Reconstruction after Mastectomy

For many women the diagnosis of breast cancer can be too overwhelming and preclude them from examining their options for breast reconstruction until after they have undergone a mastectomy or breast conservation surgery. You may feel, however, that knowing about your options and having reconstruction at the same time as your mastectomy is preferable. This can avoid the need for multiple surgeries, but also has its drawbacks, such as a slightly increased risk of tissue necrosis.

Rebalancing Your Appearance

Breast reconstruction can rebuild your breast to rebalance the appearance and match your remaining breast. If you have undergone a double mastectomy then both breasts may be reconstructed. Most women who have a mastectomy have reconstructive surgery, either immediately or after they have healed from the mastectomy. Nipple reconstruction is also an option for you to consider, although this is usually conducted in a separate, later, procedure as an outpatient.

Immediate Reconstruction

You may feel, like many women, that mastectomy is more than the loss of your breasts and that you have also lost a little of your femininity. In this case you might consider breast reconstruction in order to restore your previous appearance and rebalance your figure. Breast reconstruction that occurs as part of the mastectomy procedure can mean that you wake up from surgery with reconstructed breasts and never see the loss of the breast at all. There are usually some differences between the original breast and your reconstructed breast in that they may be a little fuller and firmer than they were before surgery. If breast implants are used, there may be some capsular contracture leading to your breast feeling a little hard or becoming painful, with further surgery required; this complication is rare.

Available Breast Reconstruction Techniques

A number of techniques are available to your surgeon to offer you the best possible outcome in terms of your breast reconstruction. One technique is the skin expansion procedure where the skin of the breast is stretched in order to insert a breast implant. There are also grafting techniques such as the latissimus dorsi musculocutaneous flap graft procedure which may be preferable for women wanting a larger breast reconstruction.

Prophylactic Mastectomy and Breast Reconstruction

As breast reconstruction is not considered a cosmetic procedure it may be available as a part of your cancer treatment. You should discuss this with your doctor and surgeon in order to make a choice that feels right for your circumstances. If there is a history of breast cancer in your family then you may, like a number of other women each year, decide to undergo a prophylactic mastectomy and breast reconstruction in order to reduce the risk of breast cancer significantly.

Contraindications for Breast Reconstruction Surgery

Certain conditions may reduce your options for breast reconstruction such as obesity, high blood pressure, and if you are extremely thin. Surgeons will often recommend that you quit smoking for at least two months prior to surgery and surgery might be postponed in this case as your recovery will be greatly affected if you continue to smoke. Breast reconstruction is almost always performed under general anaesthesia and is a major operation which may require more than one procedure.

After the Procedure

If you undergo mastectomy and reconstruction then you need to be aware that you will feel a considerable amount of pain after surgery as this surgery is quite extensive. Fatigue and soreness is usual for a week or two after surgery and you may feel the need to manage this pain with medication. Discussing appropriate medication with your physician prior to surgery can make it easier for you to be prepared as you recover. Most women take up to six weeks to recover from a combined mastectomy and reconstruction and it is advisable for you to ensure support during this time, particularly in the first few days after you return home as you may feel too sore to manage normal daily activities.

You should talk to your surgeon about when and how to begin exercises, stretches, and normal activities in order to ensure that your recovery is not compromised. Although scars will usually fade over time you may wish to talk to your surgeon about possible ointments that can be used, after your incisions have healed, to help reduce their appearance. It is important not to use any lotions of creams on the incisions while they heal as this can cause problems such as infection.

Understanding Your Options

You may also decide that, rather than reconstruction, you are content with your post-mastectomy appearance and forego further surgery. Some women choose to wear a prosthesis inside their bra, and this can be a good option if you are also waiting for reconstructive surgery after your mastectomy. By looking at your options for reconstruction you can choose the path that feels most comfortable for you in order to maintain, or restore your vitality after breast cancer surgery.