For a woman who has lost one or both of her breasts due to cancer or another condition, breast reconstruction is a physically and emotionally rewarding procedure. The reconstruction of your breasts can dramatically improve your self-confidence and self-image, as well as your overall quality of life. While surgery can give you a relatively natural-looking breast, one that is reconstructed will never look and feel exactly like the breast that was removed.

Breast reconstruction is conducted through several plastic surgery techniques in an attempt to restore a near-normal shape, size and appearance after a mastectomy (removal of the whole breast tissue) or lumpectomy defects (removal of part of the breast tissue). If only one breast has been removed, it can be reconstructed alone, although a breast lift, reduction or augmentation may be recommended for the other breast, in order to improve symmetry.

 

Surgical options and considerations:

Each breast reconstruction procedure is highly personalized, and thus the technique used – and therefore the recovery time and other factors – will depend largely on the patient and her wishes. Breast reconstruction generally requires several surgical procedures performed at various stages. The process can begin at the same time as the mastectomy, or can be delayed if time is needed to heal and recover from additional cancer treatments.

Different methods of breast reconstruction are available, which Dr. Sati, MD, will discuss with you in order to select the one that best suits your needs and wishes. There are two procedure options available: the flap technique and the tissue expansion technique. The flap technique repositions a woman’s own muscle, fat and skin – typically from the abdomen or back – to create or cover the breast mound. The tissue expansion technique stretches healthy skin to provide coverage for an implant; this method usually requires at least two procedures to complete.

Although breast reconstruction is a very rewarding procedure, results are highly variable. For example, a reconstructed breast will not have the same feel and sensation of a natural breast. Visible incision lines, whether from the mastectomy or reconstruction, will always be present. Additionally, incision lines from the donor site (typically less exposed areas like the back or abdomen), used for the flap technique, will also be present.

 

About the procedure:

Breast reconstruction is performed under general anesthesia. The length of the surgery depends on the technique being used and your current stage of reconstruction, as the process is highly individualized and some reconstructive surgeries require multiple operations. Breast reconstruction may be performed on an outpatient basis, although if the flap technique is used, you may need to stay in the hospital for three to five days after the surgery.

 

Post- operative instructions:

  • Following the operation, you will wake up with bandages and a brassiere covering your breasts. Dr. Sati, MD, may decide to insert drainage tubes (small tubes the size of IV tubing) during the operation.
  • Occasionally, patients complain of nausea following the operation. This generally passes after 24 to 48 hours, and is minimized by consuming liquids frequently and avoiding taking pain medication on an empty stomach.
  • Once home, you may get up to use the bathroom or to take a light walk around the house. When taking pain medication, exercise caution in the home, particularly when performing tasks like climbing stairs.
  • The bandages and brassiere must stay in place for two days, after which you may remove them to shower. It is important to have someone assist you in the shower, in case you feel faint. Do not remove the tape over the incisions, although it can get wet. Avoid directing the water pressure toward your breasts, and gently pat dry when finished.
  • With the exception of showering, a brassiere or sports bra should be worn at all times, day and night, until Dr. Sati, MD, advises you that it is okay to remove it. Use a supportive sports bra without underwire; some have a zipper enclosure in the front, which can be helpful during the recovery period.
  • Rest and sleep on your back for at least the first week after the operation.
  • You will be able to resume driving after one to two weeks, though it should be avoided when taking pain medication, which causes drowsiness. Light exercise, such as walking or using a stationary bike, may be resumed after at least two weeks. Heavy exercise, heavy lifting and carrying a backpack are not permitted for at least six weeks after the procedure.

 

The healing process:

  • Following the procedure, your breasts will be swollen, bruised and sensitive, though discomfort is generally mild. Pain medication may be used as prescribed whenever experiencing discomfort. Swelling and bruising will take approximately two weeks to subside.
  • Most patients take a week off work following the procedure.
  • The incisions may be raised, red or hard to the touch for several months.
  • Your breasts will resume a more natural shape gradually over the following months, as breast implants tend to settle over time.
  • The final results of the procedure can be judged three to six months after the operation, although the final healed results may not be apparent until one year after the procedure.

 

Follow-up appointments:

  • First follow-up: Within one week of the operation
  • Second follow-up: Three weeks after the operation
  • Subsequent appointments are typically scheduled for three months after the procedure.