Breast reconstruction after removal of the breast due to a tumor or other disease is one of the most successful surgeries in plastic surgery. Thanks to new technologies in medicine, surgeons can now create a breast that is very similar to a natural breast.
Today, these surgeries can be performed simultaneously with breast removal surgery (mastectomy). In this way, the patient has a new breast when she comes out of surgery and is relieved of the psychological distress that a period without breasts can cause.
However, it should be kept in mind that breast reconstruction after mastectomy is not a simple surgery. There are many options to be decided by you and your doctor. Below you will find some basic information about the operation: when it is performed, how it is done, and what kind of results can be expected. However, it is not possible to answer all questions. You will therefore be better informed if you talk to your surgeon in person.
Who is the Best Candidate for Breast Reconstruction?
Almost all mastectomy patients are medically cleared for breast reconstruction and most patients are suitable for reconstruction concurrently with mastectomy. However, the best candidates for breast reconstruction are patients in whom the cancer has completely disappeared after mastectomy. There may be many reasons to wait; for example, some patients do not want another surgery, some find it difficult to accept the diagnosis of cancer and are unable to consider the options of breast reconstruction. Some patients may have been advised by their surgeon to wait, especially in cases where the breast is reconstructed with the patient’s own tissue (flap transfer). Patients with obesity, high blood pressure and smoking may also be advised to wait.
All Surgery Involves Some Uncertainty and Risk
Breast reconstruction can be performed in almost every woman who has lost her breast due to cancer. However, as after any kind of surgery, some problems may occur after this surgery.
Bleeding, fluid collection or anesthesia problems, which are general problems of surgery, can also be seen after this surgery, but they are rare. In smokers, wound healing may be delayed or impaired or more scars may appear. Sometimes these problems may require a secondary surgery. If a prosthesis is used, there is rarely a risk of developing an infection within two weeks. In some such cases, it may be necessary to remove the prosthesis and reinsert it months later.
The most common problem, capsular contracture, occurs when the scar tissue around the implant compresses the implant. This results in the breast feeling hard. There are several treatments for capsular contracture; sometimes it may require removal and relief of the scar tissue or replacement of the prosthesis.
Reconstruction has no effect on cancer recurrence and does not interfere with radiotherapy/chemotherapy. Your surgeon may recommend that you continue to have periodic mammograms of your normal breast and your reconstructed breast.
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Getting Back to Normal and Your New Look
After mastectomy and reconstruction or flap reconstruction only, it can take up to 6 weeks to get back to normal. With prosthesis surgery, this may be shorter. Reconstruction does not restore normal sensation; however, some sensation may return over time. Most of the scars may fade over time. However, this may take 1-5 years and the scars never completely disappear. As long as the quality of the reconstruction is high, you will care less about these scars.
Listen to your surgeon’s advice on when to start exercising and moving. As a general rule, it may be good to avoid sexual intercourse and heavy exercise for 3-6 weeks.
Your new breast may look firmer, rounder and flatter than your other normal breast. It may not have the same contour as before mastectomy or may not be exactly symmetrical to your other breast. These differences may seem obvious to you. For many mastectomy patients, reconstruction dramatically improves appearance and quality of life.