Restoring Wholeness
Breast Reconstruction
Dr. Jonathan Zelken, MD · Board-Certified · Newport Beach, CA
As an artist and scientist, Dr. Zelken rebuilds the breast after cancer using implants or your own tissue — restoring femininity, symmetry, and a genuine sense of wholeness.
Approach
Dr. Zelken's Philosophy
At the Zelken Institute for Aesthetic Medicine in Newport Beach, we encourage every woman to focus on the positive aspects of the breast cancer journey: beating cancer and living a full life. It is never easy to learn that you have breast cancer, or that you carry a genetic predisposition to it — a challenge that one in eight women will face in her lifetime.
Board-certified plastic surgeon Dr. Jonathan Zelken believes you should be an empowered partner in every decision. Most women are unaware of just how many reconstructive options exist, and how personal the right choice can be.
Drawing on fellowship-trained microsurgical skill and state-of-the-art tools, Dr. Zelken will do his best to restore your femininity and sense of wholeness — whether that means rebuilding with implants or with your own natural tissue. His guiding principle is simple: the aesthetic standards he holds for reconstruction are exactly the same as those he holds for elective cosmetic surgery.
The Procedure
What is Breast Reconstruction?
Breast reconstruction rebuilds the shape and contour of the breast after cancer treatment, restoring what surgery has taken. There is no single right way to do it — the best approach depends on your anatomy, your treatment plan, and your goals.
Reconstructive options after a lumpectomy differ from those after a mastectomy. After a lumpectomy, the defect may be left alone, filled with fat grafting, addressed with an oncoplastic reduction, or repaired with local tissue. After a mastectomy, most women choose reconstruction using either an implant or their own tissue, though some elect no reconstruction at all — a feasible and understandable choice you can always return to later.
Timing matters, too. The sequence of surgery, chemotherapy, and radiation must be weighed on a case-by-case basis, and reconstruction can be performed immediately at the time of mastectomy or delayed until treatment is complete. Dr. Zelken will walk you through the trade-offs of each path so the plan fits your life, not the other way around.
Tailored to You
Reconstruction Options We Offer
Dr. Zelken approaches every patient individually. Depending on your treatment, anatomy, and goals, there are several paths to rebuild the breast.
- Oncoplastic Reduction Dr. Zelken's "silver lining" option — cancerous tissue is removed while the breast is reduced and reshaped, with a matching lift for symmetry.
- Fat Grafting Your own purified fat is transferred to fill smaller defects — a minimally invasive, nearly scar-less option, often over two or three sessions.
- Flap Reconstruction Local tissue, such as the latissimus muscle from the back with its overlying skin, is transferred to restore the breast's natural curves.
- Implant-Based Reconstruction The most common option after mastectomy — a tissue expander gradually creates the pocket before exchange for a soft, natural silicone implant.
- Direct-to-Implant "One-and-done" surgery places the implant the same day, skipping the expander stage — suited to select healthy candidates.
- DIEP Flap A gold standard in autologous reconstruction — abdominal skin and fat rebuild the breast while sparing your core muscles.
- TRAM / Free TRAM Flap Time-tested abdominal flaps that transfer your own tissue to the chest, using specialized microsurgical technique.
- Nipple & Areola A final refinement, usually months later, recreating the nipple mound with artful tattooing to complete your result.
Benefits of Reconstruction
Restores the natural shape and contour of the breast.
Rebuilds a sense of femininity and wholeness after cancer.
Offers reconstruction with implants or your own natural tissue.
Can often be performed immediately at the time of mastectomy.
Autologous results grow, age, and change naturally with you.
Holds reconstruction to the same standards as cosmetic surgery.
Is It Right For You
Who is a Good Candidate?
Almost every woman facing mastectomy or lumpectomy is a candidate for some form of reconstruction — the question is which approach fits best. Good candidates are in reasonable health, understand the trade-offs of their options, and have realistic expectations about the process and timeline.
Certain techniques suit certain patients. Healthy women with smaller breasts who are comfortable staying the same size, or going slightly smaller, may be candidates for direct-to-implant reconstruction. Women with radiated skin, a higher BMI, or a preference to avoid implants are often ideal candidates for autologous options such as the DIEP flap.
Some women are not candidates for reconstruction right away, and that is perfectly acceptable — you can always return to it later. During your consultation, Dr. Zelken will evaluate your anatomy, treatment plan, and priorities to recommend the safest, most natural path forward.
What to Expect
The Reconstruction Process
Every reconstruction begins with a thorough consultation, where Dr. Zelken reviews your diagnosis, treatment plan, and goals, and draws out your options in plain language. He coordinates closely with your oncology team so that surgery, chemotherapy, and radiation are sequenced safely. Throughout, he follows the same principles, sutures, and perfectionism he brings to elective cosmetic surgery — because reconstruction deserves nothing less.
Healing Timeline
Recovery
If No Reconstruction
- Most patients take about a week off work to recover comfortably.
Implant-Based
- Plan roughly two weeks after expander placement, then another week following the exchange for implants.
Flap Reconstruction
- Tissue flaps from the back or abdomen typically require three weeks or more of recovery.
Drains & Follow-Up
- When needed, drains usually come out around two weeks, occasionally staying up to four.
The Outcome
Results & Longevity
The goal of reconstruction is not merely to fill a space, but to restore balance, symmetry, and a natural silhouette you feel at home in. Results depend on the technique chosen, but the aim is always the same: an outcome that meets the aesthetic standards of elective cosmetic surgery.
Autologous reconstruction, in particular, offers remarkable longevity. Because the breast is rebuilt from your own living tissue, it does not need to be replaced — it grows with you, ages with you, and changes with your weight over time. In a very real sense, it becomes you. Implant-based reconstruction can likewise deliver a soft, natural, and durable result, with revisions available to refine contour and symmetry.
Many women are surprised by how complete they feel afterward. When asked whether it is possible to look better after mastectomy than before, Dr. Zelken's answer is honest and hopeful: anything is possible, and a refined, natural result is exactly what he aims for.
Transparency
Risks & Considerations
As with any surgery, reconstruction carries risks, and these vary by technique. Implant-based procedures can involve skin-healing problems, capsular contracture, or the need for revision. Flap procedures using abdominal muscle may lead to hernias or bulges, and microsurgical flaps carry a small risk of clotting that occasionally requires a return to the operating room. Dr. Zelken reviews every relevant consideration candidly during your consultation.
Explore More
Related Procedures
Begin Your Journey
Ready to Feel Whole Again?
If you're considering breast reconstruction, contact us today to schedule a consultation with Dr. Jonathan Zelken and explore the options that are right for you.
Common Questions
Breast Reconstruction FAQ
Common questions about breast reconstruction, answered by Dr. Jonathan Zelken.
It depends on the technique. No reconstruction or expander placement typically needs one to two weeks; flap procedures often need three weeks or more. Drains, when used, usually come out around two weeks.
Reconstruction should never delay chemotherapy — beating cancer comes first. Occasionally, delayed healing or infection can push treatment back slightly, but we coordinate closely with your oncologist to keep you on schedule.
Yes. You may radiate a reconstructed breast or delay reconstruction until radiation is complete. Each path has trade-offs, and expanders carry added risk if radiated, which Dr. Zelken will discuss with you.
It's very unlikely. Cancer arises from breast tissue, which mastectomy aims to remove. You cannot develop breast cancer in abdominal or shoulder tissue used for reconstruction, though a small remnant risk remains.
Yes. Modern silicone implants use a highly cohesive gel that does not bleed beyond the shell. They are well studied and considered safe, which is why Dr. Zelken uses them.
Implants vary in fill, shape, size, and texture. Options include silicone or saline, round or teardrop, smooth or textured. Dr. Zelken helps you choose the right combination for a natural result.
Yes. Skin and fat from the thigh or buttock can be transferred to rebuild the breast. These options are less common and offer less tissue, but Dr. Zelken is happy to discuss them.
The DIEP flap rebuilds the breast using your own abdominal skin and fat while sparing the muscle — offering a natural, lasting result without the long-term weakness of older flap techniques.
Anything is possible. Dr. Zelken holds reconstruction to the same aesthetic standards as elective cosmetic surgery, and a refined, natural, and balanced result is exactly what he aims to achieve.