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Northwest Breast Center

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Spokane, WA
Northwest Breast Center

Our board-certified plastic surgeons provide comprehensive breast reconstruction services for WA, ID, MT, & OR

10/07/2022

Stacked DIEP flap reconstruction

Surgeon:

This 47 year old woman had right ni**le sparing mastectomy and breast reconstruction with stacked DIEP flaps (two flaps for one breast reconstruction).

Why two flaps? Her goals were to be symmetric with the non-cancer side, and she needed more than a hemi-abdomen to accomplish that goal. To keep that tissue alive, two blood supplies were required.

Slide 2 shows that vascular anatomy, with a right medial row perforator hooked to a side branch of the left DIEA/V.

She is six months from DIEPs and two months from revisions in the final photos.

🏥 Northwest Breast Center at Plastic Surgery Northwest
💻 www.plasticsurgerynorthwest.com
💻 www.northwestbreastcenter.com
📞 509-838-1010
📍Spokane, WA

**lesparingmastectomy **lereconstruction

08/16/2022

CT angiogram helps me to draw a blood vessel roadmap, and virtually plan your operation. This patient had an ideal perforating vessel—one that hooked around the inside (medial) border of the re**us muscle. This means that no muscle was injured, no nerves were cut, and the harvest occurred through a 4.5cm incision—great for her postop recovery!

If you are having a DIEP, this is the ideal anatomy!

👨‍⚕️Christopher Pannucci MD

🏥 Board Certified Plastic Surgeon

💻 www.plasticsurgerynorthwest.com

📞 509-838-1010

📍Spokane, WA

**lesparingmastectomy **lereconstruction

08/06/2022

Microsurgery

Surgeon:

This intra-operative photo shows the deep inferior epigastric artery and vein (right) connected to the internal mammary artery and vein (left). The penny shows the scale to understand the artery (red) and vein (blue) size.

Microsurgery is based on connecting small (1.5-3mm) blood vessels. For scale, flip a penny on its side—the edge is 1.5mm in diameter! This level of technical challenge explains why only a small number of plastic surgeons perform microvascular surgery, and why you should choose a surgeon who does this procedure regularly.

and surgeons perform over 300 free flaps every year—high volume correlates with superior outcomes in microsurgery, so choose a group that performs this surgery regularly.

🏥 Northwest Breast Center at Plastic Surgery Northwest
💻 www.plasticsurgerynorthwest.com
💻 www.northwestbreastcenter.com
📞 509-838-1010
📍Spokane, WA

**lesparingmastectomy **lereconstruction

07/30/2022

Great to even better! With LICAP flaps.

Surgeon:

This patient has an outstanding result after DIEP breast reconstruction, but had concerns with persistent upper/outer quadrant hollowing.

used a LICAP (lateral intercostal artery perforator) flap to improve the reconstructed breast’s contour, moving excess tissue from the axilla based on blood supply through the serratus anterior chest wall muscle.

She has a great improvement in upper/outer reconstructed breast contour at eight weeks from her last surgery.

🏥 Northwest Breast Center at Plastic Surgery Northwest
💻 www.plasticsurgerynorthwest.com
💻 www.northwestbreastcenter.com
📞 509-838-1010
📍Spokane, WA

**lesparingmastectomy **lereconstruction

07/24/2022

Weight loss improves DIEP results

Surgeon:

Upper abdominal bulging is the result of visceral (intra-abdominal) fat pushing forward, often through a weakness between the six pack muscles ( **usdiastasis).

For elective surgery (eg delayed reconstruction that is not time sensitive), pre-emptive weight loss can optimize the abdominal contour through visceral fat reduction—this improves the functional and aesthetic abdominal outcomes of DIEP breast reconstruction, with improved abdominal healing, tighter re**us plication, and improved aesthetic.

**usdiastasis **lereconstruction

🏥 Northwest Breast Center at Plastic Surgery Northwest
💻 www.plasticsurgerynorthwest.com
💻 www.northwestbreastcenter.com
📞 509-838-1010

📍Spokane, WA

07/15/2022

Cost of Breast Reconstruction

We received this question on our Northwest Breast Center . answers…and we hope that this helps to answer your question about the financials of breast reconstruction.

There is a federal mandate, the Womens Health and Cancer Rights Act of 1998, which ensures that insurance providers that cover mastectomy services must also cover breast reconstruction, including symmetry procedures on the non-cancer side. However, your specific insurance program, including co-pays and deductibles, will also determine what your out-of-pocket costs for breast reconstruction will be.

🏥 Northwest Breast Center at Plastic Surgery Northwest
💻 www.plasticsurgerynorthwest.com
💻 www.northwestbreastcenter.com
📞 509-838-1010
📍Spokane, WA

**lesparingmastectomy **lereconstruction

07/14/2022

Pre-Mastectomy Reduction

Surgeon:

Previvor patients (high risk for breast cancer, usually with genetic mutations) have the opportunity to optimize their breast footprint and ni**le position prior to elective mastectomy. Here, discusses the concept of “pre-habilitation” with a breast reduction prior to mastectomy in a 41 year old patient with a known genetic mutation.

🏥 Northwest Breast Center at Plastic Surgery Northwest
💻 www.plasticsurgerynorthwest.com
💻 www.northwestbreastcenter.com
📞 509-838-1010
📍Spokane, WA

**lesparingmastectomy

07/09/2022

Lumpectomy Reconstruction

Surgeon:

This 60 year old had breast conservation therapy (lumpectomy + radiation) for left breast cancer. Here, discusses the role of cancer-side parenchymal rearrangement and non-cancer side reduction for symmetry in her care.

🏥 Northwest Breast Center at Plastic Surgery Northwest
💻 www.plasticsurgerynorthwest.com
💻 www.northwestbreastcenter.com
📞 509-838-1010
📍Spokane, WA

**lesparingmastectomy

06/30/2022

Implant based breast reconstruction using textured anatomic implants

Surgeon :

This beautiful patient was in her early 40s when she was diagnosed with an invasive left breast cancer. She initially had a mastectomy with tissue expanders placed which allowed her to complete radiation to conclude her cancer treatment. She then had her tissue expanders removed and permanent implants placed. She chose to use anatomic contoured implant that are 375cc in volume. You can really appreciate the natural appearance of her reconstructed breasts despite the radiation that often can distort the appearance of an implant. In fact, she looks phenomenal! She is now 3 years out from surgery and is happy to be moving on with her life!

Photos taken at 3 years post op

06/21/2022

TUG flap reconstruction

Surgeon:

What do you do when there is no lower abdominal tissue to take for ? We don’t talk a lot about TUG flaps, which use the inner thigh—but this is another great possibility!

The TUG takes blood vessels that run through the gracilis muscle—an expendable inner thigh muscle—and leaves the incision on the inside of the thigh in a concealed location. In some women, the TUG flap (or the PAP flap, which harvests similar tissue) can provide reasonable volume to reconstruct the breast.

🏥 Northwest Breast Center at Plastic Surgery Northwest
💻 www.plasticsurgerynorthwest.com
💻 www.northwestbreastcenter.com
📞 509-838-1010
📍Spokane, WA

**lesparingmastectomy **lereconstruction

06/12/2022

DIEP After Ni**le Sparing Mastectomy

Surgeon:

This 62 year old breast cancer patient chose ni**le sparing mastectomy with DIEP flap reconstruction. She is 1 year out from DIEPs and 4 months from final revisions in the photos.

Who is a candidate for ni**le sparing mastectomy? From the cancer perspective, the tumor has to be 3-4cm from the ni**le or more. From the aesthetic perspective, the ni**le needs to be in a good position, as it cannot reliably be moved after surgery. This patient had lower (grade 1 ptosis) ni**les at her initial presentation, but preferred to keep the slightly low ni**le position, as opposed to having a surgically created ni**le later. She looks amazing, and is thrilled with her results!

🏥 Northwest Breast Center at Plastic Surgery Northwest
💻 www.plasticsurgerynorthwest.com
💻 www.northwestbreastcenter.com
📞 509-838-1010
📍Spokane, WA

**lesparingmastectomy **lereconstruction

06/02/2022

BRCA1 reconstruction

Surgeon:

BRCA1 reconstruction

This 31 year old has a BRCA1 mutation—carrying up to 80% lifetime risk for breast cancer.

She chose a preventative ni**le sparing mastectomy and two stage reconstruction with tissue expanders and silicone implants (435cc, moderate projection). At 4 months from Stage II, she looks incredible!

🏥 Northwest Breast Center at Plastic Surgery Northwest
💻 www.plasticsurgerynorthwest.com
💻 www.northwestbreastcenter.com
📞 509-838-1010
📍Spokane, WA

**lesparingmastectomy

Address

530 South Cowley Street
Spokane, WA
99202

Opening Hours

Monday	8am - 5pm
Tuesday	8am - 5am
Wednesday	8am - 5pm
Thursday	8am - 5pm
Friday	8am - 5pm

Telephone

+15098381010

Website

https://www.northwestbreastcenter.com/

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