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, for his Manhattan patients.
What is Breast Reconstruction?
Breast reconstruction is a cosmetic surgery that restores the breasts, usually after treatment for cancer. This is most often done for patients who have undergone a mastectomy, but it can also be performed following a lumpectomy or to restore deformities of the breast tissue. We see many patients who choose prophylactic mastectomies to lower their cancer risk.
While some patients find they are okay with their appearance following a mastectomy, some are self-conscious about the changes to their body. This can be especially emotional when coupled with a cancer diagnosis. We are dedicated to helping patients in Manhattan and throughout New York City rebuild their confidence and love their bodies once more.
Breast Reconstruction Techniques
Dr. Lerman offers several breast reconstruction techniques to help you look and feel your best.
- Microvascular (Natural Tissue) Breast Reconstruction
- DIEP & PAP Perforator Flap Natural Tissue Breast Reconstruction
- Restoring Sensation after Mastectomy with Nerve Grafting
- Breast Implant Reconstruction
- Pre-Pectoral (in Front of the Muscle) Implant Breast Reconstruction
- Corrective / Revision of Previous Breast Reconstruction
- Single-Stage Direct-to-ImplantReconstruction
- Form Sable (Gummy Bear) Implant Reconstruction
- Mastectomy
- Double Mastectomy
- Nipple Sparing Mastectomy & Reconstruction
- BRCA+ and Prophylactic Mastectomy
- Immediate Breast Reconstruction
Our Doctor Works With Your Oncologist To Create the Best Results
Dr. Lerman accepts referrals from oncologists. Our board-certified plastic surgeon can work alongside your care provider to ensure you receive the safest reconstruction plan possible.
Our gallery shows the typical plastic surgery results provided by Dr. Lerman in Manhattan. Both flap- and implant-based procedures can lead to natural-looking outcomes. Explore our before and after photos to see the possibilities, or contact one of our New York City-area offices to get started.
Reclaim Your Curves With Breast Reconstruction
Trust Your Care to a Leading Surgeon
Request a Breast Surgery Consultation
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
Helping Manhattan Patients Feel Like Themselves Again
"I am a Breast Cancer Survivor and have been a patient of Dr.Lerman since 2017 He did an amazing job and I’m so happy with his work." Tomar Alston
Flap Reconstruction Offers an Alternative to Implants
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
Pedicled 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 microscope. Because this advanced technique requires special training in microsurgery, free flap breast reconstruction is not as widely available as pedicled flap reconstruction.
Types of Microvascular Flaps
SGAP Flap
A flap is created using tissue from the buttocksPAP Flap
Tissue is harvested from the posterior thighTUG Flap
Tissue from the inner thigh is used to reconstruct the breastTAP Flap
Uses tissue transferred from the backStacked Flaps
Combines two flaps such as the DIEP and the PAP to create one breastMake an Informed Decision
Request 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 Manhattan team will be in touch to schedule your surgery consultation. You may also call our Manhattan, New York, office at:
(212) 434-6980
"Amazing plastic surgeon, a master at his craft! I dont have enough words of gratitude and praise. Dr Lerman is not only extremely professional and skilled, he also shows great care to his patients. He made me look like new, after a debilitating disease. The eight hour surgery performed by him proved to be a great success, with beautiful results. Highly recommended!" Cosmina Anka L
Breast Reconstruction Candidates
While we want every patient to look and feel their best, not everyone is initially a good candidate for breast reconstruction. You may be a good candidate for breast reconstruction if:
- You have had or currently have breast cancer and a mastectomy or lumpectomy.
- You do not have additional medical conditions or other illnesses that may impair healing. Please let your surgeon know of any medical conditions you have or medications you take. This is important as it could impact your surgery and healing.
- You have a positive outlook on your diagnosis and situation. It is important to have realistic goals and discuss this with your plastic surgeon.
Thousands of Women Benefit from Breast Reconstruction Each Year
"Dr. Lerman is an incredible & talented surgeon. His expertise in reconstructing my body to look so natural after undergoing bilateral mastectomy w DIEP Flap has everyone amazed. He was honest, caring, smart, and top notch. I highly recommend Dr. Lerman!"
Leigh-Ann Grasso
Implant-Based Breast Reconstruction
Our New York City–area surgeon specializes in reconstructive procedures for the breasts. Whether you're considering reconstruction with natural tissue or implants, he can explain your treatment options and guide you through the process.
Direct-To-Implant Breast Reconstruction
A Visual Demonstration of Breast Reconstruction with Tissue Expansion
Explore Your Breast Reconstruction Options
Request a Consultation Today
We understand that going through cancer and a mastectomy is difficult enough. Breast reconstruction can help you get your figure back and help you feel confident in your body. Dr. Lerman coordinates care with your oncologist and other healthcare providers. This allows him to customize each procedure to give you the most aesthetic benefits and do so in a manner that is safe for you.
If you are ready to start your breast reconstruction journey, or you simply want to discuss your options, request a consultation at our office in Manhattan, NY. Fill out out online form and a member of our staff will contact you to schedule an appointment. You can also call our office directly at:
(212) 434-6980
A Staff That Goes Above and Beyond For Our Manhattan Patients
"I want to share my experience as a physician and a patient of Dr. Lerman. In April mammogram found cals in right breast. I did biopsy showing ADH, high-risk lesion not cancer. I went on lumpectomy showing multiple ADH. Treatment for this lesion is med and MRI every 6 mo for 10 yr. I hate side effects of med and horrible MRI. I decided to go for bilateral mastectomy and DIEP-FLAP. As soon as I met Dr. L and his nurse Jennifer, I knew I am in the best hands. They are not only beautiful persons but also they work so hard for the best results of patients. The day after 9-hr surgery, Dr.L checked me to be sure everything was all right. On hospital discharge day, Dr. L checked me to be sure I was ready for discharge. While I had problems at home and I contacted Dr.L or Jeniffer, I was always responded within 2 min, problems were solved next day. I am in five weeks postop. I am completely recovered from the surgery, and I am very satisfied with my reconstructed breasts. My suggestions to all planning for breast plastic surgery is to go to Dr. Lerman. This will be the best decision in your life." xiaoqing o'leary
Immediate Versus Delayed Reconstruction
Aesthetic outcomes are generally more favorable following immediate reconstruction, but many women who qualify do not realize this option is available to them.
It is not uncommon for a woman to be told to wait until after a mastectomy and radiation treatment for breast cancer to receive 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 who undergo reconstruction at the time of mastectomy is less than 40%.
Dr. Lerman utilizes the latest techniques that for many women obviate the need for delayed reconstruction. Immediate reconstruction begins on the same day as the mastectomy, whether it is a breast implant or autologous DIEP flap reconstruction.
If you've already had a mastectomy but wish you'd received reconstruction, it's not too late. 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. These delayed cases can occur months or even years after the mastectomy.
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.
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.
Finalizing Your Breast Reconstruction
Breast and Nipple Resensation
When you undergo a mastectomy, you lose feeling in your breast and nipple because the nerves have to be cut to remove breast tissue. During your reconstruction, Dr. Lerman can use the advanced microsurgical technique Resensation® to potentially restore feeling. Using processed nerve allograft, Dr. Lerman can connect the nerves in the chest with the nerves in the reconstructed breast tissue. Dr. Lerman is one of the few plastic surgeons in the world who can perform this technique.
Nipple Reconstruction
After the breast heals from reconstructive surgery and the mound has stabilized, Dr. Lerman can reconstruct the nipple and areola to completely restore the appearance of your breast. Our doctor can use a small flap of skin to create the projection of the nipple. Once this heals, you can return to our Manhattan, New York, office to recreate the areola. We work alongside specialized tattoo artists who use 3D tattooing techniques to create an areola that has both dimension and definition.
Frequently Asked Questions About Breast Reconstruction
Q. Will insurance cover my breast reconstruction surgery?
A. The Women’s Health and Cancer Rights Act (WHCRA) of 1998 is a federal law in the United States that requires plans that cover mastectomy to also cover breast reconstruction surgery. However, it is important to remember that not all types of breast reconstruction surgery are covered. WHCRA does not apply to Medicare or Medicaid, and some government plans and religious organizations may be exempt from following this law. During your consultation, we will review your insurance coverage once Dr. Lerman develops your treatment plan.
Q. How long does it take to recover from surgery?
A. This will depend on you as an individual and the type of technique performed. On average, full recovery takes about six to eight weeks for most breast reconstruction patients. You may experience longer or shorter healing times depending on your unique situation.
Q. Does breast construction hurt?
A. You will be under general anesthesia so you will not be awake for the procedure. Some discomfort as you heal is to be expected. This is usually managed by rest, taking prescription medications, or over-the-counter-medications. We will provide you with all the needed instructions to make your recovery as smooth as possible.
More Praise From Manhattan
"I decided to make an appointment with Dr. Lerman after reading reviews here, for which I am extremely grateful, and so I feel honored to leave my own. Dr, Lerman is a highly skilled surgeon with an amazingly easygoing bedside manner, and I can agree with the other reviews 100% that he is not only extremely knowledgeable and particularly gifted in his trade, but also exceedingly compassionate and truly wants to make a positive impact in the lives of his patients. He has an outstanding level of professionalism and expertise as evidenced by his numerous and varied academic and professional accomplishments. I was initially drawn to Dr. Lerman because of that, and also because has such tremendous experience with microsurgery and breast cancer reconstruction."
Connie Selinsky Brockett