Breast cancer diagnosis or genetic predisposition to breast cancer is an extremely traumatic physical and mental health experience. Breast amputation (mastectomy) is often associated with severe psychological trauma. Breast reconstruction surgery helps women to go through stress associated with mastectomy and gives a chance for normal life.
Who is a candidate?
If you have already undergone mastectomy or will have the breast amputation in the future, you may be a candidate for breast reconstruction surgery. In this case, age is not a limiting factor. If your overall health condition allows the surgery, it is very possible that it will be possible to reconstruct your breast using one of the techniques described below.
Before the surgery
The plastic surgeon will discuss your expectations regarding the breast appearance after the surgery. Your medical history will be thoroughly analyzed and the physical examination will be performed. After the consultation, you will decide on the most suitable method of breast reconstruction in your case.
You will also receive detailed information that will help you to properly prepare for the procedure. It includes:
- quitting smoking,
- list of contraindicated drugs,
- proper wound care technique,
- eating and drinking restrictions day before the surgery.
The course of the surgery
Flap reconstruction is a type of breast reconstruction with the use of your own tissue. This type of surgery usually provides more natural breast appearance when compared to the implant reconstruction. The effects are usually more sustained, which allows to avoid further surgeries.
The types of flap reconstruction include:
- DIEP flap (deep inferior epigastric perforator flap) is a free flap, which means that the surgeon will transfer a flap of skin, fat, vessels and muscle from the lower abdomen to the chest. The flap blood vessels are anastomosed to the vessels in the chest using microsurgical techniques.
- LD flap (latissimus dorsi flap) is a method in which a flap of skin, fat and muscle is transferred from the posterior axillary area or back to the breast region. Due to the small amount of fat tissue in this region, this method is usually combined with the implant placement in order to increase the volume of the breast.
Prosthesis
After the mastectomy, the breast expander is placed under the skin and pectoralis major muscle. Over the next few weeks, the surgeon will fill the expander with saline solution to expand its volume and stretch the tissue above the expander. Once the desired breast volume is reached, the second stage of the surgery is performed – the expander is removed and the breast implant is inserted. It is also possible that the reconstruction surgery will be performed as a one-step procedure and the breast implant will be inserted during the first operation.
Type of the anesthesia
The surgery is performed under general anesthesia.
After the surgery
Patients after implant breast reconstruction will usually stay at the hospital for one night. Patients after flap reconstruction usually need more time for recovery and the hospitalization lasts about 7 days.
Majority of patients after implant breast reconstruction are able to return to their daily activities such as walking, shopping, car driving approximately one week after the surgery. The return to work is usually possible 2 weeks after the surgical procedure.
Patients after flap reconstruction will need more time for recovery. They usually return to daily activities 2 weeks after the surgery and to their work approximately 1 month after the surgical procedure.
Intense physical activity is contraindicated in both cases. Driving a car is possible when patient will no longer need painkillers.
Possible complications
Besides possible complications associated with general anesthesia, the risk of postoperative complications varies depending on the reconstruction method. All breast reconstruction surgeries are considered to be a “major” surgeries connected with possibility of postoperative complications. Not every patient is a candidate for breast reconstruction and every individual may experience different type of complications after the surgery. Your plastic surgeon will explain possible risks, complications and expected results of the surgery during the preoperative consultation.
Expected results
The main aim of breast reconstruction surgery it to restore the breast symmetry. Most of women will experience psychological comfort, when they will be able to see again their both breasts.
