Breast Reconstruction

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What is Breast Reconstruction?

Breast reconstruction is meant to recreate an absent, underdeveloped or deformed breast resulting from surgery for breast cancer, trauma or congenital deformity.

Ideal candidates for Breast Reconstruction

For women with breast cancer, reconstruction 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 deformity 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.   Sometimes breasts are removed to prevent cancer as in the case of a woman testing positive for the BRCA gene, or if she has a strong family history of cancer.   In this case, both breasts are usually removed.

What to expect during Breast Reconstruction surgery

1st Stage: Implant reconstruction is often staged in order to stretch the muscle and skin on the chest. A temporary expandable implant is placed beneath the skin and muscle on the chest at the time of (immediate) or years after (delayed) mastectomy. An overnight stay in the operating facility is recommended and covered by insurance. Expansion is performed by Dr. Gurley in her office every 2-4 weeks. Recovery: Most women refrain from driving 1-2 weeks after surgery and return to work in 2-3 weeks after surgery. Flexibility is quickly restored but full use of upper extremities is postponed for 6 weeks.

2nd Stage: This procedure involves placement of a permanent implant and occurs 3-4 months after the 1st surgery on an outpatient basis. Recovery: Most women usually drive and return to work in 2-3 days after surgery. Exercising and vigorous activities are delayed for 6 weeks.

3rd Stage: The third and final surgery allows Dr. Gurley to create a three dimensional nipple and areola. This is performed on an outpatient basis.  Recovery: Bandages are removed in one week but patients may return to work in 2-3 days, with no range of motion or weight restrictions.

Breast Reconstruction Before & After

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Please Visit Our Before and After Gallery

What results should I expect?

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 pre-existing medical conditions. The various procedures can be equally beautiful.  Many women choose to remove and reconstruct both breasts for symmetry or for “peace of mind.”

Alternatives to Breast Reconstruction surgery

Some patients choose to use custom bras with prostheses, or to do nothing, or consider using other body parts to create a breast (autologous reconstruction).  At times, a lumpectomy with radiation may be chosen to remove cancer. In this situation, other procedures such as a breast reduction, lift, or placement of implants can help to re-shape the breast or improve symmetry.

Are there any risks involved?

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.   Some skin loss may occur after mastectomy, with or without reconstruction.  This usually requires an additional minor procedure with little if any setback.  Other, more serious risks include blood clots which can be potentially fatal.  Blood thinners are used for several days after surgery to help prevent blood clots.

Dr. Gurley’s Role in Donna’s Breast Cancer JourneyLiving like a lady

It is hard to imagine cancer providing any ‘gifts’ to a patient however, in my case it did, says author Donna Heckler.  Dr. Gurley started out as my plastic surgeon as I battled stage three cancer.  She ended up being a collaborator in the development of my book and, importantly, a friend.  Her kind and gracious spirit encouraged me as I struggled with cancer.” – Donna A. Heckler

Schedule a consultation

For more information on Breast Reconstruction, or to schedule a consultation, call Dr. Judith Gurley in Chesterfield, MO today at (636) 812-4300!