Breast reconstruction has made huge strides. Breast which have been reconstructed won’t look exactly like the breast which was lost. It’s important for breast reconstruction candidates to be able to understand this and have realistic expectations for the procedure and outcome. Ideal candidates should be in good health and not suffering from any condition which would hinder proper healing and recovery. Breast reconstruction can be performed at the same time as a mastectomy or be delayed months or even years after cancer treatments have been completed.
During your consultation Dr. Setty will ask questions pertaining to your health, your lifestyle, as well as your goals and concerns for the procedure. At the consultation you will be informed of all applicable surgical options. This is also the appropriate time for you to address any concerns or questions you have, and to discuss what the best plan for achieving your aesthetic goals is.
Pre-surgery protocol may include getting tested or evaluated, taking or adjusting medications, stop taking aspirin or other anti-inflammatory drugs. If you are a smoker, it’s important to stop smoking well in advance of the procedure. Dr. Setty and his staff will advise you what to do prior to the day of the procedure. Let’s take a look at some of the basic issues related to breast reconstruction:
- Breast reconstruction may take place at the time of mastectomy or in a delayed fashion. Plans of the surgical oncologist may impact timing. Dr. Setty and the mastectomy surgeon need to coordinate a plan, considering patient desires.
- There are different techniques used for breast reconstruction including implant or tissue reconstructions, utilizing the abdominal or back tissue most commonly. In a TRAM flap, donated muscle, fat and skin from the abdomen is used to reconstruct the breast. In a Latissimus Dorsi Flap, the muscle, fat and skin is donated from the back and tunneled to the reconstruction site. An implant may be necessary to achieve the volume necessary. These “flap” techniques require at least another surgical stage for fine tuning and nipple reconstruction. Patients usually stay in the hospital one to two nights after these reconstructive procedures.
- Implant reconstruction is another option and does not impact other body regions for the reconstructive surgery. While implant reconstruction with tissue expansion may present a shorter surgical procedure and easier recovery, the process continues into the postoperative period with expansion. An expander will be placed to expand the skin, and it will be adjusted over four to six months to achieve the volume necessary. In a later stage, a permanent implant will be placed, and nipple reconstruction will be performed.
- Breast implants are used as an addition or alternative to the flap techniques, and both saline and silicone implants may be used.
- Breast reconstruction decision-making is difficult. There is a new cancer diagnosis already clouding the patient’s mind. It is important to thoroughly discuss timing and reconstructive options to assure that your decision is best for you.