Breast Reconstruction
The choice to undergo a breast reconstruction is entirely personal and optional. Women may decide breast reconstruction surgery is something they want, or they may choose to use external prosthetics placed in a bra, or forgo breast replacement entirely. I think it’s so important women are informed of all of their options, understand them and choose what is best for them.
What breast reconstruction is and when it can happen
Breast reconstruction is a surgical treatment used to rebuild a breast or fix irregularity. Women usually have a breast reconstruction following procedures such as mastectomies and lumpectomies.
Breast reconstruction may be a part of the initial breast cancer surgery, or occur later as a separate procedure after the body has had time to recover. Women have said that breast reconstructions after breast cancer have helped improve self-esteem, body image positivity, quality of life, and overall mental health.
Who can have a breast reconstruction
Your surgeon will tell you if breast reconstruction is a safe option for you now or in the future. There are some instances where a breast reconstruction may not be suitable for a person, including:
if a person’s overall health is poor or they have medical conditions such as diabetes
if they require further cancer treatment
if there is a history of smoking
when the size and shape of the removed cancer affects reconstruction options.
Your surgeon should talk you through your options and be able to tell you whether a breast reconstruction is suitable for you.
Types of breast reconstruction
There are two main types of breast reconstruction and they are implant reconstruction, and autologous (flap or tissue) reconstruction.
Implant reconstruction involves inserting a synthetic implant into the breast. This procedure can happen in one surgery, but sometimes requires two separate surgeries: one to insert a temporary tissue expander to stretch the skin, and one to replace the expander with a permanent implant made of silicone or saline.
Autologous (flap or tissue) reconstructions use tissue from your body (usually from your belly, thigh, or back) to repair and reshape your breasts. These reconstructions normally involve a longer surgery and a longer recovery time. However, the benefit of this type of surgery is that it will require less ongoing attention over time, and usually produces a more natural shape that doesn’t become uneven with changes in body weight. I will refer you to a trusted Specialist Plastic Surgeon colleague for autologous flap reconstruction, which may involve us operating together - for immediate reconstruction - or the reconstruction may be performed later, should your cancer treatment take priority.
Fat grafting is another tool we use that involves liposuction to collect fat from the stomach, legs, or buttocks. The fat is then placed around the reconstructed breast enhancing its overall shape.
What to expect after a breast reconstruction
If you have had a breast reconstruction, you will likely experience some initial soreness as the anaesthetic wears off. Most women will need to remain in the hospital for several days and wear specialised supportive bras for 8-12 weeks to help the breasts heal. Read more on post-surgery bras here.
The recovery period for women can vary greatly depending on the type of surgery and a person’s health. During this time, women may have soft drains and require dressing changes. Bruising will usually resolve within a week or two and swelling from the procedure will generally resolve after 6-8 weeks. Please note it can take months for the reconstruction to fully settle. Because the recovery period varies so greatly, it’s important to ask your surgeon when you can resume normal activity. Read more about wound care here.
The goal of breast reconstruction is to recreate the breast to help a woman feel confident in her body. Breasts after breast reconstruction will look and feel different and they may have a different shape, size or colour. This is normal. So is scarring after a major surgery like breast reconstruction. What’s important is that every person considering breast reconstruction is informed about their options and makes the choice that feels best for them in consultation with their surgeon.
To read more about breast reconstruction, check out my blog for all you need to know about breast reconstruction after breast cancer.