Reconstructive procedures can be performed in our office under local anesthesia, at the Asheville Surgery Center, the Outpatient Surgery Center of Asheville, Mission Hospital, Advent Hospital, and UNC Pardee Hospital. These facilities offer state-of-the-art equipment, experienced staff, and a high level of safety.
Skin Cancer
Successful reconstruction after skin cancer removal is critical to minimize deformity and preserve function. You may wish to see us to have a lesion removed, or come to us after a dermatologist has performed excision or a Mohs procedure. Dr. Halvorson has extensive experience with facial reconstruction ranging from simple closures to complex nasal reconstructions, and will work with you to determine an approach that is safe, minimizes scars, and provides the optimal outcome.
Breast reconstruction is an area in which Dr. Halvorson has significant experience, having focused on this area of plastic surgery at major cancer centers and in Asheville for over 15 years. There is no one-size-fits-all formula for breast reconstruction. Dr. Halvorson will review the appropriate options with you in detail, so you can be an active participant in making an informed decision that feels right for you.
Implant Reconstruction
Using implants for breast reconstruction is the most common method. It involves less surgery, less hospital stay, and less recovery than a tissue flap, without additional scars. Breast reconstruction with implants is typically performed in two stages. In the first stage, a tissue expander is placed over or under the pectoralis major muscle and breast skin. Once you recover, the expander is gradually filled with saline solution during clinic visits using a small needle until you are happy with the size. A second, outpatient surgery is then performed to exchange the expander for an implant. Fat grafting may be performed at this time as well. Certain patients are candidates for implant reconstruction in a single stage, where the permanent implant is placed at the time of mastectomy. Not all plastic surgeons are comfortable with this approach, but in properly selected patients the outcomes are excellent. Implant reconstruction has advantages and disadvantages compared to tissue flap reconstruction, which will be reviewed with you in detail. Disadvantages include the long-term risks of implants (rupture, infection, contracture) and the fact that implants do not work as well with radiation.
Breast Reconstruction Revision
Based on his extensive experience performing all kinds of complex breast reconstructions as well as countless revision and secondary procedures, Dr Halvorson has particular expertise in revision breast surgery. Almost every patient can have an improvement in their reconstruction. There are many new techniques and products that can improve unsatisfactory breast reconstructions, and Dr Halvorson sees patients from NC and well beyond to help them realize their goals.
Tissue Flap Reconstruction
Using your own tissue for breast reconstruction involves more scars and a longer surgery, hospital stay, and recovery, but the advantage is that you are using your own tissue so there are none of the long-term risks associated with implants. Tissue flaps also work better than implants following radiation. Although Dr Halvorson has extensive experience in this type of reconstruction, we are no longer offering complex tissue flap reconstruction (eg TRAM, DIEP, SIEA, SGAP flaps).
Breast Reduction
Breast reduction is an extremely common plastic surgery procedure. It is typically performed to address neck, shoulder, and back pain resulting from heavy breasts, but it is also done to improve symmetry in patients undergoing surgery for breast cancer on the other side. Dr. Halvorson has performed countless breast reduction surgeries, including various methods that utilize different incisions. Your individual anatomy, health status, and goals will determine the best approach. Most procedures are performed on an outpatient basis, without the use of drains.
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