BREAST RECONSTRUCTION

Here is a brief summary of the operation. More details can be obtained from your own surgeon or the ASPS . For more information see the most frequently asked questions (FAQs) about Breast Reconstruction after Mastectomy.

Indications: This operation is done to rebuild the breast after mastectomy.

Method: There are several methods to rebuild the breast after mastectomy. The method must be tailored to the individual patient needs. The method of surgery depends on whether you choose a flap, or expander and implant. The simplest operation is to place an implant behind the remaining muscle and create a mound that resembles a normal breast.

If you had a great deal of tissue removed more skin is created with a tissue expander. This is a balloon that is placed beneath the muscle and skin. Over several weeks this is made larger by almost painless injections of saline in the office. After several months the expander is replaced by a permanent implant. Another approach is to use tissue from your back, thigh or abdomen to rebuild the breast. This tissue is moved into its new position leaving a defect at the donor site. It is more major surgery. When you have had radiation which has caused severe scarring a flap may be the only alternative.

Whichever method is used, additional surgery is needed if you want to have the nipple and areola rebuilt. The scar from breast reconstruction depends on the method used. For expanders and implants no new incision is used because the original mastectomy scar is reopened. If a flap is used you will have a scar at the site where the flap is removed (the donor site) and another around the flap on the breast.

All surgery requires a scar and all scars take time to soften and fade. You will not see the final appearance of your scar for a year after surgery. It is usually red and raised for the first month or two after your operation. I do the operation under a general anesthetic (you are asleep). Most of the time this is an outpatient operation and a stay in the hospital is not needed.

Problems: All operations have some risk.Your surgeon will explain the operation you choose in more detail. The risks of surgery are divided into two groups. First those that are seen in all operations and second those that are unique or special for this operation. In the first group, the main risks are swelling, bruising, bleeding, infection, a scar and numbness or change in feeling. The main problems which are special for this operation include:

• for implant and expander surgery problems with the implant such as leakage or capsule formation and changes in position of the implant.
• for flap surgery, loss of the flap, weakness of the donor site and hernia formation, irregularity of the breast and significant blood loss.

Postoperative care: The recovery takes one to two weeks. Most people are back to work within a week or two, although some flap surgery may take much longer. Radiation therapy is still possible after reconstruction.

For more information see the most frequently asked questions (FAQs) or check with your doctor. There are many different ways to do this operation and your best advice comes from your own plastic surgeon. There is a lot of information about breast cancer and reconstruction on the internet.