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
Reconstructive Surgery
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.
Breast Reconstruction
 Diagram from ASPS |
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Dr. Elliott has remained committed to breast reconstruction after mastectomy since the first days of his career. For 27 years, Dr. Elliot 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: an exciting new option for patients.
Click on a reconstructive surgery procedure listed below to learn more:
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: an exciting new option for patients.
Click on a reconstructive surgery procedure listed below to learn more:
Breast Reconstruction:
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:
 Diagram from ASPS |
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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.
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):
 Diagram from ASPS |
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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. To view Dr. Elliot’s breast reconstruction with scarless latissimus results click here.
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.
 Diagram from ASPS |
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Breast Reconstruction Using a DIEP Flap:
DIEP flap breast reconstruction involves the same tissue as described for the TRAM flap, but the muscle is dissected so as to not include any muscle with the flap. Proponents of this operation have suggested that because no muscle is taken it is a better procedure for the abdomen. However, Dr. Elliott has found that there is no difference in the resulting abdominal wall function and strength when comparing a TRAM flap to a DIEP flap. These findings, coupled with the fact that the DIEP flap takes substantially longer to perform and has less blood flow, make the TRAM flap Dr. Elliott’s preferred reconstruction technique.
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.
