What is breast reconstruction?
Losing one or both breasts as a result of a mastectomy can be a distressing experience. Breast reconstruction surgery is a personal choice, and the anxiety, depression or loss of self-confidence you can feel after a mastectomy are valid reasons for a reconstruction. A breast reconstruction can make a big difference, giving your chest a more balanced appearance while restoring your breast shape. Breast reconstruction also means you will not need to use an external prosthesis inside your bra. While a reconstruction may not be a perfect substitute for the breast or breasts that were removed, the procedure will help to rebuild not just your shape, but your self confidence too.
Breast reconstruction surgery is performed to reform or reshape one or both breasts following a mastectomy (removal of the entire breast) or a lumpectomy (the removal of a part of the breast that contains a tumour.) The two main techniques used in breast reconstruction are implant reconstruction and autologous (skin flap) surgery that uses tissue from another part of the body. Some reconstructions use a combination of both techniques for best results.
Today, most traditional mastectomies are skin sparing, a procedure in which the surgeon removes all breast tissue and glands but preserves the skin, which can result in a more natural looking reconstruction and less scarring. A breast reconstruction can be done as soon as the mastectomy is performed, or it can be delayed until after the mastectomy has healed and other cancer treatments are completed.
WHAT CAN YOU EXPECT?
How do I plan for my breast reconstruction surgery?
Some other factors to consider are your body type, the type of cancer and the other cancer treatments you may have had, your general health and how soon you expect to recover.
What is the procedure for a breast reconstruction?
In an implant reconstruction, the surgeon inserts a tissue expander under the skin or muscle, which gradually stretches the remaining tissue.
After this has healed, the surgeon injects saline or saltwater into the expander over several weeks until the breast is the size you’re happy with, and then replaces the expanders with a silicone or saline implant.
In some cases, the tissue expander may not be necessary and a surgeon will insert the implant at the time of the mastectomy.
In skin flap surgery, the surgeon will rebuild the breast by transferring tissue from the abdomen or other parts of the body.
The two skin flap surgery techniques are free flap surgery, in which the surgeon will completely remove the tissue and the blood vessels and transfer them to the breast, and pedicle flap surgery, where the tissue being transferred stays attached to the body, and is rotated onto the chest.
How should I prepare for a breast reconstruction?
You will also have to have a blood test before surgery is performed.
You should stop taking certain medication, like aspirin and some anti-inflammatory drugs. Avoid recreational drugs, and disclose to your surgeon any other medication you’re taking, since you may need to adjust these.
Be sure to arrange for transport to and from the clinic, since you will not be able to drive yourself after the procedure.
Where will my breast reconstruction surgery be performed?
What anaesthetic will be used for my surgery?
How do I recover from a breast reconstruction?
What can I expect after my surgery?
You may feel some pain and discomfort but this will be relieved with the help of prescribed pain medication. You may also experience fatigue and bruising. Apart from soreness in the breasts, if you have had skin flap surgery, you may experience some abdominal pain, or pain at the site from which the tissue was removed.
Your surgeon will advise you on how to look after yourself while healing, how to take medications following surgery, and what to look out for at the surgical site and in your general health.
When can I return to normal activities?
What are the risks involved in breast reduction surgery?
Other complications and risks may include fluid buildup in the breast or at the donor site (after skin flap surgery) and slow wound healing. After a skin flap reconstruction, there may be tissue death (necrosis) or a loss of muscle strength at the donor site.
With implant surgery there is a risk of implants moving or rupturing, and they may need to be removed. There can be changes in breast or nipple sensation, and asymmetry. In some cases, further surgery may be necessary after the first reconstruction.