David J. Gray, M.D. Plastic Sugery
Laser and Skin Care Center
Breast Reconstruction
Procedure: Reconstruction of a breast that has been removed due to cancer, other disease, or injury 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 close in form and appearance to matching a natural breast.
Breast Reconstruction after mastectomy is usually covered by medical insurance.
Options: There are several options for methods of breast reconstructions. The one that is right for you depends upon several factors and must be discussed with your doctors.
IMPLANT/TISSUE EXPANSION: The most common technique combines skin expansion and subsequent insertion of an implant. Following mastectomy, your surgeon will insert a balloon expander beneath your skin and chest muscle. The expander is gradually filled over several weeks or months. After the skin over the breast area has stretched enough, the expander may be removed in a second operation and a more permanent implant will be inserted. The nipple and the dark skin surrounding it, called the areola, are reconstructed in a later procedure.
FLAP RECONSTRUCTION: An alternative approach to implant reconstruction involves creation of a skin flap using tissue taken from other parts of the body, such as the back, abdomen, or buttocks.
Follow-up procedures. Breast reconstruction usually requires a series of procedures that occur over time. Usually, the initial reconstructive operation is the most complex. Follow-up surgery may be required to replace a tissue expander with an implant or to reconstruct the nipple and the areola.
Anesthethsia/Hospitalization: General Anesthesia/The initial procedure typically requires an inpatient hospital stay. Subsequent procedures are usually performed as an outpatient.
Recovery/Side Effects: You are likely to feel tired and sore for a week or two after reconstruction. Most of your discomfort can be controlled by medication prescribed by your doctor. 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. If implants are used without flaps and reconstruction is done apart from the mastectomy, your recovery time may be less. Reconstruction cannot restore normal sensation to your breast, but in time, some feeling may return. Most scars will fade substantially over time, though it may take as long as one to two years, but they'll never disappear entirely. The better the quality of your overall reconstruction, the less distracting you'll find those scars.
Activity: Follow your surgeon's advice on when to begin stretching exercises and normal activities. As a general rule, you'll want to refrain from any overhead lifting, strenuous sports, and sexual activity for three to six weeks following reconstruction.