Franklyn Elliott, M.D.
Board Certified in Plastic and Reconstructive Surgery
President, Southeastern Society of Plastic and Reconstructive Surgeons, 2000-2001
Director, Atlanta Breast Surgery Symposium, 1989-2003
Co-Director, Atlanta Breast Surgery Symposium, 2003-Present
Located at our Northside & Alpharetta Location
While cosmetic surgery is used to improve the appearance of the face, breast, and body; reconstructive surgery is used to restore the function of facial and body features compromised by congenital defects or the treatment of long-term illnesses like chemotherapy or radiation. Dr. Elliott is experienced in various types of reconstructive surgery, but he specializes in reconstructive surgery of the breasts. Dr. Elliott continues to research and advance surgical reconstruction of the breast: developing and refining breast reconstruction procedures like the scarless latissimus flap, DIEP flap, and TRAM flap methods.
Dr. Elliott has remained committed to breast reconstruction after mastectomy since the first days of his career. For 27 years, Dr. Elliott has performed both immediate and delayed breast reconstruction after mastectomy in addition to cosmetic surgeries of the face, breast, and body at his Atlanta, Georgia practice.
His experience with the TRAM flap, both pedicled and free, is extensive. He has written many articles on this subject and has performed the procedure live in a number of centers around the world. He also employs the breast implant and/or tissue expander when the TRAM flap is not an option or not desired by the patient.
Dr. Elliott has also been involved in the development of new techniques, including the use of the scarless latissimus flap, which utilizes muscle from the back without requiring a scar on the back. He has also developed a procedure for patients who had breast augmentation but were subsequently diagnosed with breast cancer.
Click on a reconstructive surgery procedure listed below to learn more:
Reconstructive Surgery of the Breast
Breast reconstruction after mastectomy can be performed either immediately at the time of a mastectomy, or delayed until a later time after the mastectomy has been performed. Generally patients prefer immediate reconstruction because they go into surgery with a breast and come out of surgery with a breast and there is a single operation for removal and replacement of the breast. Dr. Elliott discusses each of these options with his patients in detail, being certain that they understand their alternatives. There are a number of techniques available for reconstructing the breast including: breast implants, tissue expanders, scarless latissimus surgery, TRAM/ free TRAM methods, DIEP flap, nipple / areolar reconstruction, and post augmentation reconstruction.
Breast Reconstruction Using a Breast Implant
Patients who are candidates for breast reconstruction with a breast implant usually have enough skin on the chest to easily receive the implant and do not want to be larger than their current breast size. The implant is generally covered by the muscle, and may be covered by acellular dermal matrix. The acellular dermal matrix that Dr. Elliott prefers is the SurgiMend product made by TEI. This matrix forms an additional coverage over the implant so that the implant is not directly beneath the skin: producing a more natural looking breast implant result. In some situations, injections of fat that has been taken from other areas of the body (like the abdomen or thighs) can be used in addition to a breast implant to give the breasts a further enhanced and natural appearance.
Breast Reconstruction Using a Tissue Expander
Tissue expanders are the most common method of reconstructing a breast if a breast implant is used. The tissue expander is a device that stretches the skin to the desired size and shape. Tissue expanders are particularly useful if the patient is smaller than she would like to be preoperatively. Expanders are necessary in patients who choose delayed breast implant reconstruction as the tissue contracts after the cancerous tissue is removed. The expander is used to initiate a process in which the patient visits the office every week for expansion of the device until the breast is as large as or slightly larger than the desired size and shape. At that point, a plan is made to remove the tissue expander and replace with a soft, natural looking (usually gel) breast implant. To view Dr. Elliot’s breast reconstruction with expander surgery results click here.
Breast Reconstruction Using the Scarless Latissimus (no scar on the back)
The scarless latissimus breast reconstruction was developed by Dr. Elliott and employs the use of the latissimus muscle, located on the back, for additional coverage of a tissue expander and/or breast implant. The latissimus muscle is harvested at the time of mastectomy and is rotated around to the front of the chest and coupled with the pectoralis muscle to give full muscle coverage of a tissue expander / implant. Expansion is done to achieve the desired size and shape of the breast. This is followed by exchange of the tissue expander for a gel implant, which feels more natural. The entire process involves implants placed under both the pectoralis and latissimus muscles. Because muscle function can be adapted by other muscle groups, even if they didn’t originate in the area, the scarless latissimus shouldn’t compromise the function of the arm or back.
Breast Reconstruction Using the TRAM / Free TRAM
Dr. Elliott, along with Atlanta Plastic Surgery founder Dr. Carl Hartrampf, Jr., was involved in developing breast reconstruction using TRAM. The TRAM operation transfers fat and skin from the lower abdominal wall to the chest to reconstruct the breast. This fat and skin must have its own blood supply, which comes through a small portion of muscle known as the rectus abdominus muscle.
Just as there are multiple reconstruction procedures available, there are different types of TRAM procedures: the pedicled TRAM and the free TRAM. The pedicled TRAM passes tissue behind the upper abdominal skin to reach the chest for shaping into a new breast. The free TRAM flap completely detaches the tissue from the abdominal wall (along with its blood vessels) before being transferred to the chest where it is then reconnected to an artery to re-establish blood supply. Then, it is shaped into a new breast. There are various pros and cons to each of these techniques, which Dr. Elliott takes time to discuss with each patient considering this operation.
Breast Reconstruction After Breast Augmentation
Dr. Elliott is at the forefront of developing and performing breast reconstruction surgery for patients who had breast implants prior to breast cancer. Mammaplasty is an operation Dr. Elliott developed to allow for immediate reconstruction of the breast once a mastectomy is performed. The implant from the previous breast augmentation and its covering capsule is left in place while the surgeon removes the affected tissue. Once the mastectomy is complete, the existing capsule is then accessed to remove the old implant and expand the pocket to allow for a gel implant that will remain comparable to a woman’s breast pre-mastectomy. To view Dr. Elliot’s mammaplasty results click here.
Nipple / Areolar Reconstruction
Nipple / areolar reconstruction is typically performed 2-3 months after the completion of the breast reconstruction. It is a small, outpatient procedure performed under local anesthesia. Areola reconstruction can be done on one or both sides; restoring the nipples to the patient’s desired size. To complete the breast reconstruction process, the areola, or pigmented tissue surrounding the nipple, is then added once the nipple has healed (one or two months or two later) using a tattoo technique. To view Dr. Elliot’s nipple / areolar reconstruction results click here.