Experienced and Board Certified Plastic Surgeon
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BREAST RECONSTRUCTION

Losing one or both of your breasts to breast cancer can be a devastating and mentally taxing experience. Dr. Wendel understands and has years of experience helping mastectomy and lumpectomy patients choose the reconstructive breast procedure that is right for them. He performs expander-implant-based breast reconstruction, DIEP flap, the latissimus dorsi flap, and various forms of TRAM flap.


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BREAST RECONSTRUCTION OPTIONS

Real Self Breast Reconstruction

Dr. Wendel has successfully performed over 5,000 reconstructive breast surgeries over the past 14 years. He continues to bring cutting-edge surgical technology for breast reconstruction to Nashville, TN, the surrounding community and the Southeast Region.

This procedure is for women who have suffered the devastating impact of having part of their breast or their entire breast removed due to breast cancer. Prior to having reconstructive surgery, many women have what is called a mastectomy. A mastectomy is the surgical removal of a breast or breasts due to cancer. Breast reconstruction surgery is done to restore a breast or breasts to near normal appearance, shape and size following the mastectomy.  The surgery typically involves reshaping the breast and may involve inserting breast implants or using your own tissue for the breast reconstruction. Dr. Wendel performs tissue expander placement, immediate implant placement, DIEP flap, latissimus dorsi flap, pedicled TRAM flap, and muscle sparing free TRAM flap breast reconstruction.

Dr. Wendel has a particular area of special interest in the DIEP Flap which uses your own tissue, not implants.

DIEP FLAP BREAST RECONSTRUCTION

The deep inferior epigastric artery perforator flap – DIEP Flap – is a highly specialized form of breast reconstruction. The surgery involves using your lower abdominal tissue and spares all of the muscle on your tummy so you don’t get weak or develop a hernia. Dr. Wendel performs DIEP flap surgery on a regular basis.

Dr. Wendel is an expert DIEP flap surgeon located in Nashville, TN. Dr. Wendel has performed nearly 200 DIEP flaps for reconstructive surgery with a 99% success rate. The DIEP flap procedure stands for Deep Inferior Epigastric Perforator Flap. This specialized surgery is for patients who have suffered the impact of having their breast or breasts removed due to breast cancer. This surgery is one of the most advanced forms of breast reconstruction surgery available today. Not all plastic surgeons are capable of performing microsurgery. With over a decade of experience as a former Vanderbilt University plastic surgeon, Dr. Wendel has gained the knowledge and skills needed to perform this advanced type of surgery that uses a woman’s own abdominal skin and fat to make a natural-looking breast mound following mastectomy. The DIEP flap is unique in that it preserves a woman’s muscle on her abdominal wall, lessening the chance of abdominal weakness, tummy bulge or the development of hernia.

ViOptix

In order to perform the DIEP procedure safely and effectively, Dr. Wendel makes sure to assess skin and tissue health both during and after surgery. The amount of oxygen reaching the tissue and overlying skin is a critical indicator of good DIEP flap circulation. Beginning 9/13/2018, Dr. Wendel was the first surgeon in Tennessee to incorporate the ViOptix T.Ox system, a revolutionary oxygen-sensing technology, to monitor tissue oxygen saturation (StO2). This technology is important for early detection of potential interruptions in tissue perfusion, which can significantly improve flap salvage for his DIEP breast reconstruction patients.

TAP Block

Dr. Wendel also employs the Transversus Abdominis Plane (TAP) Block method to significantly reduce pain and help breast reconstruction patients avoid narcotic use following breast surgery. Abdominal tissue is the location of the tissue used for DIEP flap breast reconstruction. While the abdomen is a popular and safe choice for many patients, the donor site can be a major source of postoperative pain. To mitigate discomfort, a TAP Block catheter is inserted to deliver local anesthetic, providing pain relief. Thanks to the TAP Block, Dr. Wendel’s patients have reported less discomfort and a decreased need for the use of narcotic or any other opioid-derived pain medication.

BREAST RECONSTRUCTION WITH LATISSIMUS FLAP

Dr. Wendel performs latissimus dorsi flap reconstruction surgery, which involves removing a flap of skin, muscle, fat, and blood vessels from your upper back. This flap is molded into a breast shape and used for reconstruction.

TISSUE SUBSTITUTES

ALLODERM

Dr. Wendel uses AlloDerm® for breast reconstruction. AlloDerm® is an acellular tissue product that helps restore tissue that was damaged by radiation, injury and disease. After it is added to the body, AlloDerm® allows for new tissue to regenerate using the body’s natural processes.

SERI

SERI® Surgical Scaffold is a unique product that slowly produces collagen over time in the breast reconstruction patient’s tissues. It’s a pure bioprotein that’s sterile and derived by silk.

STRATTICE

Strattice™ Tissue Matrix helps Dr. Wendel cover breast implants and shape breasts so that they look and feel more natural than they would with traditional breast implant reconstruction methods. With this product, Dr. Wendel can form a sort of “internal bra” that cradles and supports implants.

ONCOPLASTIC BREAST RECONSTRUCTION

Oncoplastic breast reconstruction surgery may be beneficial for a woman who chooses to undergo lumpectomy or segmental mastectomy, but is concerned about what her breasts might look like after having part of the breast removed and then radiation treatment. It is not always necessary to have the entire breast removed for breast cancer. Prior to having oncoplastic breast reconstruction, many women have what is called a lumpectomy. A lumpectomy is the surgical removal of part of a breast due to cancer. Oncoplastic breast reconstruction surgery is done to restore the breast or breasts to near-normal appearance and shape following the lumpectomy.  The surgery typically involves lifting and reshaping the breast and may involve rearranging the breast tissue to fill in the space left from the lumpectomy. Because some breast tissue is removed at the time of lumpectomy, women who undergo oncoplastic breast reconstruction surgery typically have a breast or breasts that are smaller than before surgery.  Women with large breasts compared to the size of the lumpectomy are usually the best candidates for oncoplastic breast reconstruction surgery because there is still enough breast tissue left to make the appearance and shape of the breast look good. Women with small breasts may not be desirable candidates for oncoplastic breast reconstruction surgery because there may not be enough breast tissue left after the lumpectomy to give the breast a normal appearance.

Another benefit of oncoplastic breast reconstruction surgery is that it is possible for a breast lift or a breast reduction to be done on the other breast to even the breasts and give them symmetry. This is something that can also be a covered benefit by insurance.

Cosmetic results from oncoplastic breast reconstruction surgery are best when the surgery is done before radiation treatment.  It is more difficult for Dr. Wendel to give you the result you are hoping for if you have already had radiation treatment.

BREAST RECONSTRUCTION REVISION

RealSelf Breast Reconstruction Revision

After mastectomy, reconstructive breast surgery may not always produce perfect results. Breast reconstruction is a process and calls for revision or adjustments to achieve symmetry in about 20% of cases. The need for revision does not signify failure but rather a refinement of the first reconstruction.

Dr. Wendel will perform breast reconstruction revision surgery using anesthesia in a fully accredited surgical facility. Revision breast surgery is usually an outpatient procedure. Sometimes, the revision can be combined with other procedures, such as nipple reconstruction.

BREAST RECONSTRUCTION SURGERY

Following your Mastectomy, Dr. Wendel will perform the breast reconstruction surgery using anesthesia in a fully accredited surgical facility. This surgery is typically done in two steps. First, Dr. Wendel, Nashville Plastic Surgeon, places a tissue expander under the skin and chest muscle. This acts like a balloon stretching the skin, preparing it for a breast implant. After the tissue expander is filled over time (about 4 months), it is removed and replaced with a breast implant or implants. Following the surgery, Dr. Wendel will go over breast reconstruction recovery instructions, in order to minimize any discomfort.

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