Having breast cancer is a traumatic experience made only more so by the loss of one or both breasts through mastectomy. Once this has happened a woman can feel extremely self-conscious and her self-esteem can take a nosedive. Breast reconstruction is used to restore the breasts.
Breast reconstruction can be performed immediately after the mastectomy or it may be delayed to allow for tissue expansion. Most reconstruction surgeries involve implants to replace some of the lost tissue, but there are also cases where Dr. Ferraro performs a breast reduction. Your needs are unique and treated as such.
What Will Reconstruction Do For Me?
When you’re already dealing with your cancer, the thought of an involved surgical reconstruction is the last thing you want to add to the situation. But there needs to be coordination between your breast surgeon and Dr. Ferraro before your mastectomy and during reconstruction. Plus, your recovery can be somewhat intensive.
Still, despite these obstacles, breast reconstruction usually plays a key role in a woman regaining her self-image and self-confidence following mastectomy.
Is Breast Reconstruction Needed Or Neccessary?
Breast reconstruction is not required for any physical health reasons. But many patients feel it is needed to make them feel whole again. They want to feel better about how they look, and they want the boost in self-confidence after all they’ve gone through. Here are some reasons a woman opts to have reconstruction surgery with Dr. Ferraro:
- To make her chest look balanced when wearing a bra or swimsuit
- To help make clothes fit better
- To permanently regain her breast shape
- So she won’t have to use a breast form to replicate her breast
- To feel better about her body and body image
What Is The Right Time To Get Breast Reconstruction Surgery?
As mentioned above, discussions about your desire to have reconstruction need to commence as soon as it looks likely you will need to have a mastectomy. Most mastectomy patients choose to have reconstruction done immediately after the breast is removed. This is both an emotional and practical decision. Most patients aren’t interested in seeing themselves without one or both breasts, so they opt to immediately start reconstruction.
From a practical standpoint, the patient will already need to recover from the mastectomy surgery, so why not have the reconstruction surgery at the same time? That way you have just a single recovery, instead of a second later recovery if you opted to postpone reconstruction. But other patients need more time to deal with their mastectomy and they want to wait for reconstruction, or possibly not go ahead with it.
Is Breast Reconstruction Safe?
These are major surgeries with Dr. Ferraro, but as a board-certified plastic surgeon his training, expertise, and experience make these safe procedures. Dr. Ferraro has extensive experience with various reconstruction methods. All of this works together to ensure your ultimate safety.
What Are The Possible Risks With Breast Reconstruction?
Breast reconstruction is certainly major surgery. Because of that, it involves all of the risks that accompany major surgery: poor wound healing, infection, excessive bleeding, reaction to anesthesia, fluid accumulation, and the formation of blood clots. But there are a variety of problems that can occur later in the recovery process:
- Tissue death in flap procedures
- Problems at the donor site where tissue was taken, such as loss of muscle strength
- Asymmetry between your breasts
- Changes in the arm on the side of the reconstructed breast
- Problems with the breast implant, such as leakage, rupture, or capsular contracture
- Asmmetry between your breasts
What If I Need Chemotherapy?
There is some disagreement whether it is necessary to wait until any chemotherapy or radiation therapy is completed before having breast reconstruction. There is research that suggests a reconstructed breast may interfere with radiation therapy reaching the
area affected by cancer, although this can vary with the patient. Radiation therapy, in particular, is known to cause undesirable changes to an implant reconstruction.
Radiation, and sometimes chemotherapy, can cause a reconstructed breast to lose volume and change color, texture, and appearance. None of these problems is as typical with chemotherapy as they are with radiation. Of course, it may simply be a good idea to wait until you are finished with radiation and chemotherapy before having reconstruction. This could place the surgery at 6 to 12 months after mastectomy or lumpectomy. There is no timeframe — reconstruction can be done years later if at that point you decide you want it. During your consultations with Dr. Ferraro, the two of you will discuss your options with the timing of your reconstruction.
There are essentially two methods used in breast reconstruction depending on whether there is enough tissue on the chest wall to hold/cover an implant.
The goal in tissue expansion is to stretch the skin to avoid having to transplant tissue from another area of the body to the chest. Dr. Ferraro first inserts a balloon expander beneath the skin and chest muscle where the reconstructed breast will be formed. Over the course of a few weeks or months, saline solution is injected through a tiny valve beneath the skin into the expander. As it fills with the saline solution, the expander stretches the skin, creating a pocket for the implant. Once the expander has achieved the desired size it can be left in place, serving as the implant, or it can be replaced with another saline or siliconeimplant. The final step is reconstruction of the areola and nipple.
If there isn’t enough tissue left post-mastectomy to create a new breast through tissue expansion, or if the woman doesn’t want implants, autologous-tissue reconstruction is used. In essence, a breast is created using skin, fat, and muscle taken from elsewhere on the body. The abdomen, back, buttocks, and thighs are typical donor locations. The donor tissue is called a “flap.” It is either surgically removed and reattached (this is a free flap) on the chest, or itis left connected with its blood supply and that blood supply is re-routed to the new location on the chest (pedicle flap). During a free flap procedure, the blood supply needs to be reattached to the muscle and skin for it to survive. Various flap techniques can be employed depending on where the best donor tissue is located, the ability to relocate blood vessels, the desired size of the reconstructed breasts, and otherfactors. The final step is to recreate the areola and nipple through grafting.
What Will My Scarring Be Like?
There will be scarring with either type of reconstruction. With flap procedures there will be scarring at the donor site and on the reconstructed breast. Dr. Ferraro works hard to limit the scarring with the placement of the incisions and such. These scars will begin as angry red in color, but they will fade substantially over time. Dr. Ferraro takes great pride in the quality of his breast reconstruction surgeries, and we think they will help you feel as if you’ve turned a corner in your cancer recovery and can get back to a more normal life once again. You will have scarring, but patients feel their results are worth it.
Recovery And Results
Your recovery period and difficulty can vary widely due to the variety of methods that can be employed. Hospital stays can run from one to six nights. Patients aregenerally tired and sore for up to two weeks, with full recovery taking up to six weeks.
If you’ve had a single breast removed and reconstructed, it may seem obvious, but your reconstructed breast will not look the same as your original breast. Dr. Ferraro will do everything possible to match the size, shape, symmetry, and other attributes of your remaining breast. To make both breasts similar, he may need to operate on the remaining breast, changing its size or providing a breast lift.
As you would expect, your reconstructed breast will have little or no sensation.
How Long Is Recovery After Breast Reconstruction?
Recovery from breast reconstruction surgery is not quick, but after all you’ve been through already, it may seem like a positive next step on the road to some sort of normalcy moving forward.
Your recovery period and the difficulty involved can vary widely due to the variety of methods used and your unique situation. You’ll be in the hospital for up to six nights. You’ll be tired and sore for probably about two full weeks. Overall, your recovery will take up to six weeks.