd., Aurora, CO 80045

Phone: 303.724.8700


CU Medicine Plastic & Reconstructive Surgery - Highlands Ranch

Address: 1500 Park Central Drive , Suite 401,Highlands Ranch, CO 80129

Phone: 720.516.4085


Children's Hospital Colorado - Adolescent Breast and Chest Program

Address: 13123 E 16th Ave, Aurora, CO 80045

Phone: 720.777.6409


Surgery

CU Anschutz

Academic Office One

12631 East 17th Avenue

Room: 6111

Aurora, CO 80045


303-724-2750

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