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Breast Procedures

Meet The Surgeons

Dr. James Romanelli, Dr. David Pincus, and Dr. John Layliev make up the uniquely qualified team of plastic surgeons at Romanelli Cosmetic Surgery.

Dr. James Romanelli Dr. David Pincus Dr. John Layliev

Breast Reconstruction

It can be overwhelming to weigh all the possible breast reconstruction options at the same time as trying to understand the ramifications of a mastectomy. It helps to have a breast surgeon who is not only compassionate, but who has the experience and training to help provide the details you need to make an informed choice about breast reconstruction. Women from Long Island and New York City confidently choose Romanelli Cosmetic Surgery because they know Dr. Romanelli, Dr. Pincus, and Dr. Layliev have advanced training in breast surgeries.

If you've been diagnosed with breast cancer or are considering a preventive mastectomy, request a surgical consultation to meet with one of our surgeons. Or, you can call (631) 424-3600 to schedule an appointment.

Breast Reconstruction
Before & After Photos


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Breast Reconstruction
Before & After Photos

Keep in mind that each patient is unique and your results may vary.
  • Breast Reconstruction case #55 before photo
    Breast Reconstruction case #55 after photo

    Case #55

    This 47 year old health care worker underwent bilateral mastectomies and immediate (Direct to Implant) reconstruction using silicone gel implants and Alloderm.  After she was diagnosed with breas... View Case 

  • Breast Reconstruction case #56 before photo
    Breast Reconstruction case #56 after photo

    Case #56

    This woman was diagnosed with breast cancer and underwent bilateral mastectomies a number of years ago. At the time she came to our Long Island office regarding breast reconstruction we knew that she... View Case 

  • Breast Reconstruction case #57 before photo
    Breast Reconstruction case #57 after photo

    Case #57

    This is a woman in her sixties who was referred to our Long Island plastic surgery practice to repair a failed breast reconstruction.  At another institution (with other surgeons) she underwent r... View Case 

  • Breast Reconstruction case #81 before photo
    Breast Reconstruction case #81 after photo

    Case #81

    At 52 years of age this Long Island woman was shocked to learn of an early stage breast cancer on the left side, as well as abnormal cells on the right.  She had no family history of breast... View Case 

  • Breast Reconstruction case #86 before photo
    Breast Reconstruction case #86 after photo

    Case #86

    What a tough situation for this 19 year old young woman who was born with a nearly complete absence of her right breast.  She had just a small amount of tissue, and sagging skin on the righ... View Case 

  • Breast Reconstruction case #88 before photo
    Breast Reconstruction case #88 after photo

    Case #88

    This 60 year old Long Island mother of three was diagnosed with right sided breast cancer and needed a mastectomy.  Her breasts were quite full and she was open to lifting the left breast b... View Case 

  • Breast Reconstruction case #121 before photo
    Breast Reconstruction case #121 after photo

    Case #121

    This 63 year old woman came to us for a consultation for breast cancer reconstruction. A patient of a local breast surgeon, she was interested in knowing her options. She had previously had reconst... View Case 

The Consultation

Although it can be difficult to think about breast reconstruction after being diagnosed with cancer or choosing a preventive mastectomy, your consultation can be a time when you can regain an empowering sense of control. Dr. Romanelli, Dr. Pincus, or Dr. Layliev will meet with you to discuss your goals and provide all the information you need to reach a decision. That will include discussing the risks and disadvantages of each procedure, in addition to the advantages. Successful breast reconstruction involves knowing both the potential and the limits of what surgery can achieve.

Breast Reconstruction Surgery Options

Choosing a Procedure

Learn more about VectraEach woman's personal circumstances and physical condition are unique. Certain options — including not having breast reconstruction — might be more appropriate for one patient than another. Our mission at Romanelli Cosmetic Surgery is to provide you with the facts and expertise you need to make a well-informed decision.

Reconstruction surgery may be performed either at the time of your mastectomy (in an "immediate" procedure) or later ("delayed"). Sometimes a general surgeon recommends that a patient delay the reconstruction if she is still undergoing treatment for cancer.

Immediate Reconstruction

When you choose an immediate reconstruction procedure, Dr. Romanelli, Dr. Pincus, or Dr. Layliev will collaborate with your breast surgeon to formulate a surgical plan. One advantage of immediate reconstruction is the ability to preserve and use much of the breast skin. Many patients also feel it helps emotionally to awake from surgery with complete or partial breast volume. Here are some options for immediate procedures:

Direct-to-Implant Reconstruction

Breast Reconstruction With Implant

In many cases, our surgeons can immediately insert permanent breast implants. Our patients who are good candidates for this procedure have enough healthy skin remaining after a mastectomy to accommodate full-sized implants. The advantages of a direct-to-implant procedure include avoiding additional surgeries and beginning your recovery immediately.

Immediate Tissue Expansion

Some women who opt for reconstruction using breast implants require tissue expanders. One reason an expander might be chosen would be if you needed radiation treatment after the mastectomy. Expanders are temporary implants that are gradually inflated at a few appointments in the weeks after your mastectomy. We fill the expanders with a saline solution until your skin and tissue grow enough that the desired size is reached. Then, in another surgery, your physician will insert permanent implants, much like a breast augmentation procedure.

Autologous Tissue Reconstruction (Flap Surgery)

Some patients choose to use their own tissue to reconstruct the breast mound after a mastectomy. Although a more complex surgery than using artificial implants, autologous tissue reconstruction (known as flap surgery) can result in breasts that look and feel more natural than those with implants. We transplant a section of skin, muscle, fat, and blood vessels to the chest and shape it into a viable breast shape. Dr. Romanelli, Dr. Pincus, and Dr. Layliev usually take the tissue from the abdomen or upper back. Because this surgery is longer and involves more than 1 area of the body, recovery from a flap surgery is also longer than reconstruction with implants.

Abdominal Tissue Flap Scars After Flap Surgery

Delayed Reconstruction

Some women choose to delay their breast reconstruction. That includes patients who initially choose not to have reconstruction surgery, and then change their minds. Other women may be undergoing treatment such as radiation therapy and are not physically able to undergo the reconstruction surgery. Still other patients simply want to make their decision after the mastectomy is finished. Patients who delay reconstructive surgery can still choose either tissue expansion with implants or one of the flap surgeries.

The facts on breast enhancement

Our Team Approach

Dr. Romanelli, Dr. Pincus, and Dr. Layliev possess unique experience, training, and skills, ensuring you receive the best possible care before, during, and after your reconstruction surgery. The physicians work with each other and with Romanelli Cosmetic Surgery's medical team to create a personalized surgical plan for you.

Dr. Romanelli is Chief of Staff at Huntington Hospital and has more than 20 years of private surgical experience. He is among a select group of investigative plastic surgeons chosen to participate in 3 FDA-approved silicone-gel breast implant studies sponsored by leading manufacturers Mentor® and Allergan.

Before & After Breast Reconstruction


This patient, age 47, underwent bilateral, nipple-sparing mastectomies and then immediate (direct-to-implant) reconstruction with silicone gel implants. For additional photos of our breast reconstruction patients, visit our photo gallery.
Keep in mind that each patient is unique and your results may vary.

Common Questions

How long does it take to recover after breast reconstruction surgery?

Recovery depends on the reconstruction method, as well as your physical condition before the surgery and a number of other factors. Generally, a direct-to-implant procedure results in the shortest and least painful recovery, usually lasting about 1 to 2 weeks. Recovering after having tissue expanders inserted is similar, but you will also undergo a second surgery about 3 months or longer after your mastectomy.

Flap procedures require longer recovery time — usually 4 to 6 weeks of limited activity — because the surgery involves more than 1 area of the body.

If I have a mastectomy on only 1 breast, will you enhance my other breast, as well?

Federal law requires insurance companies to cover not only reconstruction surgery, but also any cosmetic surgery needed to bring balance to the breasts and create symmetry. That includes a breast lift on your other breast if necessary, to lift, reduce, or enlarge that breast. Insurance also covers the cost of procedures related to reconstruction, such as filling tissue expanders and nipple reconstruction.

For answers to other common questions about breast reconstruction surgery, visit our Breast Reconstruction FAQ page.

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