The goal of breast reconstruction is to restore one or both breasts to near normal shape, appearance, symmetry and size following mastectomy, lumpectomy or congenital deformities.
Breast reconstruction often involves multiple procedures performed in stages and can either begin at the time of mastectomy or be delayed until a later date.
Breast reconstruction generally falls into two categories: implant-based reconstruction or flap reconstruction. Implant reconstruction relies on breast implants to help form a new breast mound. Flap (or autologous) reconstruction uses the patient’s own tissue from another part of the body to form a new breast.
There are a number of factors that should be taken into consideration when choosing which option is best:
Type of mastectomy
Patient’s body type
Who is a good candidate for breast reconstruction?
You may be a candidate for breast reconstruction 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
Although breast reconstruction can rebuild your breast, the results are highly variable:
A reconstructed breast will not have the same sensation or feel as the breast it replaces
Visible incision lines will always be present on the breast, whether from reconstruction or mastectomy
Certain surgical techniques will leave incision lines at the donor site, commonly located in less exposed areas of the body such as the back, abdomen or buttocks
How should I prepare for breast reconstruction?
In preparing for breast reconstruction surgery, you may be asked to:
Get lab testing or a medical evaluation
Take certain medications or adjust your current medications
Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding
Breast reconstruction surgery is typically performed in a hospital setting, may include a short hospital stay and will likely use general anesthesia. Some follow-up procedures may be performed on an outpatient basis and local anesthesia with sedation may be used.
What should I expect during my breast reconstruction recovery?
Following your breast reconstruction surgery for flap techniques and/or the insertion of a breast implant, gauze or bandages may 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.
You will be given specific instructions that may include: How to care for your surgical site(s) following surgery, medications to apply or take orally to aid healing and reduce the risk of infection, specific concerns to look for at the surgical site or in your general health and when to follow up with your plastic surgeon.
Healing will continue for several weeks while swelling decreases and breast shape/position improve. Continue to follow your plastic surgeon’s instructions and attend follow-up visits as scheduled.
What results should I expect after breast reconstruction?
The final results of breast reconstruction following mastectomy can help lessen the physical and emotional impact of mastectomy.
Over time, some breast skin sensation may return, and scar lines will improve, although they will never disappear completely.
There are trade-offs, but most women feel these are small compared to the large improvement in their quality of life and the ability to look and feel whole.
Careful monitoring of breast health through self-exam and other diagnostic techniques is essential to your long-term health.