Breast Reconstruction

What Is a Breast Recontruction?
Breast reconstruction is the process through which a patient with breast cancer has restored ‘breasts’ through either implant and/or tissue based techniques. Reconstruction is planned when a breast cancer diagnosis is first received and generally combined with the mastectomy…either one breast or both depending on many factors. Reconstruction is most commonly a staged technique requiring a series of surgeries with the timing influenced by the need for chemotherapy and/or radiation.

How long will surgery be?

The length of surgery depends on the technique selected. If a tissue expander is used, this is placed at time of mastectomy in most patients and takes about an hour at the completion of the first stage of that surgery. The return to the operating room for implant placement once the expander is filled is about a 1 or 2-hour procedure depending on a number of factors. Fat grafting to shape the breast and nipple reconstruction are relatively minor procedures and take approximately an hour as an outpatient surgery. If a flap is performed…either a latissimus dorsi flap or a perforator flap…this surgery takes much longer, sometimes 4 hours or more.

What kind of Anesthesia will I have?

General anesthesia for most procedures. Breast reconstruction is performed at the hospital and patients may spend a night or two; sometime of the later stages of breast reconstruction are performed as outpatient surgery. Nipple reconstruction can safely and effectively be performed under local anesthesia.

What is recovery like?

Recovery depends on the technique used for reconstruction. Expanders are slowly stretched with addition of fluid in the office weekly and this feels tight, a little sore to most patients. Recovery from each subsequent stage in reconstruction gets progressively easier and most of these procedures are performed as outpatient surgery.

What are the risks?

The risks of reconstruction are related to the technique utilized and range from bleeding, infection, failure to heal, breakdown of incisions, flap loss and asymmetry.

How do I prepare for surgery?

A preoperative appointment is scheduled approximately 2 weeks prior to surgery. At this time, all consents and recommendations, instructions for before and after surgery are reviewed. A long list of medications to avoid is reviewed and prescriptions are given for postoperative management.  The day before surgery, all patients are called to review final questions, confirm nothing has occurred since the patient was seen at preop that might require rescheduling of the procedure and to finalize arrival time at the facility. All patients are given ample information at the preoperative appointment regarding a time line of what to expect in the recovery process and when.