How Breast Reconstruction Works After a Mastectomy

Any woman who has undergone a mastectomy may consider going for breast reconstruction. Mastectomy involves having the breast removed, usually due to cancer. Reconstruction helps in building the shape of the lost breast.
It is a great way of giving the woman her dignity back as losing a breast can affect their self-esteem and confidence. So as long as you are doing it for yourself, that’s all that matters. Breast reconstruction also gives the two breasts asymmetrical look by replacing breast tissue, skin, and the removed nipple.

In most cases, the extent of breast augmentation depends on the mastectomy, location, size, and width of the removed tumor. The surgery can be done immediately, which usually happens when the mastectomy is going on or later where the wound is left to heal, and the woman has completed her cancer therapy. This can happen anywhere from months to years later. It is common for a woman to have reconstruction surgery done on her other breast to ensure both of them match in shape and size.

Breast reconstruction is not considered a cosmetic procedure since it is part of treating an ailment, and insurance providers are mandated to pay for it. Before a woman can go for the reconstruction, she has to discuss with the surgeon about the different options that include implants or the use of autologous tissue.

Implants Breasts Reconstruction

Implants are commonly used to reconstruct breasts after a mastectomy. You can choose to have saline or silicone implants. It is possible to have an immediate implant reconstruction done in various ways, depending on:

• The surgeon’s advice and experience
• Your tissue condition
• The type of cancer you have

This procedure is normally carried out in two phases. The first one involves the surgeon inserting a tissue expander under the skin or chest muscle and leaving it there to be filled with saline every time the woman goes for a visit. This is after the surgery.

The second phase takes place after the chest tissue relaxes and heals completely. This is when the expander gets removed, and an implant is inserted in its place. The procedure is performed 2 to 6 months after losing the breast. If the reconstruction surgery takes place immediately/when undergoing a mastectomy, there is no need for a tissue expander.

During a mastectomy, a plastic surgeon can lift the pectoralis muscle up and put an implant behind the tissue layer. However, others might decide to put the implant immediately behind the skin, and if need be, an artificial skin layer can be used to fill the empty pocket for more support and protection. These implants come with upsides and cons.

Pros:

• The procedure is easier and is done within a shorter time than any other
• Implants’ recovery period is usually shorter
• You only get surgical scars on your breasts

Cons:

• You will need to replace the implant after some time
• Silicone implants require undergoing MRI monitoring after a number of years to detect ruptures
• You might get infections and scars with implants
• It might be harder to get future mammograms once you have implants
• An implant might affect your ability to breastfeed

Autologous Tissue Reconstruction

For this procedure, a piece of tissue that has skin, fat, and blood vessels is taken from another part of a woman’s body and used to reconstruct the breast. The piece is known as a flap. Usually, the surgeon can take this flap from different areas of the body but normally from the back or abdomen. However, they can also decide to get the flap from a woman’s buttocks or thighs. Depending on where the flap came from, it can either be free or pedicled.

A pedicled flap has both the tissues and blood vessels moved in unison through the body to the chest area. Since the tissue has its blood supply intact, there is no need for the blood vessels to get reconstructed after moving it.

Free flaps come with the tissue unattached to the blood supply and, therefore, the surgeon has to attach new vessels in the breast region through microsurgery. The procedure allows the reconstructed breast to have a blood supply.

Pros:

• Tissue flaps normally feel and look more natural than implants
• There is no need of replacing tissue unlike when you get implants
• These flaps act like the rest of the body and in case you add weight, they also do, and vice versa

Cons:

• The procedure takes longer than when inserting implants, and the recovery time is also longer
• You will be left with many surgical area scars from the multiple body areas to be operated on
• The surgery is complicated, and the tissues can fail to take shape
• It is possible for the patient to feel weak in their muscles or damage the tissue of the donor area

Follow-Up Care and Rehabilitation after Breast Reconstruction

It is common to experience some discomfort some days after the procedure, but your surgeon will provide you with pain medication.

A reconstruction increases the risk of side effects that might be experienced by the woman, which is unlike when she only had a mastectomy. Any sign of complications will be closely observed, which might even take years after the procedure.

After the reconstruction, a woman might benefit from physical therapy. This will help her improve shoulder motion and make it possible to recover from any weakness present. Such therapy includes exercises that are supposed to help the woman gain back her strength and get used to any new physical limitation. She also has to figure out the safest ways of going about her daily activities.

Breast reconstruction does not increase the risk of cancer recurring or make the mammography checks difficult. Even after losing one breast, the woman can still go for mammograms on the surviving one. Also, if the breast was reconstructed using autologous tissue, the woman can go for the checks.

However, implants don’t undergo any mammograms as there is a risk they might get damaged. If you have a breast implant, make sure to let the radiologist know of the fact before going for your mammogram check.