Breast Reconstruction

Purpose - Reconstruction is meant to recreate an absent, underdeveloped or deformed breast resulting from surgery for breast cancer, trauma or congenital deformity. It can be performed at the same time as removal of the breast (immediate reconstruction) or years later (delayed reconstruction). Fortunately, when a patient has immediate reconstruction, she is spared the emotional and psychological distress of seeing herself with significant asymmetry and no breast at all. It is rare that a woman is not a candidate for immediate breast reconstruction after mastectomy. If immediate reconstruction is not performed and post-mastectomy radiation therapy is needed, a woman's surgical reconstructive options may be limited.
Expected Outcomes - New medical techniques and devices have made it possible to recreate a breast that closely resembles the shape and appearance of the opposite natural breast. The surgical options will depend on a number of factors which include: the size and shape of the opposite breast, the desire to use your own tissue (autogenous) versus tissue expansion with an implant, your body habitus, the availability of your own tissue, and any preexisting medical conditions. The various procedures can be equally beautiful.
How Procedure is Performed - Implant reconstruction is often staged in order to stretch the muscle and skin on the chest. Immediate reconstruction involves placement of a temporary expandable implant at the time of mastectomy and an overnite stay in the operating facility. The second procedure involves placement of a permanent implant and occurs 2-4 months later on an outpatient basis. One stage reconstruction is recommended in select individuals.
Alternatives - Some patients choose to use custom bras with prostheses, or to do nothing.
Recovery - The recovery process will be less demanding with implant reconstruction than with using body tissues. Immediate breast reconstruction with implants involves the use of drains which may remain 1-2 weeks. Limiting upper arm motion and lifting is recommended for 2-4 weeks. Woman usually return to work in 2-3 weeks. The recovery process for the second stage procedure is much quicker. Woman usually return to work in 2-3 days.
Risks - See similar procedures. Preservation of the skin on the breast is one of the most important components to successful post-mastectomy reconstruction. Smoking is strongly discouraged for 1-2 months prior to immediate reconstruction after mastectomy.