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 Reduction Safe?
Breast reduction surgery is considered safe and effective for qualified patients. As a surgical procedure, there are inherent risks associated with anesthesia, infection, bleeding, and wound healing. Dr. Ferraro has performed many breast procedures and utilizes surgical techniques that minimize risks as much as possible. Most patients who undergo breast reduction surgery recover without serious complications. If you are feeling anxious about the risks associated with this procedure, talk to Dr. Ferraro about your concerns. Part of ensuring your best experience is listening to your concerns and discussing how the risk of complications is managed, as well as how complications are addressed if they were to occur.
How Do I Prepare for Breast Reduction?
Obtaining the best results from breast reduction involves active collaboration between you and your surgeon. On the doctor's end, there is the matter of determining the best surgical technique and procedure. The doctor also provides the full amount of information you need to prepare for and recover from your procedure without unnecessary stress. On your end, the work is to prepare your body for surgery and surgical recovery. There are a few ways to do this.
Exercise is an excellent step in preparing for surgery, especially breast reduction. If you are not at your ideal weight before surgery and your breasts are made up primarily of fatty tissue, there is a chance that you will lose even more breast volume after surgery should you lose weight. That said, there is no denying that having massively enlarged breasts can seriously interfere with regular exercise due to comfort and mobility issues. If you find it nearly impossible to exercise, having breast reduction may be a necessary first step in restoring a more physically-active lifestyle. In that case, you might prepare for breast reduction by doing whatever exercises you can to strengthen your core muscles and also open up your chest. Yoga is a great option for this because it involves both strength and stretching motions.
In addition to exercise, good nutrition also has a significant effect on surgical recovery. Before surgery, make it a point to consume mostly fresh, whole foods that provide you with an abundance of nutrients. Lean proteins, leafy vegetables, and fresh fruits help to reduce inflammation and promote optimal tissue repair. In the area of tissue repair, we must also look at tobacco use. It is imperative that you do not smoke before having surgery, as the effects of cigarette smoking impair tissue healing. The necessity to quit for surgery often provides the perfect catalyst for people to quit for good.
Depending on your pre-surgical medical history review and examination, Dr. Ferraro may advise you to see your primary care physician to obtain medical clearance or to undergo certain tests such as an EKG or lab work. You also need to have a mammogram before undergoing breast surgery. These visits and tests should be scheduled well in advance of surgery to allow enough time for the doctor to review the results.
As is outlined in pre-surgical instructions, you will need to cease the use of all medications and supplements that thin the blood. This must begin two weeks prior to surgery. Examples of blood-thinning drugs include all NSAIDs, non-steroidal anti-inflammatory drugs like ibuprofen (Motrin, Advil, Aleve). Aspirin also thins the blood, as do supplements like vitamin E and omega 3 fatty acids.
How Many Cup Sizes Can My Breasts be Reduced?
Several factors must be considered when determining the degree of reduction that is safe and satisfying. We want you to feel comfortable in your own skin, and we understand that many women who seek breast reduction are so fed up with the consequences of large breasts that they are willing to swing to the other extreme. That said, Dr. Ferraro will compare your concerns and desired outcome with your body frame to thoughtfully discuss the breast size that will look most natural for your overall shape. Generally, this can be achieved by reducing about two cup sizes worth of volume. Another factor that must be carefully considered is how much breast tissue can be removed without comprising blood supply to the nipple. The nipples receive the vast majority of their blood supply from the breast tissue, so, removing an excessive amount of that tissue could result in nipple loss.
How Much Weight Will I Lose After My Breast Reduction?
It is normal to expect some amount of weight loss after breast reduction. This is especially so when the breasts are quite large and uncomfortable. That said, we expect the reduction of breast tissue usually removes between two and eight pounds of fatty and glandular tissue. Where this makes an enormous difference in appearance and physical comfort in the neck, shoulders, and back, it may not do much for the scale. Breast reduction is not a weight loss surgery. However, many women who have this procedure go on to lose 10, 20, or more pounds due to the increase in comfort that allows them to exercise as they would like.
Will My Breast Reduction Procedure be Painful?
Your breast reduction procedure is performed while you are anesthetized with general anesthesia. You will not feel anything during the procedure because the pain receptors are shut down for a short time. The pain-relieving effects of the anesthesia tend to linger for a few hours, keeping you relatively comfortable. Once you return home from the surgery center, you will manage post-operative soreness with prescription pain medication. You will also wear a compression bra that gently holds the surgical area during the initial recovery period. In general, the recovery from breast reduction surgery is expected to involve mild to moderate soreness for about three days, after which you may be ready to switch to an over-the-counter pain reliever.
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.