Breast Reconstruction Surgery
What is bresat reconstruction surgery?
Many women diagnosed with breast cancer undergo a breast removal surgery known as mastectomy. Women who undergo breast removal surgery choose to opt for breast reconstruction procedure for restoring the appearance of the missing breasts or breast. Reconstructive procedure followed by a mastectomy can help in renewing the sense of a woman’s beauty and femininity by recreating both the shape and size of the natural breast. Factors such as the need for any postsurgical radiation or chemotherapy, individual anatomy and aesthetic goals would determine the options. Discussing cancer surgery with a surgeon before mastectomy is important because the cancer removal procedure might affect the choices as well as the results of any type of breast reconstruction.
Who is the right candidate for breast reconstruction procedure?
Here are a few reasons why you might consider undergoing breast reconstruction procedure:
- • You can get the best results if you are not obese or overweight (body mass index is under 30)
- • Radiation therapy greatly affects the timing as well as the type of breast reconstruction that you might undergo. It delays the process of wound healing and might cause skin to tighten and darken. reconstruction, which have to be delayed for many moths after radiation, might encompass the use of your own tissue to help in replacing some affected skin.
- • You should not suffer from any kind of blood flow circulation problems or any other serious health issues, such as heart disease and high blood pressure. Autoimmune disease such as scleroderma and rheumatoid arthritis and diabetes, increase the possibility of infections and wound healing. Clotting problems might increase the peril of breast reconstruction using flaps, and bleeding agents and disorders used for preventing formation of blood clots might increase the rate of bleeding after surgery.
- • Chemotherapy after mastectomy can also significantly affect the timing of reconstruction.
- • As smoking interferes with the blood flow, it might trigger problems after surgery, lead to larger scars and delay in the process of healing.
- • Coexisting ailments, previous medical history and past surgical history are some factors that help in determining if you are the right candidate for breast reconstruction.
How is the breast reconstruction surgery done?
When it comes to breast reconstruction surgery, there are three basic options to consider:
- • Reconstruction of breasts using patient’s own muscle, fat and skin
- • Using breast implants, either silicone or saline
- • And a combination of these above mentioned methods
There are different approaches to perform this surgery. Most breast reconstruction techniques involve various steps. In most cases, the entire surgical procedure is performed as outpatient surgery. However, some patients might require to stay at the hospital for the initial procedure particularly when it is performed in combination with the mastectomy. Expander or implant insertion might need for the extra hospital time if it is performed right at the time of the mastectomy. The plastic surgeon would help you understand and weigh the pros and cons and choose the technique that is best for you.
Implant reconstruction methods
This usually involves two to three steps.
- • In the initial procedure, the plastic surgeon inserts a tissue expander below the chest muscle and skin, creating a skin-muscle envelop. The tissue expander can be best defined as a modified saline implant with a valve so that more saline can be added after the first procedure. Serial injections of saline are administered through the skin into the valve to slowly fill the implant and would subsequently expand the breast mound of the patient. During the visits to the plastic surgeon for next three to six months, the skin muscle envelop slowly stretchesuntil it reaches the size a patient wants for the final implant.
- • In the next step, patient will undergo outpatient surgery.In this step, the expander is removed and then replaced with a softer breast implant that is usually made of silicone or saline.
- • Sometimes, when saline implants are used, the expander is kept in place for a relatively longer duration, so that the size of the reconstructed breast can be modified (by decreasing or increasing the amount of saline) without removing the implant. If a silicone implant is used then the size of the breast cannot be changed without undergoing yet another surgery.
- • It is only in rare cases that a woman can have an implant placed directly without tissue expansion. In such a situation, the size of the skin-muscle envelop at the time of breast removal or mastectomy should be large enough for covering the final implant.
Recovery and aftercare
Before the surgery, the plastic surgeon would discuss when you can resume normal level of activity as well as work. Post-surgery, patient along with the caregiver would receive detailed instructions about the postsurgical care that also include the information:
- • Potential signs of complications
- • Normal symptoms that you might experience
- • Drains, in case they are placed
What will happen immediately after the surgery?
The plastic surgeon would prepare you for the experience however listed below are a few things that you can expect:
- • You might have compression sleeves on the legs for blood circulation.
- • You might feel groggy or tired after the surgery
- • Though you will be given pain medication, you can expect to feel sore.
- • You might have drains placed under your arms for healing. And, in some cases, drains are placed in stomach in case you underwent autologous reconstruction making use of tissue from abdominal area.
Recovery duration after breast reconstruction surgery
- • Make sure you adhere to the patient care instructions provided by the plastic surgeon. This would include the information related to the compression garments, intake of antibiotic and other medication, the type and level of activities you can do and care of your drains. In addition, the surgeon would also provide instructions about the normal symptoms and those that might trigger complications. It is important to know that amount or duration of time it requires for recovery varies from patient to patient.
- • Implant based reconstruction is not only simple but also least painful and has the shortest time for recuperation. Usually, most women can resume daily and routine activities within five to six weeks of the surgery. Flap-based surgeries, on the other hand, need you to undergo surgery in two areas, and take much more time in recuperation on the basis of which flap procedure was done.
Duration of the procedure
When it comes to implant based surgery, you can feel secure as both silicone and saline implants are effective and safe if used as per their label. Silicone and saline implants come with lifetime warranties from the manufacturers, however the longer implants are placed, the more likely you might experience complications. According to the recent data, over 95 percent of implants remain intact even after seven-eight years of the procedure, however other available data show that half of women who have received implants for breast reconstruction would need exchange or removal within a decade of the implantation.
- • For those who are undergoing breast reconstruction of a single breast, modifications in that breast will, after sometime, be different from that in the other breast. The natural breast tissue of the patient are more likely to sag and lose elasticity in comparison to an implant based reconstruction that stays youthful with less drooping.
- • Patients who undergo bilateral reconstruction and a bilateral mastectomy with implants would project young appearing breasts without any sagging even in the seventh decade of their life.
- • Breast construction done using flaps are subject to the same forces of natural breast tissue and gravity. The tissues might not age as tissues are taken from other part of the body.
- • The fat and skin from the buttocks or upper buttock region is more fibrous and thicker and does not sag or droop as muchover time as breast tissue.
- • The fat and skin of the abdomen is very same to that of breast tissues and thus sags or droops over the period, just like natural breast tissue. Tissues do not know that they have been moved from one part of the body to the other and might shrink or grow in response to weight loss.
Consult the plastic surgeon timely
It is very important to consult the plastic surgeon from time to time, or as scheduled. For safety, along with healthy as well as beautiful outcome, it is important to visit the surgeon for follow-up visits and whenever you notice any changes. Also, consult the surgeon in case you have any questions or concerns.
Cost of breast reconstruction
When it comes to breast reconstruction procedure, the cost depends on several factors including the experience, skills and qualifications of the surgeon, type of surgery and method used, tools and equipment used, anaesthesiologist and facility fee, to name a few. Your chosen plastic surgeon would discuss the cost during the initial consultation. Make sure you discuss everything you have in mind to know the exact cost of the procedure.