Many women who have breast cancer surgery can have the option of breast reconstruction. A woman having mastectomy prefers have the breast mound rebuilt after surgery to restore the appearance of the breast. A woman may consider in getting fat grafted into the affected breast in certain breast-conserving procedures to remove any dimples left from the surgery. The option of breast reconstruction depends on the medical situation and personal preferences of the woman. The patient can opt for breast reconstruction at the same time as the surgery (immediate reconstruction) or later (delayed reconstruction).
Patients may undergo breast reconstruction surgery at the same time or after mastectomy. A plastic surgeon with special training in reconstruction surgery performs this kind of procedure. The surgeon uses an implant or tissue from another any part of the body to create a breast-like shape that substitutes for the missing breast. The surgeon may even make a nipple outline and add a tattoo, which looks like the areola (the dark region around the nipple).
There are two main types of breast reconstruction surgery:
Breast implant: Breast reconstruction with an implant is performed in steps such as:
- The plastic surgeon places a balloon expander under the chest muscle which is the first step in the procedure, also called as tissue expansion.
- Saline is applied to the expander over weeks or months to stretch the chest muscle and the skin above it. This phase creates an implant pocket.
- When the pocket is the appropriate size, the surgeon removes the expander and inserts an implant in the pocket (filled with saline or silicone gel). This creates a new breast-like shape.
- Although it looks like a breast, since nerves were cut during the mastectomy, you will not have the same feeling as before.
Breast implants do not last a lifetime. If you want to have an implant, you will possibly need further surgery to remove it or repair it later on. Implants can cause issues such as breast hardness, pain and infection. An implant can break, move or change its position too. These problems can occur soon after the surgery in in later times.
Tissue flap: A reconstructive plastic surgeon with special training performs this surgery. He creates a new breast-like shape from the muscle, fat, and skin taken from other parts of the body (usually the belly or back) in tissue flap surgery. This new shape to the breast should last for lifetime. Women who are extremely underweight or obese, who smoke or who have severe health issues cannot undergo tissue flap surgery. Healing after this surgery sometimes takes longer than healing after surgery with the breast implant. You may have other issues, such as infection, low wound healing capacity and pain.
What is recovery like after breast cancer surgery?
Any patient who undergo breast cancer surgery can expect few after effects including:
- To be taken to a recovery room where blood pressure, pulse and breathing of the patient are monitored
- Can experience possible pain, numbness and a pinching sensation in the axillary area
It is important for a patient to follow certain set of measures to avoid any complications after the surgery. Doctor should give instructions to the patient on:
- How to care of themselves at home, including taking care of the incision and drains, identifying the signs of infection, and understanding activity restrictions
- When to resume wearing a bra or wearing a breast prosthesis
- Prescriptions for pain medication and antibiotics
- Instructions on regular diet and daily routine
Patients who have breast reconstruction after mastectomy are advised to spend one night in the hospital. Those undergoing mastectomy without reconstruction or lumpectomy may leave the hospital the day of surgery with the proper instructions and guidance from the doctor for home care.
Radiation Therapy (RT) After Surgery
Many women who undergo a lumpectomy may have radiation treatment to the breast following surgery, and sometimes the underarm area. Likewise, some of the women who are under the treatment of mastectomy can have radiation therapy to chest along with the underarm area. Radiation therapy is given after the chemotherapy if the treatment plan includes chemotherapy.
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