Breast Reconstruction:

What is breast reconstruction surgery?

Reconstruction of a breast that's been removed due to cancer or another disease is one of the most rewarding surgical procedures available today. New medical techniques and devices have made it possible for surgeons to create a breast that can come impressively close in form and appearance to a natural breast.

Frequently, reconstruction is possible immediately following breast removal (mastectomy), so the patient wakes up with a breast mound already in place, having been spared the experience of seeing herself with no breast at all.

How is the procedure performed?

Most breast reconstruction involves a series of procedures that occur over time. The initial reconstructive operation is usually the most complex. Follow-up surgery may be required to reconstruct the areola and many surgeons recommend an additional operation to enlarge, reduce, or lift the natural breast to match the reconstructed breast.

The most common technique in breast reconstruction surgery combines skin expansion and subsequent insertion of an implant. Following a mastectomy, Dr. Bootstaylor will insert tiny valve mechanism that expands under your skin and chest muscle. When the skin has stretched enough, the expander may be removed in a second operation and a more permanent implant will be inserted. Some expanders are left in place as the final implant.

How quickly will I heal?

You're likely to feel tired and sore for a week or two after reconstruction, but medication can control most discomfort. Depending on the extent of your surgery, you'll probably be released from the hospital in two to five days.

Many reconstruction options require a surgical drain to remove excess fluids from surgical sites immediately following the operation, but these are removed within the first week or two after surgery. Most stitches are removed in a week to 10 days. It may take you up to six weeks to recover from a combined mastectomy and reconstruction or from a flap reconstruction alone.

Follow your surgeon's advice on when to begin normal activities. You'll want to refrain from any overhead lifting, strenuous sports, and sexual activity for three to six weeks following reconstruction.

What are my risks?

Although they're relatively uncommon, the usual problems such as bleeding, fluid collection, excessive scar tissue, or difficulties with anesthesia can occur.

If an implant is used, there is a remote possibility that an infection will develop, usually within the first two weeks following surgery. In some of these cases, the implant may need to be removed for several months until the infection clears. A new implant can later be inserted.

The most common problem, capsular contracture, occurs if the scar or capsule around the implant begins to tighten. Capsular contracture can be treated in several ways, and sometimes requires either removal or "scoring" of the scar tissue, or perhaps removal or replacement of the implant.