Breast Reconstruction Surgery

If you are considering breast reconstruction, you need an experienced, qualified surgeon.

Dr. Oren Lerman is a board-certified authority on breast reconstruction who uses microvascular surgery and other advanced techniques.

We invite you to learn more about how Dr. Lerman in Manhattan, NY, consistently delivers beautiful results with minimal surgical risks…

Thousands of Women  Benefit from Breast Reconstruction Each Year

Flap Reconstruction

Although most patients are candidates for flap reconstruction, they may not have been told so. If you are scheduled to undergo a mastectomy, find out if you are a candidate for one of the numerous perforator flap surgeries, including the DIEP flap, offered by our plastic surgeon. Dr. Lerman has performed hundreds of DIEP flaps and other perforator flap breast reconstructions, and he can help determine if this is the right plastic surgery option for you.

Exploring Flap Reconstruction Surgery

Autologous breast reconstruction, or flap reconstruction, involves transferring a flap of living tissue - which usually includes skin and fat from another part of the body - to recreate the breast. Flap procedures result in a recreated breast mound that looks and feels like the original breast. There are two primary methods of flap breast reconstruction surgery:

Pedicled Flap

Pedicled flap reconstruction involves harvesting donor tissue and tunneling it under the skin to the breast, while keeping the original blood vessels attached. This operation, known as a pedicle TRAM flap, was originally described back in 1979. Dr. Lerman prefers the more advanced and current method, called a free flap.

Free Flap

A free flap involves completely separating the tissue from the original blood supply, and reattaching the flap to new blood vessels near the breast. This process is called microvascular tissue transfer and it involves the use of a surgical microscopeBecause this advanced technique requires special training in microsurgery, free flap breast reconstruction is not as widely available as pedicled flap reconstruction.

Trust Your Care to a Leading Surgeon Request Your Breast Surgery Consultation Today

Choosing to have breast reconstruction surgery is a very personal decision, and the procedure itself requires specialized training and expertise. There are many options available, including flap surgery and breast implants with tissue expanders. Dr. Lerman will explain each option in great detail so you can make the most educated decision for yourself. You can request a breast surgery consultation online or call our Manhattan office serving greater New York at:

(212) 434-6980

Dr. Oren Lerman

"I am so thankful"

1

Kleigh NYC

2020

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Dr. Lerman is best of the best! From his bedside manner and ability to really listen to his patients to his highly skilled surgical hand, I am so grateful and fortunate to have found him. He has my highest recommendation, as well everyone on his staff. Helpful and lovely to deal with. 5 stars!

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1

Beth Stern

2019

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I came to see Dr. Lerman having begun the implant process post mastectomy but very unhappy with the tissue expander. I had constant discomfort and a misshapen breast. Within hours of flap surgery, my pain was gone. I am so thankful!

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Not All Free Flap Reconstruction Is the Same DIEP Flap vs. TRAM Flap Surgery

DIEP

The DIEP flap is considered the most advanced type of free flap breast reconstruction available because it preserves the muscle from the abdominal wall. This results in a natural appearing, natural feeling, and long-lasting reconstructed breast.

TRAM

A free TRAM flap also harvests from the abdomen, but unlike the DIEP flap, it does not preserve the whole muscle, or minimize the risk of postoperative weakness, bulging, or hernias. This results in the potential loss of core strength and an extended recovery time.

The Results of Breast Reconstruction Before and After Photos

These before and after photos show actual plastic surgery results provided by Dr. Lerman in Manhattan. Both flap- and implant-based procedures can lead to natural-looking outcomes.
Photo before breast and nippled reconstruction was performed
Before The patient had issues with sagging, asymmetrical breasts. In addition to uneven shaping, she suffered from notable changes to the appearance of her left nipple.
Photo after performing DIEP flap surgery, nipple reconstruction, and breast lift
After Dr. Lerman performed DIEP flap surgery and nipple reconstruction on her left breast, and a breast lift (mastopexy) on the right breast for symmetry.

Types of Microvascular Flaps

For patients who do not have adequate excess abdominal tissue and are poor candidates for a DIEP flap, our plastic surgeon can perform autologous breast reconstruction utilizing other microvascular flaps, including:

SGAP Flap

A flap is created using tissue from the buttocks

PAP Flap

Tissue is harvested from the posterior thigh

TUG Flap

Tissue from the inner thigh is used to reconstruct the breast

TAP Flap

Uses tissue transferred from the back

Stacked Flaps

Combines two flaps such as the DIEP and the PAP to create one breast

Implant-Based Breast Reconstruction

Reconstruction with breast implants is the most common type of breast reconstruction surgery performed in the United States every year and it is often the best choice for certain patients. Implant reconstruction is typically performed in two stages:

Tissue Expander

The first stage can occur at the time of the mastectomy, and involves placing a tissue expander under the skin and muscle of the chest wall. Patients will periodically visit our Manhattan office to gradually expand their device over time, causing the skin and muscle to slowly stretch and create a pocket to hold the breast implant.

Implant Placement

A saline or silicone implant is placed about three to four months later during a second surgery to complete the reconstruction process. Dr. Lerman takes your body type, aesthetic goals, and other factors into account when determining which kind of implant can provide the best outcome for our patients.

"I could not be happier with the results"

1

Kimberly del Gaizo

2019

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As my body persisted in presenting formidable challenges, Dr. Lerman never wavered in his thoughtful and methodical decisions and treatments. His empathy and humanity gave me reassurance and hope throughout the five surgeries he performed on me. Dr. Lerman is the ideal doctor. I feel lucky and blessed to call him my doctor.

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1

Lisa

2019

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Dr. Lerman changed my life! After a double mastectomy, he did reconstruction via DIEP flap. My fears were quelled by his excellent care. His staff is amazing. They saw and spoke with me throughout my recovery. I could not be happier with the results. Thank you!

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Direct-To-Implant Breast Reconstruction

Some implant reconstruction patients may be able to skip the two-step delayed process in what is called direct-to-implant reconstruction. This innovative technique is performed immediately at the time of mastectomy, allowing the patient to avoid a second surgery. During your consultations, Dr. Lerman will work with you and your other providers to determine if this approach is right for you.
During this procedure, our plastic surgeon will place the permanent silicone or saline implant and reinforce the reconstruction with AlloDerm® Tissue Matrix, essentially creating an internal bra.
This safe, state-of-the-art technology promotes tissue regeneration by supporting cell population and rapid revascularization (delivery of blood to the capillaries).
This method also provides increased support for the implant to optimize the shape, symmetry, and contour of the breast mounds.

A Visual Demonstration of Breast Reconstruction with Tissue Expansion

This is just one method that can be used to help breast cancer and mastectomy patients recreate the bust line. During your consultation at our Manhattan practice, Dr. Lerman can explain candidacy for breast implants and flap surgery, the use of a tissue expander, and other topics relevant to your needs.

IMMEDIATE VERSUS DELAYED RECONSTRUCTION

Immediate reconstruction begins on the same day as the mastectomy whether it is a breast implant or autologous DIEP flap reconstruction. Some patients never had reconstruction at the time of the mastectomy or chose to wait to have reconstruction later. These delayed cases can occur months or even years after the mastectomy. Aesthetic outcomes are generally more favorable following immediate reconstruction.

Delayed reconstruction is sometimes necessary in order to complete all treatment for breast cancer (such as radiation) before moving on with the reconstruction. Unfortunately, the number of women in the United States that undergo reconstruction at the time of mastectomy is less than 40%. It is not uncommon for a woman to be told to wait until after radiation treatment for breast cancer following mastectomy and perform a delayed reconstruction.

Dr. Lerman, however, utilizes the latest techniques that obviate the need for delayed reconstruction. Most patients who did not undergo immediate reconstruction at the time of the mastectomy are still good candidates for "Delayed Reconstruction" and can usually have all of their options available to them including both autologous tissue- and implant-based procedures.

Schedule Your Breast Reconstruction Consultation

Dr. Lerman wants his patients to have all the information they need to make the right decision for themselves when choosing a breast reconstruction technique. He is qualified to provide his patients the most advanced surgical procedures that help deliver the most satisfying results.

He will work closely with you and your other healthcare providers to determine a treatment plan that maintains your safety, gives you the best aesthetic outcome, and allows you to heal both inside and out.

To get started, fill out our online form and a member of our team will be in touch to schedule your surgery consultation. You may also call our Manhattan, New York office at:

(212) 434-6980

Preventative Mastectomy and Breast Reconstruction

Women at a high risk of developing breast cancer, whether due to family history or testing positive for the BRCA gene, may choose to have a preventative mastectomy and reconstruction. This is an important and very personal decision requiring close consideration of health, goals, and lifestyle, as well as insurance coverage for the breast procedure. Fortunately, the decision is generally not an urgent one. Patients usually have ample time to consult their plastic surgeons and other medical professionals. After becoming educated, patients often feel confident in deciding if a preventative mastectomy is in their best interest.
breast cancer

Nipple-Sparing Mastectomy and Breast Reconstruction

Many women who choose to receive a preventative mastectomy as well as some women with breast cancer are eligible for a nipple-sparing procedure. This technique preserves the nipple and skin, removing only the underlying breast tissue to provide very natural-looking results. In fact, when combined with advanced reconstructive techniques, the results can look as authentic as a breast augmentation procedure. Nipple-sparing techniques can even improve the appearance of the breasts in some cases. During a consultation, Dr. Lerman can determine if you are a candidate for this surgery.
woman covering nipple

"I highly recommend Dr. Lerman"

1

I Am Liz Marie

2019

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Dr. Lerman is an outstanding amazing surgeon. Very nice and patient. Communicated my options and what was best for me. Made me feel comfortable and confident in my skin again. I highly recommend Dr. Lerman. I am so thankful.

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1

Dana M. Panzer

2019

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Dr. Lerman is an outstanding surgeon and person. I would highly recommend him to anyone considering breast reconstruction and/or cosmetic procedures.

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Dr. Oren Lerman

Oren Z. Lerman, MD

Dr. Oren Lerman performs a variety of cosmetic and reconstructive procedures with a specialty in reconstructive breast surgery. In fact, he is the director of breast reconstruction at Lenox Hill Hospital's Institute for Comprehensive Breast Care as well as the Microvascular and Cosmetic Breast Fellowship. In addition to the hospital, Dr. Lerman is affiliated with:

  • The New York Regional Society of Plastic Surgeons (Past President)
  • The American Board of Plastic Surgery (Diplomate)
  • The American College of Surgeons (Fellow)
  • The American Society of Plastic Surgeons
  • The American Society of Reconstructive Microsurgery

You can schedule a consultation with Dr. Lerman by filling out our online form or calling (212) 434-6980.

Contact Us Today

"The one thing that is most important when we're doing cosmetic surgery and aesthetic surgery of the face or the body is to make sure that the patient is happy afterwards..." Dr. Oren Lerman

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