Oncoplastic Breast Surgery (Breast Reconstruction)
Typically, breast reconstruction takes place during or soon after mastectomy, and in some cases, lumpectomy. Breast reconstruction also can be done many months or even years after mastectomy or lumpectomy. During reconstruction, your surgeon creates a breast shape using an artificial implant (implant reconstruction), a flap of tissue from another place on your body (autologous reconstruction), or both.
Whatever your age, relationship status, sexual activity, or orientation, you can’t predict how you will react to losing a breast. It’s normal to feel anxious, uncertain, sad, and grief about giving up a part of your body that was one of the hallmarks of becoming a woman: a significant part of your sexuality, what made you look good in clothes, how you might have fed your babies. No one can ever take that away from you.
Moving forward, you now have the opportunity to determine what you want to have happen next. But first you must do some careful thinking and delving into your feelings in order to figure out what is best for you.
The following are some of the questions, that patients find helpful in examining how they feel about a breast reconstruction…
- How important is rebuilding your breast to you?<\li>
- Can you live with a breast form that you take off and put on?<\li>
- Will breast reconstruction help you to feel whole again?<\li>
- Are you OK with having more surgery for breast reconstruction after mastectomy or lumpectomy?<\li>
Types of Breast Reconstruction
There are many different reconstruction techniques available. Naturally we will discuss the options that may be right for you, but it’s in your best interest to do your own research, too. If you know someone else who had reconstruction, you might find it helpful to talk to her about her decision process, her doctors, and her satisfaction with the results.
There are two main techniques for reconstructing your breast:
Implant reconstruction: Inserting an implant that’s filled with salt water (saline), silicone gel, or a combination of the two.
Autologous or “flap” reconstruction: Using tissue transplanted from another part of your body (such as your belly, thigh, or back). Autologous reconstruction also may include an implant.
You also can choose whether or not to reconstruct your nipple. (In some cases, nipple-sparing mastectomy is possible, which means that your own nipple and the surrounding breast skin are preserved.)
Both approaches have advantages and disadvantages. Typically Implant reconstruction is easier up front: an easier surgery, easier to recover from, easier to understand. Autologous Reconstructions are generally more difficult to perform and have a longer recovery period. Over the longer term however, implants are more prone to problems and often require additional procedures to correct these problems. Flaps perform better over time; a flap done well should not need more attention over the course of a lifetime.
There are risks and complications with this procedure.
They include but are not limited to the following.
- Infection can occur, requiring antibiotics and further treatment.
- Bleeding could occur and may require a return to the operating room. Bleeding is more common if you have been taking blood-thinning drugs such as Warfarin, Asprin, Clopidogrel (Plavix or Iscover) or Dipyridamole (Persantin or Asasantin).
- Small areas of the lung can collapse, increasing the risk of chest infection. This may need antibiotics and physiotherapy.
- Increased risk in obese people of wound infection, chest infection, heart and lung complications, and thrombosis.
- Heart attack or stroke could occur due to the strain on the heart.
- Blood clot in the leg (DVT) causing pain and swelling. In rare cases, part of the clot may break off and go to the lungs.
- Death as a result of this procedure is possible.