Breast
Dr. Kiesnowski is experienced and skilled in all areas of breast surgery – whether reconstruction of a breast removed due to cancer or another disease or cosmetic augmentation, reduction, or breast lifts after pregnancy or with aging and gravity.
SERVICES
What we offer
Dr. Kiesnowski performs breast augmentation surgery at an outpatient surgery facility which is affiliated with a local hospital. This surgery is performed under a general anesthetic and takes approximately two hours. Revisional surgery of prior augmentation may take longer. Pricing includes facility, anesthesia, Mentor brand silicone breast implants and Exparel® for pain control. Mentor implants are made in the USA.
Patients are seen for an initial consultation to discuss their concerns and goals regarding augmentation. This appointment generally takes about an hour. When a decision has been made to move forward with surgery, patients are seen for a second consultation to discuss preoperative forms and complete paperwork for the surgery center.
Prepayment of surgical fees is required 14 days in advance of your scheduled procedure. In some instances Doctor may order a pre-operative mammogram to establish a baseline for future screening. After surgery, patients are usually seen the following day then at one and two week intervals for suture removal and to evaluate healing. Patients are then seen at regular intervals to evaluate overall progress and assess healing. Postoperative evaluations are included in the cost of the procedure.
A breast lift, also known as a mastopexy, is performed at the outpatient surgery center under general anesthesia. The surgery can be done in conjunction with breast augmentation if so desired. Some procedures may be performed in the office surgical suite under a local anesthetic.
Patients are seen for an initial consultation to discuss their concerns and goals regarding mastopexy. This appointment generally takes about an hour. When a decision has been made to move forward with surgery, patients are seen for a second consultation to discuss preoperative forms and complete paperwork for the surgery center. Prepayment of surgical fees is required 14 days in advance. In some instances, Doctor may order a pre-operative mammogram for routine screening.
After surgery, patients are usually seen the following day then at one and two week intervals for suture removal and to evaluate healing. Patients are then seen at regular intervals to evaluate overall progress and to assess healing.
Dr. Kiesnowski performs breast reduction surgery, sometimes called reduction mammaplasty, at an outpatient surgery center either at the hospital or affiliated with a local hospital. The doctor will perform your surgery at the facility with which your health plan participates.
Patients are seen for an initial consultation to discuss their concerns and goals regarding reduction mammaplasty surgery and if Doctor feels that you are an eligible candidate, he will submit your case to your insurance carrier for approval. Once approved, your surgery can be scheduled.
Sometime in the week prior to your scheduled surgery, you will return to the office for a pre-operative consultation and talk with Doctor about your surgery. At this time you may ask any additional questions that you may have regarding your surgery. You will sign your surgical consent forms and be given post operative prescriptions to have filled prior to your date of surgery.
After surgery, patients are seen the following day and then at one and two week intervals for suture removal and to evaluate healing. You will then be seen at regular intervals to evaluate your overall progress and to assess healing
This includes the TRAM flap which takes soft tissue from the abdomen or a latissimus dorsi flap which takes tissue from the back. The tissue is placed at the site of your mastectomy so your breast is reconstructed out of your own tissue. This operation requires 5-6 hours in the operating room for one breast and 8 or more for two. This surgery is not appropriate for all patients, such as those who have had certain previous abdominal surgeries or with other underlying health conditions, however it may be an option for some. Doctor Kiesnowski will discuss the suitability of this type of surgery and its risks and benefits with you at your initial consultation.
A common technique for breast reconstruction involves the placement of a tissue expander at the time of your mastecomy. Following your surgery the tissue expander filled with saline during routine appointments at our office. The expansions take place over the course of a few months and are generally scheduled on a weekly basis. Once the tissue expander has reached the desired size, a waiting period of two to three months is recommended before the tissue expander is removed and a permanent implant is placed. This type of breast reconstruction requires two surgeries.
Tissue expansion usually begins two to four weeks after your mastectomy surgery in order to give your surgical site time to heal and to minimize the risk of your incision site opening. Patients often experience pressure with the stretching of the skin and underlying tissue but in general the expension procedure is not painful but can be uncomfortable as the tissue expander reaches maximum fill capacity.
Nipple reconstruction is performed in the office under a local anesthetic and is usually of minimal discomfort to the patient. The nipple is reconstructed from your own tissue and usually takes about 1-2 hours. You are awake and alert throughout the procedure.
Following the initial nipple reconstruction sometimes the pigment in the new nipple will fade. If so, the new nipple can be tattooed to match the areola on the opposite side to give a more symmetrical appearance to the reconstructed breast. This is done by Doctor in the office under a local anesthetic. Tattoos will fade over time and require periodic retouching.
Throughout your reconstructive procedure you will be followed closely post-operatively for a period of at least 1 year. As with other surgeries, Dr. Kiesnowski will perform your surgery at your insurance provider’s participating hospital or outpatient surgery center.
Patients have the right, under Federal Law, to a complete breast reconstruction. This law requires insurance company compliance.
We perform both FTM and MTF “top” surgery. Most procedures are covered by insurance and we will submit a prior authorization to your carrier for determination of medical necessity prior to scheduling your surgery. Please contact the office regarding documents that are necessary to submit to your carrier for the prior authorization.
We will also provide, upon your request, documents to support legal name or birth certificate changes after your surgical procedure.
FAQ
Your questions, answered
Yes, usually you can still breastfeed after having implants. If the implant is inserted under the muscle in most cases and does not disturb the glands which produce milk or the milk ducts in the nipple. Dr. Kiesnowski encourages all women who wish to breastfeed to attempt to do so because of the overall health benefits to both mother and baby.
Some women have been successful in breastfeeding after breast reduction, however there are no guarantees that you will be able to breastfeed after breast reduction surgery. Doctor encourages all patients to try breastfeeding if they so desire, however it is important to realize that it may not be possible and patients should be prepared for this possibility before deciding to move forward with breast reduction surgery.
Breast expansion can be uncomfortable, but should not hurt.