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Breast Reconstruction
But bear in mind, post-mastectomy breast reconstruction is not a simple procedure. There are often many options to consider as you and your doctor explore what's best for you. Most mastectomy patients are medically appropriate for reconstruction, many at the same time the breast is removed. The best candidates, however are women whose cancer, as far as can be determined, seems to have been eliminated by mastectomy. Still, there are legitimate reasons to wait. Many women aren't comfortable weighing all the options while they're struggling to cope with a diagnosis of cancer. Others simply don't want to have any more surgery than is absolutely necessary. Some patients may be advised by their surgeons to wait, particularly if the breast is being rebuilt in a more complicated procedure using flaps of skin and underlying tissue. Women with other health conditions, such as obesity, high blood pressure, or smoking, may also be advised to wait. In any case, being informed of your reconstruction options before surgery can help you prepare for a mastectomy with a more positive outlook for the future. All Surgery Carries Some Uncertainty and Risk Virtually any woman who must lose her breast to cancer can have it rebuilt through reconstructive surgery. But there are risks associated with any surgery and risks specifically associated with this procedure. In general, the usual problems of surgery, such as bleeding, fluid collection, excessive scar tissue, or difficulties with anaesthesia, can occur although they're relatively uncommon. And, as with any surgery, smokers should be advised that nicotine can delay healing, resulting in conspicuous scars and prolonged recovery. Occasionally, these complications are severe enough to require a second operation. If an implant is used, there is a remote possibility that an infection will develop, usually within the first two weeks following surgery. In some of these cases, the implant may need to be removed for several months until the infection clears. A new implant can later be inserted. The most common problem, capsular contracture, occurs if the scar or capsule around the implant begins to tighten. This squeezing of the soft implant can cause the breast to feel hard. Capsular contracture can be treated in several ways, and sometimes requires either removal or "scoring" of the scar tissue, or perhaps removal or replacement of the implant. (Click here for Breast Augmentation information.) Reconstruction has no known effect on the recurrence of disease in the breast, nor does it generally interfere with chemotherapy or radiation treatment, should cancer recur. Your general surgeon may recommend continuation of the periodic mammograms on both the reconstructed and the remaining normal breast. If your reconstruction involves an implant, be sure to go to a radiology center where technicians are experienced in the special techniques required to get a reliable x-ray of a breast reconstructed with an implant. Women who postpone reconstruction may go through a period of emotional readjustment. Just as it took time to get used to the loss of a breast, a woman may feel anxious and confused as she begins to think of the reconstructed breast as her own. The psychological benefits of having a new breast reconstructed at the time mastectomy is performed are considerable. You can begin talking about reconstruction as soon as you're diagnosed with cancer. Ideally, you'll want your general surgeon and your plastic surgeon to work together to develop a strategy that will put you in the best possible condition for reconstruction. After evaluating your health, your plastic surgeon will explain which reconstructive options are most appropriate for your age, health, anatomy, tissues, and goals. Be sure to discuss your expectations frankly. Your surgeon will be equally frank with you, describing your options and the risks and limitations of each. Post-mastectomy reconstruction can improve your appearance and renew your self-confidence, but does not offer perfection. Your surgeon will also explain the general anesthesia used, the hospital stay required and so on. Usually 1 or 2 nights stay in hospital on the first of the two operations commonly required (with each technique of reconstruction) is recommended. |
Reconstruction of a breast that has been removed due to cancer or other disease is one of the most rewarding surgical procedures available today. New medical techniques and devices have made it possible for surgeons to create a breast that can come close in form and appearance to matching a natural breast. Frequently, reconstruction is possible immediately following breast removal (mastectomy), so the patient wakes up with a breast mound in place, having been spared the experience of seeing herself with no breast at all.
