What is breast reconstruction surgery?
Breast reconstruction surgery is a medical procedure aimed at restoring the shape, appearance, and size of the breast
Is breast reconstruction right for me?
Breast reconstruction is a highly individualized procedure. You should do it for yourself, not to fulfill someone else’s desires or to try to fit any sort of ideal image.
Breast reconstruction is a good option for you if:
- You are able to cope well with your diagnosis and treatment
- You do not have additional medical conditions or other illnesses that may impair healing
- You have a positive outlook and realistic goals for restoring your breast and body image
- Breast reconstruction typically involves several procedures performed in multiple stages. It can begin at the same time as mastectomy or be delayed until you heal from mastectomy and recover from any additional cancer treatments.
- It’s important that you feel ready for the emotional adjustment involved in breast reconstruction. It may take some time to accept the results of breast reconstruction.
- If only one breast is affected, it alone may be reconstructed. In addition, a breast lift, breast reduction or breast augmentation may be recommended for the opposite breast to improve symmetry of the size and position of both breasts.
What are types of breast reconstructive surgery?
Our physicians are trained in several methods of breast reconstruction. We will talk to you about your options and make a decision based on the best possible outcome and your desired results. Our plastic surgeons specialize in three different types of breast reconstructive surgery: tram flap, diep flap and free flap.
Tram flap breast reconstruction
Tram flap involves reconstructing the breast using tissue and muscle from the lower abdomen. The skin, fat, blood vessels and at least one abdominal muscle are moved from the stomach to the chest.
Diep flap breast reconstruction
Diep flap breast reconstruction is similar to a tram flap but does not harvest the rectus muscle from the abdomen. You usually experience less pain. It’s better for the abdomen, but technically more challenging. Only the skin and fat from the lower abdomen are used to form the breast, similar to a tummy tuck.
Free flap breast reconstruction
During the free flap procedure, the physician completely removes tissue from your tummy, cutting it free. The flap (the tissue) is then transplanted to your chest and the tiny vessels are connected to form the breast. A diep flap is one of several free flaps that can be used for breast reconstruction.
What should I expect at my breast consultation?
The success and safety of your breast reconstruction procedure depends very much on your complete candidness during your consultation. You’ll be asked a number of questions about your health, desires and lifestyle.
Be prepared to discuss:
- Why you want the surgery, your expectations and desired outcome
- Medical conditions, drug allergies and medical treatments
- Use of current medications, vitamins, herbal supplements, alcohol, tobacco and drugs
- Previous surgeries
- The options available in breast reconstruction surgery
- The likely outcomes of breast reconstruction and any risks or potential complications. The course of treatment recommended by your plastic surgeon, including procedures to achieve breast symmetry
Your surgeon may also:
- Evaluate your general health status and any pre-existing health conditions or risk factors
- Examine your breasts, and take detailed measurements of their size and shape, skin quality, and placement of nipples and areolae
- Take photographs for your medical record
- Discuss your options and recommend a course of treatment
- Discuss likely outcomes of breast reconstruction and any risks or potential complications
Where will my breast surgery be performed?
Surgery for your breast reconstruction is most often performed in a hospital setting, possibly including a short hospital stay, and your doctor will likely use general anesthesia. Some follow-up procedures may be performed on an outpatient basis, and local anesthesia with sedation may be used.
These decisions will be based on the requirements of your specific procedure and in consideration of your preferences and your doctor’s best judgment.
What happens during breast reconstruction?
Anesthetic medications are administered for your comfort during the surgical procedure. The choices include intravenous sedation and general anesthesia. Your doctor will recommend the best choice for you.
Next, doctors use flap techniques reposition your own muscle, fat and skin to create or cover the breast mound. Tissue expansion is another option that stretches healthy skin to provide coverage for a breast implant.
A breast implant can be an addition or alternative to flap techniques. Saline and silicone implants are available for reconstruction. Your surgeon will help you decide what is best for you. Reconstruction with an implant alone usually requires tissue expansion.
What is the breast reconstruction recovery like?
Following your surgery for flap techniques and/or the insertion of an implant, gauze or bandages will be applied to your incisions.
An elastic bandage or support bra will minimize swelling and support the reconstructed breast. A small, thin tube may be temporarily placed under the skin to drain any excess blood or fluid.
A pain pump may also be used to reduce the need for narcotics.
Healing will continue for several weeks as swelling decreases and breast shape and position improve. Continue to follow your plastic surgeon’s instructions and attend follow-up visits as scheduled.
If you experience shortness of breath, chest pains, or unusual heart beats, seek medical attention immediately. Should any of these complications occur, you may require hospitalization and additional treatment.
What are the risks of breast reconstruction?
When breast reconstruction is performed by a qualified plastic surgeon, complications are infrequent and usually minor.
The possible risks of breast reconstruction include, but are not limited to, bleeding, infection, poor healing of incisions, and anesthesia risks.
You should also know that:
- Flap surgery includes the risk of partial or complete loss of the flap and a loss of sensation at both the donor and reconstruction site.
- The use of implants carries the risk of breast firmness (capsular contracture) and implant rupture.
Breast implants do not impair breast health. A careful review of scientific research conducted by independent groups such as the institute of medicine has found no proven link between breast implants and autoimmune or other systemic diseases