SOURCE: Plastic Surgery of the Carolinas

August 14, 2012 05:01 ET

Charleston Plastic Surgeon on Combining Breast Reconstruction With Mastectomy

CHARLESTON, SC--(Marketwire - Aug 14, 2012) - Many women facing a mastectomy for breast cancer choose to undergo breast reconstruction. Until recently, the two basic techniques for breast reconstruction were using one's own tissues, known as "autologous," or using a tissue expander to make room for a final implant at a second stage. Dr. Ram Kalus, a board-certified plastic surgeon in Charleston, says tissue expansion can be a very effective method to prepare the breast for an implant; however, he adds that the process consists of multiple office visits to adjust the expander, as well as a second surgery to insert the permanent implant. Due to advancements in the field, he says his practice has adopted a relatively new technique that can potentially eliminate the need for two separate surgeries:

"The development of the use of acellular dermal matrix (ADM) has allowed for bypassing the placement of a tissue expander in the vast majority of women undergoing mastectomies. This means that a woman undergoing mastectomy can have a single-stage breast reconstruction wherein the permanent implant is inserted at the time of mastectomy, without the need for an interim expander. ADM can eliminate the need for the first stage of tissue expansion with subsequent weekly visits to the office to expand the skin, as well as a second operation under anesthesia where the expander is removed and the permanent implant placed."

While most women who require mastectomies would be considered candidates for breast implants using acellular dermal matrix, Dr. Kalus says some exceptions may apply. He says the technique is mainly suitable for patients whose reconstructed breast(s) are to be relatively close to the same size as their own breasts, adding that those interested in significantly enlarging their breasts may still require a tissue expander because their skin may not allow for the placement of a larger implant at the time of the mastectomy. He says that this technique is ideally suited for the patient who wishes to be about the same size, slightly smaller, or slightly bigger.

As with many procedures, recovery times typically vary depending on the individual. Dr. Kalus says patients at his Charleston plastic surgery practice are often 85% recovered from the acellular dermal matrix method within 10-14 days, and 95% recovered by four weeks. He says as a one-time procedure, he normally lifts all restrictions about four to six weeks following surgery as opposed to the six weeks to three months that he recommends for patients undergoing more complex reconstructive procedures like the two-stage tissue expanding technique demanding two post-operative healing phases. Dr. Kalus also says patients interested in breast reconstruction or any other cosmetic procedure should always consult with a board-certified plastic surgeon to ensure the safest, most effective treatment.

About Ram Kalus, M.D., F.A.C.S.

After receiving his medical degree from Boston University, Dr. Ram Kalus served as Associate Professor of Plastic Surgery at the University of South Carolina School of Medicine in Columbia. The founder of Plastic Surgery of the Carolinas, he devotes his time and energy to optimizing patient care through continued education and the use of state-of-the-art plastic surgery techniques. Dr. Kalus is board certified by the American Board of Plastic Surgery, a Fellow of the American College of Surgeons, and a member of the American Society of Plastic Surgeons, the American Society for Aesthetic Plastic Surgery, and the Southeastern Society of Plastic Surgeons. He has also served as both treasurer and president of the South Carolina Society of Plastic and Reconstructive Surgeons.

Plastic Surgery of the Carolinas is located at 578 Lone Tree Drive, Suite 102, Mount Pleasant, SC 29464, and can be reached at 843-881-3881. Dr. Kalus can also be contacted online at or

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