Breast Reconstruction

What is breast reconstruction surgery?

Some women are forced to have all or part of their breasts removed by mastectomy or lumpectomy because of breast cancer or because they have masses in the breasts. The shape and appearance of the breasts play an important role in women’s confidence and sense of femininity. Breast reconstruction surgery in many ways can greatly enhance the appearance of the breast to its normal appearance. Occasionally, breast reconstruction may be performed concurrently with your mastectomy or lumpectomy, but it usually needs to be postponed for a period after your treatment. This is usually performed by a plastic surgeon. It usually takes two or more operations to get the best results. It is also usually necessary in the first three months to have some appointments with your doctor to take action to improve your breast shape. These appointments and actions will vary depending on either the silicone implants or your body tissue are used to reconstruct your breasts.

Who is a good candidate?

• Women who have had a complete or partial mastectomy or lumpectomy.

• Women who preferably completed their treatment 12 months ago.

Types of Breast Reconstruction

• Implant Reconstruction: This procedure is performed with the help of silicone implants filled with saline water or silicone gels.

• Autologous or flap reconstruction: This procedure is done by removing one’s own body tissue from various areas such as the thigh, abdomen or back.

• Nipple reconstruction: Sometimes it may be necessary to correct one’s nipples too.

Breast reconstruction pre-operative instructions

Before undergoing breast reconstruction surgery, you should meet with an experienced plastic surgeon in the field of breast reconstruction. The surgeon takes the medical and pharmaceutical history of the patients. Your breast surgeon will usually need to work with the plastic surgeon to choose the best surgical strategy. Sometimes, even if a breast is perfectly healthy, surgery may need to be the same for both breasts, although the surgeon will try to do as much as possible. At least 2 weeks before breast reconstruction, patients should avoid taking aspirin and blood thinners and anti-inflammatory drugs. Women who suffer from anemia should take iron supplements. Patients should stop smoking at least 2 weeks before and after surgery, and avoid drinking alcohol at least one week before breast reconstruction surgery. They should not drink anything after midnight (including water) and should not eat at least 8 hours before surgery.

Breast reconstruction procedure

Breast reconstruction begins by inserting a breast implant or tissue expander under the breast skin. Breast reconstruction often requires several operations. In breast reconstruction with implants, a rounded or tear-shaped silicone shell filled with saline or silicone gel is inserted into the breast. The plastic surgeon places the implant beneath or on your chest muscle. Implants that are placed on the muscle are held in place using a special tissue called acellular dermal matrix. Over time, your body replaces it with collagen. Some women can have permanent breast implants at the same time as having a mastectomy. However, many women require a two-step process before a permanent implant is inserted, in which a tissue expander is inserted into the breast. Next, the implant is replaced. Tissue expansion is a process in which the skin of the breast and its soft tissues expand to provide a suitable space for breast implants. Your surgeon places a balloon-like tissue expander at the time of mastectomy under or on the pectoral muscle. Then within a few months, the surgeon gradually injects a fluid into it. This gradual process causes the skin to stretch over time. It is usually necessary to see your doctor once or twice a week to inject saline. You may feel discomfort or pressure in the area as the tissue expander grows. A newer type of tissue expander uses carbon dioxide which causes less discomfort compared to the expansion using saline. After the tissue has expanded sufficiently, the surgeon removes the tissue expander and replaces it with a permanent implant. This will be the second stage of breast reconstruction surgery.

Breast reconstruction post-operative instructions

The recovery and start of daily activities usually take about 6 to 12 weeks. Postoperative swelling, pain, and bruising are common. The surgeon may prescribe antibiotics and painkillers for you. Strenuous activities and heavy lifting should be avoided until 12 weeks after breast reconstruction surgery. The sutures are removed after about a week. For the first 6 weeks, the patient should lie on his back. It may take up to a year for a complete recovery.

Scars

Probable scars

Discomfort

Moderate

Duration of results

Permanent

Potential risks

Soreness, swelling or pain, scars, infections and bleeding

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