Breast Reconstruction involves reconstructing a new breast that has been removed due to cancer or other disease. It is one of the most rewarding surgical procedures available today.
The latest techniques enable reconstruction of a new breast similar in form and shape to a natural breast. This technique is often possible to perform immediately following breast removal or mastectomy, so that when the patient wakes up, she is spared the experience of seeing herself with no breast at all. Even performed at a later date, this rewarding procedure enables a return to an easier lifestyle with improvement of body image and self-esteem.
WHO IS THE BEST CANDIDATE?
The best candidates for breast reconstruction are women whose cancer, or similar disease, as far as can be determined, has been eliminated by mastectomy. Most mastectomy patients are appropriate candidates for reconstruction. Many procedures can be preformed at the time of the mastectomy.
For those who prefer to, and are medically able to have the mastectomy and reconstruction at the same time, the period of adjustment to having only one breast is eliminated. In many cases the Surgeon prepares the reconstruction while the mastectomy is taking place, thereby reducing the total operative time.
Some women prefer to wait and have the breast reconstruction at a later date. Mastectomy in itself, is enough to struggle with, and some women simply don’t want to have any more Surgery than is absolutely necessary. Certain conditions such as high blood pressure, obesity, diabetes or smoking may mean that your surgeon advises you to wait.
WHAT TO EXPECT
If performed for medical reasons, breast reconstructive surgery can attract medicare rebates. A percentage of your surgeons, anaesthetist and hospital fees may be claimed from both Medicare and your private health fund if you have cover. You will need a referral from your general practitioner if you wish to claim.
As soon as you are diagnosed with breast disease, you can begin talking about breast reconstruction. At your initial consultation with your Surgeon, you will be assessed and examined and your suitability for this type of surgery will be discussed with you. Be frank in your discussions and cover all of your questions, so that you are familiar with the type of surgery, the complications that surround the surgery, your anticipated outcome and your expectations.
Emotional stability is an important factor in considering any surgical procedure as a stable and realistic mental attitude to surgery often results in a more successful outcome. You must be realistic in your expectations and it is advisable to cover this aspect of your surgery at length with doctor in your consultations. We realise that this is a difficult time for you and will do our best to be supportive in every manner.
Following the consultation with your surgeon, you can consult further with our Cosmetic Consultant who is very experienced in the cosmetic field and you may discuss further issues with her.
Breast Reconstruction is performed under General Anaesthetic and you will need to be an inpatient in a hospital facility for at least two days postoperatively.
The surgery itself is performed in several stages, the first being the major reconstruction and the second a more minor procedure to reconstruct the nipple.
All surgery carries some risk and uncertainty. It is impossible to predict every outcome because everyone is different. Breast Reconstruction is a complicated but safe procedure providing the clients have been carefully selected and the surgeon is adequately trained in the procedure as well as having training in General Surgery.
Complications in the short term include infection which is treated with antibiotics and dressings and haematoma, or a collection of fluid under the skin which may need drainage.
Complications in the long term include wound breakdown from persistent infection, requiring continued antibiotics and dressings, thick or hypertrophic scar formation which may require surgical revision or injections, asymmetry requiring adjustment at a second minor procedure, and weakness of the abdominal wall may occur at the point where the flap was taken.
If you have questions about BIA-ALCL please see the following article.
It will be necessary to have some help at home after you are discharged from hospital following breast reconstruction. You will need to take things easy for at least several weeks following your surgery. You will need someone to drive you to and from the hospital for surgery and also to provide transportation to our rooms following your surgery for regular visits to monitor your care during the postoperative period.
Lifting, straining or exertion should be avoided for the first four to eight weeks following surgery.
You will be advised as to when you may commence exercise, however gently walking is encouraged as soon as you are able to do so. You will asked to refrain from lifting your arms above your head for two weeks
following surgery so as not to put excessive strain on the suture lines.
Breast reconstruction is an extremely rewarding procedure assisting in the return of your self image following breast excision treatment. Women both young and old opt for breast reconstruction, even those having had mastectomy in the times when reconstruction was not an option. Surgical techniques today enable reconstruction of a new breast which has a very natural appearance. There is no need for prostheses that float around in your bathing suit, you will be able to fill out that suit naturally following breast reconstruction and no one will know the difference.