What to Expect From Breast Reconstructive Surgery: Preparation & Tips

Reconstructive breast surgery is a procedure performed after a mastectomy. Anticipation for any surgery can be stressful. Knowing how to prepare, what to expect before and after surgery, and some insider tips can help ease stress and anxiety.

Key takeaways:
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    Breast reconstructive surgery is a procedure done after mastectomy.
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    There are two types of breast reconstruction: flap and implant.
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    Prepare for surgery by asking questions and following the surgeon’s instructions.
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    Breast reconstruction can be a two-step process. Expander placement followed by reconstruction.
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    There are advantages and risks, as with any surgery.

What is breast reconstructive surgery?

When a person has a mastectomy (the removal of one or both breasts), they may choose to undergo reconstructive breast surgery. This treatment reconstructs the breast after a mastectomy. As of 2020, almost 150,000 breast reconstruction surgeries have been performed.

There are two types of breast reconstruction surgeries:

  1. Flap Surgery is breast reconstruction that takes a section of tissue from one area of the body - usually the abdomen - and relocates it to create a new breast mound.
  2. Implants are a type of breast reconstruction that places silicone implants in front or behind the chest muscle. They come in various shapes and sizes to suit all body types.

Your surgeon will discuss your options and advise you of the best and safest route.

What is the process of getting breast reconstructive surgery?

Before having the mastectomy, you will meet with a plastic surgeon. The surgeon may measure and take pictures of your breasts. They will also go over the details of the procedure and answer any questions you have.

The process can be a two-step procedure. The first step is to place expanders in your chest, which enable the skin to remain stretched enough to accommodate your future implants. Expanders are often put in place during the mastectomy operation. The second step is tissue reconstruction to create the shape of your new breast mound.

It may take several reconstruction surgeries to achieve the look you desire. Some people choose to have autologous fat grafting - a form of liposuction using fat from other parts of the body to reshape the breast.

Many people are worried about the look and feel of their nipples after reconstructive surgery. You can choose to have new nipples constructed by your surgeon. Or, if you don't want a constructed nipple, you can opt for nipple-sparing surgery, which involves an incision made around your areola, enabling you to retain your nipple.

What does breast reconstruction involve?

1. Preparing for surgery

Before scheduling surgery, check with your insurance about the coverage available for breast reconstructive surgery. It is also a good idea to ask about hospital stays and medications that are or are not covered.

When meeting with the breast and plastic surgeon, you may be overwhelmed. Preparing yourself for surgery can be difficult. Knowing what to expect can ease worries and anxiety. Here are a few questions you can take to your surgeon:

  • Will there be discomfort or pain?
  • How long will I be in the hospital?
  • Will I need blood transfusions?
  • What is the recovery time?
  • What care will be required at home after the surgery?
  • Will there be activity limitations?
  • What are the risks and possible complications?

Tell the surgeon about any medications you take, including prescription and over-the-counter drugs. Remember any supplements and herbs you are taking as well.

Discuss whether or not you smoke. Smoking can affect recovery. The surgeon may request that you stop smoking and other medications before surgery.

2. Undergoing breast reconstructive surgery

Your surgeon will perform the procedure while you are under anesthesia. You will be asleep and won't feel any pain. If you are having a mastectomy, your surgeon will perform that procedure first.

Depending on if you are having a flap or implant procedure, you may have tissue moved from another part of your body into the breast mound or have the implant put in place. You may also have a drain inserted - a thin tube under your skin to drain fluid and blood as you recover. Your doctor will remove them when you don't need them anymore.

3. Recovering from breast reconstruction surgery

While everyone has a slightly different experience, there are many similarities in the healing processes. You can expect to stay in the hospital for one or two nights. On discharge, your activity will be limited your activity.

Be prepared to feel tired and sore for a couple of weeks post-operation. You'll have sutures, so make sure you are mindful of them as you wash, dress, and move around the house. Most often, these sutures will be absorbable and dissolve into your skin over time.

You'll wear a compression or surgical bra to support the breasts and minimize swelling. The bruising and swelling can last up to eight weeks, and it could take up to two years for the tissue to heal and the scars to fade.

What are the risks of breast reconstructive surgery?

As with any surgery, there are always risk factors. Your surgeon will talk through these with you. To prepare, look through this list and check in with your surgeon about anything that concerns you:

  • Problems with anesthesia.
  • Bleeding or blood clots.
  • Fluid build-up in the breast or donor site.
  • Infection.
  • Improper wound healing.
  • Fatigue.
  • Radiation after a reconstruction may cause additional risks.
  • Tissue necrosis.
  • Loss of sensation.
  • Changes in the arm on the reconstructive side.
  • Implant issues.
  • Future surgeries.

Autologous fat grafting can have risks, too. Some of these risks are:

  • Loss of muscle strength.
  • Dimples in skin.
  • Bulging in the abdominal wall.

Advantages of breast reconstructive surgery

The advantages are numerous and far-reaching. Many people who have undergone the surgery report that although it was difficult, the result was worth it. Among the most reported benefits are the following:

  • Improved self-confidence.
  • Better fitting clothing.
  • Feeling more confident about wearing a swimsuit.
  • Eliminating the need to use a prosthesis.
  • Generally, you do not need mammograms on the side of reconstruction.
  • Restoration of balance and proportion to the body.

Anticipation of a surgical procedure can be overwhelming. Knowing what to expect; advantages and risks help minimize anxiety. Preparation includes talking with the surgeon, asking questions, and getting answers. Recovery may require a time commitment, but patience and perseverance can pay off giving you the results you wanted, breasts.

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