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If
you are facing the loss of a breast due to cancer or other
disease, you may now have the option of a breast
reconstruction.
Post Mastectomy Breast
reconstruction is a surgical procedure to recreate the
natural contour of your breast, using either a prosthesis
or your own tissues.
A
consultation with a plastic surgeon is the first step a
woman should take if considering breast reconstruction.
You may choose to have a consultation before your
mastectomy to learn about the various reconstruction
possibilities available to you. The plastic surgeon and
your general surgeon often work closely together on those
aspects of your mastectomy that influence reconstruction.
Great
strides have been made in the field of breast
reconstruction in recent years, resulting in more natural
breast shape and appearance. It is important, though, to
realise that your reconstructed breast will not look or
feel exactly like your natural breast. Many women who have
undergone breast reconstruction experience a faster and
more complete emotional recovery from the loss of their
breast.
The
following information will introduce you to the most
common breast reconstruction procedures used today, and
will summarise some of the differences between them. Also
included is a list of questions and a resource guide
designed to help you to find more information for your
breast reconstruction decision.
The
breast reconstruction process may begin at the time of
your mastectomy (immediate) or weeks to years
afterwards (delayed).
Immediate
reconstruction means that the procedure is done at the
same operation as the mastectomy, i.e. under the one
anaesthetic. It is important to know that any type of
surgical breast reconstruction may take several steps to
complete.
Two
potential advantages to immediate reconstruction are that
your reconstruction process is already underway when you
wake up from the mastectomy, and there may be a cost
savings in combining the mastectomy procedure with the
first stage of the reconstruction. However, there may be a
higher risk of complications with immediate reconstruction
and your initial operative time and recuperative time may
be longer.
A
potential advantage to delayed reconstruction is that you
can delay your reconstruction decision and surgery until
other treatments, such as radiation therapy and
chemotherapy are completed. Delayed reconstruction may be
advisable if your surgeon anticipates healing problems
with your mastectomy, or if you just need more time to
consider your options.
There
are medical, financial and emotional considerations to
choosing immediate versus delayed reconstruction. Talk
with your plastic surgeon about the options available in
your particular case.
Reconstructive
mammaplasty is performed to recreate a breast that has been removed during
mastectomy. The extent of the breast reconstruction procedure depends on what
changes are desired and what you and your surgeon deem appropriate.
The
operation usually is performed in a hospital under general anaesthetic, which
will make you sleep through the entire procedure.
The
type of breast reconstruction procedure available to you depends on your
medical situation, your breast shape and size, your general health and
lifestyle, and your goals. Every woman's situation is unique.
Breast
reconstruction can be accomplished by:
-
the
use of a prosthesis (a breast
implant);
-
the
use of your own tissues (a tissue
flap); or
-
a
combination of a tissue flap and prosthesis.
The
above links contain detailed information about each method, and a comparison
summary is provided below.
If
you are considering breast reconstruction your plastic surgeon can provide you
with information that fully explains the risks and complications associated
with breast implants, tissue flaps, and with surgery itself. It is recommended
that you read all of the information that you can find so that you are well
informed to consider reconstructive surgery and evaluate all of your options.
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Expander
& implant
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Latissimus
dorsi flap
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Pedicle
Tram flap
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Average
Operation Time
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1.5
2 hrs
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3
5 hrs
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4
- 6 hrs
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Average
Hospital Stay
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0
- 2 days
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2
- 3 days
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2
- 5 days
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Blood
transfusion
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unlikely
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unlikely
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maybe
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Average
time to resume daily activity
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2
- 3 weeks
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2
- 3 weeks
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6
- 8 weeks
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Characteristics
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Uses
an implant
No
additional scars
Muscle
strength not impaired
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May
or may not use an implant
Scar
on back
May
have some muscle weakness in shoulder
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No
implant
May
have scar
May
have persistent muscle weakness in abdomen
May
result in flatter abdomen (tummy tuck)
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NOTE:
The cost of breast reconstruction includes surgeons fees and hospital
charges. The cost to you will vary depending on your medical circumstances and
your insurance coverage.
In
general, implant reconstruction is initially less expensive and less extensive
than flap surgery, and immediate reconstruction is less expensive than delayed
reconstruction. Consult your surgeon and your insurance company for more
information.
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