Breast Reconstruction. What is involved?
Breast reconstruction surgery is performed to restore one or both breasts back to normal shape and symmetry after undergoing a mastectomy, lumpectomy or other trauma. Generally, breast reconstruction falls into two categories: implant based reconstruction and flap reconstruction, which may also involve an implant.
Some factors that may play a role in considering either of the above surgeries are future cancer treatments, patient’s body type, and type of mastectomy. Some patients may be concerned about one breast being affected and reconstructed, which is common. In addition to having breast reconstruction surgery, many patients undergo a breast lift, breast reduction, or breast augmentation depending on the opposite breast, in order to improve symmetry.
One of the first decisions a patient must make with Dr. Roth is what type of breast reconstruction she will undergo. There are two general breast reconstruction categories- implant reconstruction or flap reconstruction.
- Implant-based reconstruction involves the insertion of silicone or saline breast implants to help form a new breast mound immediately after a mastectomy. If needed, a balloon expander is inserted under the skin and chest muscle to stretch the skin before insertion. This often requires a number of visits.
- Flap reconstruction uses the patient’s own tissue (skin, fat, and muscle) from another part of the body, usually from the abdomen, to form a new breast. This procedure is more complex, often involving a longer recovery. Some women prefer this natural breast reconstruction option. An implant may also be used to add volume in these surgeries.
Usually, breast reconstruction is performed after a full or partial mastectomy. Having breast reconstruction immediately after a mastectomy accelerates a woman’s physical and emotional recovery and also enhances the long-term results. However, women getting chemotherapy or radiation will need to wait until their therapy is completed.
Most breast reconstruction involves a series of procedures over a set period. The first operation—to construct the foundation for a new breast mound. A second operation is typically performed 3-6 months later to provide final shaping of the breast mound, as well as the reconstruction of the nipple and the areola. You may still undergo breast reconstruction even if you are years past your mastectomy. At this time, surgery may be performed to enlarge, reduce or lift a second, natural breast to match the reconstructed breast.
Benefits of Breast Reconstruction
There are significant, life-changing advantages to breast reconstruction. Most important of all–it helps most women feel much better about their bodies, significantly boosting their confidence. The procedure results in a natural-looking, balanced shape. Immediate post-mastectomy reconstruction offers the psychological and aesthetic advantage of waking from the mastectomy procedure with a lesser deformity and reconstruction well underway.
What You Need to Evaluate
This decision should be made with Dr. Roth prior to your mastectomy and is usually based on your risk factors and information from your biopsy.
- Speak with Dr. Roth to share your surgical goals for restoring your breast and body image.
- Do you have additional medical conditions or other illnesses that may impair healing?
- Would a breast prosthesis suit you and your everyday life?
- The first stage of reconstruction is almost always done using general anesthesia to ensure you sleep and feel no pain during surgery. Follow-up procedures may only require local anesthesia, depending on your circumstances. A sedating drug may also be administered to make you feel relaxed.
Some patients may choose to delay reconstruction. Some may have signs of advanced disease, or radiation may be required as part of the treatment plan before any surgery is performed.
Planning Your Breast Surgery
Scheduling your consultation at Dr. Roth’s plastic surgery office is the first step in the path to your surgical goals and needs. This meeting allows for the development of a relationship between you and Dr. Roth, which is vital for the success of your surgical procedure.
Dr. Roth will give you clear instructions on how to prepare for surgery.
After surgery, you need to arrange to have someone take you home from the hospital. You will also need a friend or relative to help you for a few days so you can rest and avoid strenuous physical activity.
Your Implant Options
Dr. Roth will guide you through this process and help you choose the implants that are most suited to your goals. All materials used by Dr. Roth are high quality, safe, and effective. The implants you select will primarily depend on your body type, aesthetic goals, and health preferences. When you come to Dr. Roth’s office, you can try on different implant sizes to help you determine what size, shape, and material is best for you.
Following your surgery, most patients experience some mild swelling and discomfort. Rather than significant pain, most patients feel numbness and tightness where the incisions were made.
- It’s critical that you rest and avoid strenuous physical activity. You’ll need to avoid overhead lifting, strenuous sports, and some sexual activities for 4 to 6 weeks after reconstruction.
- It may take as long as 8 weeks for bruising and swelling to resolve and 1 to 2 years for tissues to heal fully and scars to fade.
In addition to periodic checkup visits with your doctor, you’ll need to do self-exams of your breasts every month, and have an annual mammogram.
Dr. Roth takes an active role in your recovery. He will call you the night of your surgery to check on your progress and answer any questions. He provides a direct contact number so that you can reach out to him with any urgent concerns. Following your surgery, you will have several follow-up visits so that he can monitor your healing and progress.