The results of breast reconstruction have improved remarkably over the past ten years. Many types of procedures are now available for reconstructing the breast after a complete or partial mastectomy. Each procedure is associated with specific potential complications and it is here where careful patient evaluation is necessary to choose the “right” procedure for the individual patient., Breast Reconstruction requires up to seven days of hospital stay. Postoperative recovery generally takes 3-8 weeks. Insurance usually covers breast reconstruction procedures.
The loss of a breast to breast cancer is an unpleasant and sometimes devastating event in a woman’s life. Current techniques of breast reconstruction enable us, in almost every case, to restore a feeling of wholeness, femininity, and sexuality, thus improving your quality of life.
A reconstructed breast is superior to an external breast prosthesis in virtually every way. Your reconstructed breast is a part of you. You don’t have to be reminded of losing your breast each time an external prosthesis is removed. Also, you’re not as limited in clothing options or activities because of fears of an external prosthesis displacing or becoming visible.
There are many different types of breast reconstruction procedures available. The best procedure for you depends on the type of surgery you’ve had on your breasts, characteristics of your breast cancer including its location and size, and your personal preferences about each of the different procedures.
You should decide about reconstruction only after getting complete information about all alternatives. It is tempting to choose methods which sound “simple” only to find out after reconstruction that you may have a “simple” looking result rather than the most aesthetic look possible. Remember that you will live with your new breast for the rest of your life.
Dr. Sonderman will review information with you about your mastectomy or partial breast removal and discuss the options available for breast reconstruction. After the initial examination, he will recommend the most suitable option for your breast reconstruction.
Below is a detailed video explaining breast reconstruction.
Almost any woman who has lost a breast to cancer can be reconstructed. We’ll coordinate your reconstruction with any other treatments necessary to obtain the best cure of your breast.
Breast reconstruction can be performed at the time of mastectomy if Dr. Sonderman feels that the type and size of your breast cancer is appropriate to allow immediate reconstruction. Otherwise, reconstruction can begin after an appropriate delay of three months or longer depending on other necessary treatment. In many cases a delay may allow tissues to recover and be healthier for the reconstruction.
Breast reconstruction restores components of your breast that were lost during mastectomy. The first and simplest way to reconstruct the breast is to fill the skin envelope with a tissue expander that is eventually exchanged with the permanent implant at a later date. For other patients, tissue from the back is used with or without an implant. This procedure is referred to as a Latissimus Flap Reconstruction. A tissue expander is typically used in addition to the Latissimis Flap followed by exchanging it with an implant at a further date.
In some instances, it is possible to reconstruct the entire breast from tissue of your lower abdomen without any type of implant being necessary. In this procedure, excess tissue is removed from the abdomen and is used to reconstruct the breast, simultaneously improving both areas.
After reconstructing the mound, the tissue is allowed to “settle” to its final shape and position. Then, the best location for the nipple is determined and nipple-areola reconstruction is completed.
Nipple-areola reconstruction is usually performed, as a day surgery or outpatient procedure, 4-6 months after the mound reconstruction. Dr. Sonderman will discuss the options and techniques for nipple-areola reconstruction during your consultation after determining available options.
The number of stages necessary to achieve reconstruction can vary according to the type of procedure and just how optimal you want your breast to look. Breast reconstruction surgery is usually performed using general anesthesia.
There is not a single procedure that is the best for every client’s reconstruction. The creation of an optimal breast depends on tissues left during your mastectomy and the availability of other tissues. After examining you, Dr. Sonderman will outline the available options in detail so you can make an informed choice of which you prefer.
The scar produced by your mastectomy will remain after reconstruction, but in many cases can be improved in the reconstruction process. Additional scars may be necessary for reconstruction, particularly if tissue is moved from another location to the chest for reconstruction. The presence of scars is usually offset by the enhanced contour and appearance when tissue is added back to the breast for reconstruction.
Sometimes adjustments in the size and shape of your opposite breast are necessary to achieve the best symmetry. For instance, if your opposite breast is too large or too small in comparison with your newly reconstructed breast, we can decrease (by performing a breast reduction) or increase (by performing abreast augmentation) the opposite breast to insure as much symmetry as possible. All of these factors will be discussed during your consultation.
Limitations and risks are present with each different type of procedure, but they rarely occur. Also, risks common to all surgical procedures such as bleeding, infection and scar tissue formation occur in a very small percentage of cases. We will give you more detailed information about these risks in our written information and encourage you to discuss any which concern you during your consultation.
If there is an adequate amount of skin remaining following a mastectomy, then a breast implant or prosthesis can be placed beneath it to reconstruct the breast mound. If not, then remaining skin can sometimes be expanded by placing an inflatable expander beneath the skin and filling it in increments over several weeks, then replacing it with a permanent implant.
With expander or implant techniques, a pocket is created beneath the remaining skin where the implant is placed to create a breast mound.
All your incisions will be carefully placed beneath the skin, so you’ll have very fine line scars instead of “railroad track” type marks. You’ll be able to shower or bathe two days after surgery. None of the sutures will have to be removed – the stitch ends simply need to be snipped off.
You won’t even need to wear a bra at all after surgery! Dr. Sonderman wants you to spend some time without a bra to allow tightened skin to relax. You can wear a bra depending on your own preference after a few weeks.
Following breast reconstruction procedures, the degree of discomfort depends on the type and extent of your procedure. Most patients experience discomfort that requires medication for 2-5 weeks.
Your breast and chest may feel very tight or somewhat sore, but this will gradually diminish over the next several weeks as the swelling decreases. You may develop slight bruising around the breast a day or two after surgery which will resolve in about one week.
- Recovery from mastectomy with a tissue expander reconstruction is approximately 3-4 weeks.
- Mastectomy with the LAT flap and tissue expander reconstruction usually entails a 4-6 week recovery.
- Recovery time for a TRAM flap breast reconstruction is generally 8-10 weeks.
Patients can return to work sooner than the approximated recovery time depending on each individual, the type of work the patient does, and the amount of hours the patient expects to work. All of this is addressed by Dr. Sonderman with each patient.
Additional Resource: breastreconstructionmatters.com.