Breast Reconstruction

Breast reconstruction in Ohio restores breast shape, comfort, self-confidence, and emotional well-being. At pēkomd®, our board-certified surgeons combine advanced microsurgery training with personalized, compassionate care to guide you toward renewed wholeness.

Restore Your Comfort and Self-Image With Breast Reconstruction

Facing breast loss or deformation—whether due to mastectomy, trauma, or congenital issues—can bring emotional and physical challenges that impact your daily life. Breast reconstruction aims to restore not only the shape of your breasts but also a sense of wholeness that supports your overall well-being. At pēkomd®, our board-certified surgeons approach each reconstruction with empathy, expertise, and a commitment to authenticity. We tailor each surgical plan to your unique anatomy and goals, ensuring the final result harmonizes with the rest of your body and aligns with your personal vision. Reach out to pēkomd® today to learn how breast reconstruction can be a vital step toward renewed confidence and peace of mind.

woman smiling with her hands on her hips

What Is Breast Reconstruction?

Breast reconstruction is a specialized procedure designed to rebuild the breast mound and contour after tissue loss or deformity. This can occur following mastectomy for breast cancer, a traumatic injury, or congenital differences in breast development. The surgery often involves restoring both shape and symmetry, and may even recreate the nipple-areolar complex for a more natural appearance.

At pēkomd®, we recognize that each patient's story is unique. Our board-certified providers offer a range of reconstructive options—from implant-based techniques to microvascular tissue transfers—so you can choose the path that feels most aligned with your body, lifestyle, and aesthetic preferences. We aim to create outcomes that blend seamlessly with your natural proportions, enhancing both comfort and self-confidence.

Reasons to Consider Breast Reconstruction

Choosing breast reconstruction is a deeply personal decision, often influenced by physical, emotional, and lifestyle factors. Many individuals seek reconstruction to:

Restore breast shape and volume lost to mastectomy or trauma
Regain a sense of wholeness and balance in their appearance
Reduce the need for external prostheses in clothing or swimwear
Improve self-esteem and overall body image

Regardless of the motivation, our goal at pēkomd® is to guide you toward a solution that supports both your physical health and emotional well-being.

Implant-Based vs. Microvascular Reconstruction

When planning breast reconstruction, there are two primary routes: implant-based reconstruction and microvascular (tissue) reconstruction.

Implant-Based Reconstruction

In this approach, a saline or silicone implant is used to recreate the breast mound. This can be done immediately during a mastectomy or as a staged procedure involving a tissue expander to gradually stretch the chest muscles and skin. Implants tend to offer a shorter surgery and recovery period, though future revision surgeries may be needed for implant maintenance or replacement.

Microvascular (Tissue) Reconstruction

Also known as autologous or “flap” reconstruction, this method uses your own tissue from areas such as the abdomen (DIEP flap), back (latissimus dorsi flap), or thighs to recreate the breast. Because the tissue is your own, results can feel and look more natural, with less risk of complications like implant rupture. The surgery is typically more complex and requires a longer recovery, but many patients find the outcomes particularly satisfying in terms of touch and long-term stability.

Before & After

Implant Breast Reconstruction

Secondary Breast Reconstruction: Advanced Options After Prior Surgery

Not every reconstruction journey concludes after the initial procedure. Some patients may experience complications, scarring, issues with implants, or may simply feel that their initial results do not align with their goals.

At pēkomd®, we specialize in secondary breast reconstruction, which involves refining, repairing, or redoing previous reconstructions.

One of the most advanced revision methods is the DIEP (Deep Inferior Epigastric Perforator) flap. This technique utilizes skin and fat from the lower abdomen to recreate the breast while preserving the abdominal muscles. Because it uses living tissue, the DIEP flap often produces a soft, natural appearance and feel, with durability surpassing that of implant-based methods.

Secondary reconstruction can also involve:

Converting implants to autologous flaps, especially when implants cause discomfort or complications
Correcting asymmetry or radiation-related damage through advanced microsurgical techniques
Hybrid solutions that blend implants with tissue flaps for volume and natural contour
Fat grafting (lipofilling) to soften transitions, refine shape, and improve skin quality

pēkomd® offers rare expertise in Ohio for even the most complex revision cases. Our two fellowship-trained microsurgeons' skill in microsurgery allows them to take on challenging secondary reconstructions, giving patients new hope and outcomes that feel authentically their own.

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What to Expect During Your Breast Reconstruction Procedure at pēkomd®

Your journey starts with a thorough consultation, where our board-certified surgeon will review your medical history, current breast condition, and overall goals. We encourage you to share any preferences or concerns, whether it's the size and shape you envision or the type of reconstruction you're leaning toward. From there, we'll recommend a personalized plan—implant-based, microvascular, or a combination of techniques.

On the day of surgery, you'll arrive at our accredited facility, where patient safety and comfort guide every step. Depending on the complexity of your procedure, you'll receive either general anesthesia or sedation. If you opt for implants, your surgeon may place a tissue expander first, or proceed directly to implant placement if there's enough skin and muscle coverage.

In microvascular reconstruction, the harvested tissue—often from the abdomen or back—is meticulously transferred and reconnected to blood vessels in the chest. Our team's precision and attention to detail ensure the best possible outcome. Once the procedure is complete, you'll recover in a monitored setting before returning home with detailed aftercare instructions.

Recovering After Your Breast Reconstruction Procedure

Recovery times vary widely based on the type of reconstruction. Implant-based surgeries generally require a shorter convalescence, with many patients resuming light activities within two to three weeks. Microvascular flap surgeries tend to be more extensive; expect a longer hospital stay and a few weeks of limited activity. In both cases, it's common to experience swelling, bruising, and mild to moderate discomfort in the chest or donor sites.

Pain management strategies may include prescription medication, over-the-counter pain relievers, or cold compresses. Our team remains available to guide you through follow-up appointments, ensuring your incisions heal properly and that you're adapting well to your new breast shape. Over time, swelling subsides, and the reconstructed breast settles into a natural position. Regular check-ins with our staff help address any concerns and optimize your final result.

Autologous Breast Reconstruction

Another form of breast reconstruction offered at our clinic is autologous breast reconstruction. Autologous breast reconstruction uses tissue from your own body—commonly the abdomen, back, or thighs—to form the new breast mound. The harvested flap is reattached to blood vessels in the chest, providing a living tissue solution that behaves more like natural breast tissue over time. While this approach involves a more intricate surgical process, many patients appreciate the realistic feel and permanent nature of autologous reconstruction.

Tubular Breast Deformity Surgery

Tubular breast deformity is a congenital condition where the breast appears constricted and elongated, often with enlarged areolas. Surgical correction typically involves releasing constricted tissue, reshaping the breast mound, and sometimes using implants or fat grafting for additional volume. At pēkomd®, we personalize this surgery to address each patient's specific degree of tubular formation and aesthetic goals, helping achieve a more rounded, symmetrical shape.

Are You an Ideal Candidate for Breast Reconstruction?

Breast reconstruction may be right for you if you're physically healthy, have realistic expectations, and desire to restore or improve the shape of your breasts after mastectomy, trauma, or congenital anomalies. Good candidates typically have enough tissue or skin to accommodate reconstruction, although expansions or alternative flap sites can often be used if necessary. You should also be prepared for a surgical process that might require multiple stages, particularly if you choose microvascular techniques.

During your consultation at pēkomd®, our board-certified providers will conduct a thorough evaluation, discussing your health history, available tissue for reconstruction, and any personal preferences. If additional or alternative procedures might suit you better—such as a different flap type, fat grafting, or implant-based techniques—we'll outline all possibilities to ensure you make an informed choice.

You Have the Legal Right to Unlimited Reconstruction

You deserve every opportunity to feel whole and complete. That’s why it is essential to know that, under federal law, women who have undergone a mastectomy due to breast cancer are legally entitled to unlimited coverage for breast reconstruction.

The Women’s Health and Cancer Rights Act of 1998 (WHCRA) mandates that group health plans covering mastectomies must also cover all stages of reconstruction, symmetry procedures, prostheses, and related treatments, with no limits on the number of surgical revisions.

Thanks to WHCRA, most insurance plans are required to offer comprehensive reconstructive benefits following a mastectomy. Our team is here to assist you with navigating prior authorizations, appeals, and claims support.

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Testimonials

Dr Koltz and his team are fantastic. I was always made to feel so comfortable and welcomed.

The team that he has assembled are just phenomenal women who truly brighten your day. They have offered me endless support and I will forever be grateful for them. I have received excellent care from everyone at pēkomd and would very highly recommend them. 10 out of 10! ... Read More

Jennifer N.

Dr. Markov is one of the best microsurgeons in Southwest Ohio

I have had surgery is some of the top hospitals in Ohio and beyond. Dr. Markov is one of the best microsurgeons in Southwest Ohio, and the surrounding areas. His education, military background, and work experience speaks for itself. I have found him to be professional, highly-skil... Read More

Candy

Mr. Dr. Fourman has been the best doctor hands down

Mr. Dr. Fourman has been the best doctor hands down so far that I have ever experienced in my life so far and I only have had my first office visit. He is so polite, listens and exsplained in full detail. He made me feel heard and he actually listened to me as his patient and did... Read More

Heather

Dr. Straka is very personable, professional, and earned my trust right away!

My daughter first had some work done a few years ago with Dr. Straka. Of course she was/is a beautiful girl in every way, but this definitely enhanced things for her. I inherited the worst bags you could ever imagine. Getting older I thought let me do something for me! I schedule... Read More

Youlanda J.

Thank You for saving my life!!

Dr. Fourman and his whole team have always made me feel not judged and welcomed. They are helpful, knowledgeable, informative and take time to discuss my health. There are few physicians that don't make patients feel comfortable and Dr. Fourman is not one. So thankful I cho... Read More

Amanda L

Make you feel like your best self.

Every experience I've had at pēkomd® has been amazing. The staff and providers truly take the time to make you feel like your best self. Dr. Koltz takes the time to get to know his patients and listens to their needs, concerns and dreams. I would absolutely recommend gi... Read More

Megan M.

I would say Dr. Markov is a bit of a perfectionist.

After learning I had breast cancer a second time in 2023 I opted to have a bilateral mastectomy with a DIEP flap reconstruction. I looked into 3 different doctors and while I am sure they are all very capable, I chose Dr. Markov. He was straight forward and to the point and he wa... Read More

Susan T.

Wish I had done this 10 years sooner.

Don't put it off any longer! If you have thought about weight-loss surgery, Dr. Fourman is the Dr. you need to see! He's very personable, understands and is caring. I followed all the pre op instructions, did out patient, in the morning, and was up and moving around very well by th... Read More

Patricia M

I couldn't be more pleased with my experience with Dr. Straka

I couldn't be more pleased with my experience with Dr. Straka and Kaleigh! Dr. Straka took the time to thoroughly explain my condition, answer all my questions, and walk me through the entire procedure. The follow-up care has been excellent as well, and I am so happy with my resu... Read More

Hannah

It’s like meeting with a friend at every consult.

Dr Koltz is one in a million. He sits down and listens to every concern. It's like meeting with a friend at every consult. He has worked miracles for me on correcting another local surgeon mistake. He is very skilled and knowledgeable in profession. Dr Koltz and his staff t... Read More

Jen. H.

Feel beautiful from the inside out

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Why Choose pēkomd® for Your Breast Reconstruction Procedure?

At pēkomd®, we're dedicated to marrying expertise with genuine compassion, offering you a supportive environment from the moment you walk through our doors. Our board-certified surgeons keep pace with cutting-edge reconstructive methods, delivering natural-looking, enduring results while prioritizing your safety and comfort. Because we offer a broad range of procedures, you'll never be pushed into a single approach—our recommendations reflect what's truly best for your anatomy, health, and lifestyle. Whether you visit us in Columbus, Dayton, or Toledo, expect consistent, high-quality care rooted in honest communication and a sincere commitment to your well-being.

How pēkomd® is Leading the Way in Advanced Reconstruction: Elite Microsurgical Expertise

What truly sets pēkomd® apart is the unique presence of two fellowship-trained microsurgeons, a distinction few practices can claim. Microsurgery is a highly specialized field that requires advanced skills to reconnect tiny blood vessels and nerves under a surgical microscope. This precision is essential for modern breast reconstruction, particularly in free-flap procedures that utilize the patient's own tissue to create natural and durable results.

Dr. Nickolay Markov trained at Dartmouth and Yale University, where he completed elite fellowships in plastic surgery and microsurgery. He then served as the Chief of Microsurgery at Wright-Patterson Air Force Base Medical Center, combining his military discipline with meticulous technical expertise. Currently, he is the only plastic surgeon in Dayton with advanced microsurgical training, providing patients access to autologous reconstruction options that are often unavailable in many community settings.

Dr. Peter Koltz, based in Toledo, completed his fellowship at the world-renowned University of Pennsylvania and is widely published across the full spectrum of plastic surgery. He dedicated two additional fellowship years to clinical research to ensure he can consistently offer the latest advancements in the field. His dual fellowship background enables him to manage even the most complex reconstruction cases with scientific rigor and artistic finesse. His contributions have been recognized with awards such as the Joseph M. Serletti, MD, Resident Award for Excellence in Academic Plastic Surgery, as well as through authorship of multiple textbooks, grants, international presentations, and invited lectureships—demonstrating his commitment to advancing the field through research and patient care.

Breast Reconstruction Frequently Asked Questions

Ready to explore how breast reconstruction can restore both your figure and your sense of self? Contact pēkomd® to schedule a consultation and begin your journey toward renewed confidence.

How soon after a mastectomy can I have reconstruction?

Timing varies. Some opt for immediate reconstruction during the same operation as the mastectomy, while others choose delayed reconstruction to focus on healing, cancer treatments, or personal preferences.

Will I regain sensation in the reconstructed breast?

Sensation can improve over time but may not fully return to pre-surgery levels. Nerve regeneration varies, especially in microvascular procedures, but some patients do see partial recovery.

Can I combine implant and flap reconstruction?

Yes. Some patients benefit from a “hybrid” approach, using both a flap to provide soft tissue coverage and an implant for additional volume.

Will insurance cover breast reconstruction?

Many insurance plans cover reconstruction following mastectomy or trauma, as it's considered medically necessary. We recommend checking your policy, and our staff can assist with documentation if needed.

Is breast reconstruction a single-stage procedure?

Some procedures, like direct-to-implant reconstruction, may be done in one stage, but many involve multiple steps for optimal shaping and healing. We'll outline a timeline during your consultation.