Breast Reconstruction

What It Does

Breast reconstruction is often indicated following a mastectomy (the surgical removal of one or both breasts) due to breast cancer or other medical condition. Although a reconstructed breast will never look or feel exactly like a natural breast, a breast reconstruction helps many women regain a sense of self-confidence and will go a long way to improve self-image and quality of life.  The decision to have breast reconstruction surgery is a very personal one, and your surgeon will work with you to understand the risks of surgery, as well as the benefits and possible outcomes.

Procedure Basics

Unlike some other breast surgeries, breast reconstruction involves several procedures performed at multiple stages. Often the preliminary surgery can be started in conjunction with a mastectomy, or the reconstruction can be delayed until healing from the mastectomy and any additional therapy such as chemotherapy or radiation is complete. Your breast cancer surgeon will usually consult with you on the best approach for your particular condition.

Generally, breast reconstruction surgery will be performed in a hospital setting and under general anesthesia. The most common surgical option uses an expandable implant that over a period of several weeks stretches the tissue area to create a breast mound. This option requires continued office visits and a second surgery to remove the expander and replace it with a traditional implant. More sophisticated techniques use muscle and/or skin and fat transferred to the breast area from various donor sites on the body. Sometimes an implant is inserted beneath these flaps for additional size and shape. Your surgeon may also suggest techniques to reconstruct the nipple and areola.

Recovery

Depending on the extent of surgery, a short hospital stay may be required following initial procedures. For any procedures that might be done on an outpatient basis, be sure to have someone available to drive you to and from your procedure and stay with you for the evening.

Following breast surgery, a support bra or elastic bandage will be used to help minimize swelling and support the reconstructed breast. A small tube, or drain, may be placed under the skin temporarily to drain any excess blood or fluid. Your surgeon may also recommend a pain pump to reduce post-operative pain and the need for narcotic medications.

You will be given specific instructions concerning post-surgical medications, breast care, activity level, and when to follow up with your surgeon. The success of your procedure and healing will be greatly enhanced by carefully following your doctor’s post-surgical instructions. Be sure to attend any follow up visits with your surgeon as directed.

Additional Information

Risks involved with breast reconstruction surgery include bleeding, infection, poor healing of the incisions, breast symmetry problems, permanent loss of sensation at both the flap donor and reconstruction site, and implant rupture. Your surgeon will discuss the risks of surgery with you as part of your consultation based on you medical history, current physical health, and the extent of surgery required.

Incision lines will be permanent, and although they may fade over time, scars will remain on the breast. Surgical techniques will also leave incision lines at the donor site, usually in less exposed areas of the body, including the back, abdomen, or buttocks.

Breast implants are not guaranteed to last a lifetime. You should consider that future surgery may be required to replace one or both implants. Pregnancy, weight fluctuations, menopause, and aging may also affect the appearance of a reconstructed breast, the opposite natural breast, or the symmetry between the two. These changes may require additional corrective surgery. You should revisit your surgeon periodically to review your breast health and appearance, the position and status of your implants, and any changes to your breasts that might occur.

Additional Resources

For information on FDA-approved implants and current information on safety, visit www.breastimplantsafety.org. There is a good deal of information available concerning breast reconstruction surgery provided by the American Society of Plastic Surgeons (www.plasticsurgery.org); click on “Cosmetic” and choose from the list of procedures. The American Society for Aesthetic Plastic Surgery, Inc. (www.surgery.org) also provides in-depth information; choose “Procedures” for a list of topics.

To schedule a consultation to discuss breast reconstruction with Dr. Christine Kelley, please call 317/575-0330.