What is a Breast Reconstruction?
Breast reconstruction surgery is a procedure used to restore the breasts to their normal shape, size, and proportion after a mastectomy, injury, or other circumstance that has altered the breast's appearance. The areola (dark area around the nipple) and the nipple can also be reconstructed.
Why Get Breast Reconstruction?
Losing your breasts to a mastectomy is difficult physically, mentally, and emotionally. A breast reconstruction will restore your chest to how it looked before you became sick, so your self-image will once again match your physical appearance. Breast reconstruction is a way to help you move on after cancer treatment, reclaiming your body and your life.
Once you have the procedure, you will no longer need to use a breast form to fill out one side of your bra or bathing suit (if you had a single mastectomy). While the reconstructed breast will look and feel differently than your natural breast when you aren't wearing any clothes, your body will regain balance and proportion.
What Are the Different Kinds of Breast Reconstruction?
A woman who has had a mastectomy has a few options when it comes to breast reconstruction.
Breast Reconstruction With Implants
The most common method of rebuilding the breast is by using breast implants. You can select saline implants or silicone implants. Saline implants consist of a shell filled with salt water. Silicone implants are solid pieces made of a soft silicone gel that feels similarly to human fatty tissue. Your plastic surgeon will help you select the type of implant that is best for your situation.
If you decide to get breast reconstruction with implants, there is another option: immediate breast reconstruction and delayed reconstruction. Immediate breast reconstruction happens during the same surgery as the mastectomy. Your oncology surgeon removes the breast, and the plastic surgeon places the implant to replace the lost tissue.
Delayed reconstruction is more common, and is done in stages. After you heal from your mastectomy, a tissue expander is placed in the breast position and it is slowly filled with saline over about six months. This stretches the skin over the breast area. Once the skin is stretched far enough, you will have another procedure to place the implant.
Breast Reconstruction With Tissue Flap Procedures
Tissue flap reconstructions are analogous procedures, meaning they use tissues from your own body to rebuild the breast. The most common forms of tissue flap reconstruction are the latissimus dorsi flap, which uses tissues from the upper back, and the transverse rectus abdominus muscle flap (TRAM), which uses tissues from the lower abdomen.
The TRAM flap procedure often provides enough issues that you don't need an additional implant for reconstruction. Since it requires removing fat and skin from the belly area, you are left with not just a reconstructed breast- you've also had a tummy tuck!
The latissimus dorsi flap procedure uses skin and muscle from your upper back to create a pocket in the breast area, where an implant will be placed. Other flap options include using tissues from the buttocks, inner thigh, and variations on the TRAM flap.
Who is A Good Candidate for a Breast Reconstruction?
A good candidate for breast reconstruction will have had a mastectomy or other trauma to the breast that has altered its appearance. The patient must be in good enough health to handle an operation. Generally, they must wait until six weeks after chemotherapy and six months after radiation to begin reconstruction so these therapies don't interfere with the wound healing.
A good candidate will not be obese, and will not be a smoker. Breast reconstruction patients must have realistic expectations of the results of the surgery. Reconstructed breasts will not feel or look exactly like your natural breasts, and having breast reconstruction does not guarantee that cancer will not return.
If you want to pursue breast reconstruction, contact a plastic surgeon as soon as possible after your diagnosis. Your surgeon can work with your oncology team to complete the reconstruction on a timeline that will not interfere with your cancer treatment.
What Happens During My Consultation for a Breast Reconstruction?
During your initial consultation, the Board Certified Plastic Surgeon performing the breast reduction will review your medical history and your treatment plan for cancer. He will give you a physical examination, and possibly take photographs of your breasts or surgical site. If you are getting a flap reconstruction, he will select the best donor site.
The surgeon will discuss your breast reconstruction options based on your stated goals, including the type of surgery he thinks you should have. He will be in contact with your oncologist to come up with your reconstruction timeline.
How Do I Prepare for a Breast Reconstruction?
Your surgeon will probably order some lab tests beforehand to make sure you are well enough to proceed with the surgery. You will need to stop smoking at least six weeks before hand, and will stop eating and drinking at an instructed time the night before the surgery. Your surgeon (along with your oncologist) may need to adjust any medications you're taking so they don't interfere with your recovery. You may also be asked to have a pre-operative mammogram.
Review any paperwork and post-operative instructions beforehand, and make sure you have cold compresses, your medications, and button-down shirts on hand at home. You will need to arrange to have someone drive you home after the procedure.
How is a Breast Reconstruction Done?
First, you will be prepped for surgery and given whatever anesthesia the surgeon has selected. The actual steps of the reconstruction will depend on what type of reconstruction you have selected. If you are having immediate reconstruction (the type where an implant is placed at the same time as your mastectomy), then the surgeon will create a pocket for the implant after the mastectomy portion of the surgery is complete. He will then place the implant carefully, and close the incision.
For flap procedures, the surgeon removes the donor tissues from the donor site, and moves them to the chest to rebuild the breast mound. Some donor sites (like the latissimus dorsi flap) allow the tissues to remain attached to the blood supply because the tissues are tunneled through the body to the chest. Once the tissue flap is in place on the chest, an implant may be placed behind it, if necessary. Some flap procedures do not require the use of an implant.
If you are having delayed reconstruction, you will have an initial procedure to place the tissue expander. Once it has reached a certain expansion level, you will have a second procedure wherein the expander is removed and an implant is permanently placed.
If you have elected to have areola and nipple reconstruction, this is usually done as the last stage and in a separate procedure.
What is Recovery Like for a Breast Reconstruction?
When you are done with the surgery, you will be taken to a recovery room. There will be dressings in place over your breasts, and over any donor sites if you had a flap procedure. There may also be drains in place to prevent fluid build-up, and supportive compression garments over the breasts. You will need to stay in the hospital for one to six days, depending on your individual situation. Any discomfort you have can be managed with medications from your doctor.
Once you get home, you will need to take it easy for several weeks. You will notice bruising and swelling that worsens immediately after the surgery, but should begin to fade after a few days. It should be gone by about eight weeks. You should be up and around after about six to eight weeks, but you will need to continue avoiding strenuous activity until cleared by your doctor (patients who get flap procedures generally have longer recoveries). You should also speak with your doctor about when you can start wearing normal bras again, which will vary from patient to patient.
Keep in mind that breast reconstruction recovery isn't just physical. You may have an emotional reaction to your new breasts, and there might be a period of adjustment. Talk to your doctor about how you are feeling both physically and mentally.
When Can I See My Final Results?
The results of a breast reconstruction will be mostly visible after about two months. The swelling and bruising will have gone down by then. However, your breasts will continue to shift and settle into their new positions for up to a year after that.
What Are the Risks of a Breast Reconstruction?
A breast reconstruction surgery comes with risks, though they depend on what kind of surgery you get. Flap procedures come with a risk that you may have skin sensation changes in the donor site and the chest. There's also a risk of muscle weakness in the donor site.
If you have implant reconstruction, there is a risk that the implant will develop capsular contracture, or hardening. Both forms of surgery come with risks that accompany all surgeries: infection, bleeding, and reactions to the anesthesia. Your doctor will discuss the risks with you in detail during your consultation.
Will My Insurance Cover a Breast Reconstruction?
Your insurance should cover your breast reconstruction if it is due to a mastectomy, though the details of your plan may vary. Call your insurance company to inquire about your plan.
Dawn Gibbs writes for NOVA Plastic Surgery, a state-of-the-art plastic surgery office in Northern Virginia. Dr. Fadi Nukta is our board certified plastic surgeon. Call (703) 574-2588 for more information.
Article Source: http://ezinearticles.com/?Breast-Reconstruction&id=7307676
Breast reconstruction surgery is a procedure used to restore the breasts to their normal shape, size, and proportion after a mastectomy, injury, or other circumstance that has altered the breast's appearance. The areola (dark area around the nipple) and the nipple can also be reconstructed.
Why Get Breast Reconstruction?
Losing your breasts to a mastectomy is difficult physically, mentally, and emotionally. A breast reconstruction will restore your chest to how it looked before you became sick, so your self-image will once again match your physical appearance. Breast reconstruction is a way to help you move on after cancer treatment, reclaiming your body and your life.
Once you have the procedure, you will no longer need to use a breast form to fill out one side of your bra or bathing suit (if you had a single mastectomy). While the reconstructed breast will look and feel differently than your natural breast when you aren't wearing any clothes, your body will regain balance and proportion.
What Are the Different Kinds of Breast Reconstruction?
A woman who has had a mastectomy has a few options when it comes to breast reconstruction.
Breast Reconstruction With Implants
The most common method of rebuilding the breast is by using breast implants. You can select saline implants or silicone implants. Saline implants consist of a shell filled with salt water. Silicone implants are solid pieces made of a soft silicone gel that feels similarly to human fatty tissue. Your plastic surgeon will help you select the type of implant that is best for your situation.
If you decide to get breast reconstruction with implants, there is another option: immediate breast reconstruction and delayed reconstruction. Immediate breast reconstruction happens during the same surgery as the mastectomy. Your oncology surgeon removes the breast, and the plastic surgeon places the implant to replace the lost tissue.
Delayed reconstruction is more common, and is done in stages. After you heal from your mastectomy, a tissue expander is placed in the breast position and it is slowly filled with saline over about six months. This stretches the skin over the breast area. Once the skin is stretched far enough, you will have another procedure to place the implant.
Breast Reconstruction With Tissue Flap Procedures
Tissue flap reconstructions are analogous procedures, meaning they use tissues from your own body to rebuild the breast. The most common forms of tissue flap reconstruction are the latissimus dorsi flap, which uses tissues from the upper back, and the transverse rectus abdominus muscle flap (TRAM), which uses tissues from the lower abdomen.
The TRAM flap procedure often provides enough issues that you don't need an additional implant for reconstruction. Since it requires removing fat and skin from the belly area, you are left with not just a reconstructed breast- you've also had a tummy tuck!
The latissimus dorsi flap procedure uses skin and muscle from your upper back to create a pocket in the breast area, where an implant will be placed. Other flap options include using tissues from the buttocks, inner thigh, and variations on the TRAM flap.
Who is A Good Candidate for a Breast Reconstruction?
A good candidate for breast reconstruction will have had a mastectomy or other trauma to the breast that has altered its appearance. The patient must be in good enough health to handle an operation. Generally, they must wait until six weeks after chemotherapy and six months after radiation to begin reconstruction so these therapies don't interfere with the wound healing.
A good candidate will not be obese, and will not be a smoker. Breast reconstruction patients must have realistic expectations of the results of the surgery. Reconstructed breasts will not feel or look exactly like your natural breasts, and having breast reconstruction does not guarantee that cancer will not return.
If you want to pursue breast reconstruction, contact a plastic surgeon as soon as possible after your diagnosis. Your surgeon can work with your oncology team to complete the reconstruction on a timeline that will not interfere with your cancer treatment.
What Happens During My Consultation for a Breast Reconstruction?
During your initial consultation, the Board Certified Plastic Surgeon performing the breast reduction will review your medical history and your treatment plan for cancer. He will give you a physical examination, and possibly take photographs of your breasts or surgical site. If you are getting a flap reconstruction, he will select the best donor site.
The surgeon will discuss your breast reconstruction options based on your stated goals, including the type of surgery he thinks you should have. He will be in contact with your oncologist to come up with your reconstruction timeline.
How Do I Prepare for a Breast Reconstruction?
Your surgeon will probably order some lab tests beforehand to make sure you are well enough to proceed with the surgery. You will need to stop smoking at least six weeks before hand, and will stop eating and drinking at an instructed time the night before the surgery. Your surgeon (along with your oncologist) may need to adjust any medications you're taking so they don't interfere with your recovery. You may also be asked to have a pre-operative mammogram.
Review any paperwork and post-operative instructions beforehand, and make sure you have cold compresses, your medications, and button-down shirts on hand at home. You will need to arrange to have someone drive you home after the procedure.
How is a Breast Reconstruction Done?
First, you will be prepped for surgery and given whatever anesthesia the surgeon has selected. The actual steps of the reconstruction will depend on what type of reconstruction you have selected. If you are having immediate reconstruction (the type where an implant is placed at the same time as your mastectomy), then the surgeon will create a pocket for the implant after the mastectomy portion of the surgery is complete. He will then place the implant carefully, and close the incision.
For flap procedures, the surgeon removes the donor tissues from the donor site, and moves them to the chest to rebuild the breast mound. Some donor sites (like the latissimus dorsi flap) allow the tissues to remain attached to the blood supply because the tissues are tunneled through the body to the chest. Once the tissue flap is in place on the chest, an implant may be placed behind it, if necessary. Some flap procedures do not require the use of an implant.
If you are having delayed reconstruction, you will have an initial procedure to place the tissue expander. Once it has reached a certain expansion level, you will have a second procedure wherein the expander is removed and an implant is permanently placed.
If you have elected to have areola and nipple reconstruction, this is usually done as the last stage and in a separate procedure.
What is Recovery Like for a Breast Reconstruction?
When you are done with the surgery, you will be taken to a recovery room. There will be dressings in place over your breasts, and over any donor sites if you had a flap procedure. There may also be drains in place to prevent fluid build-up, and supportive compression garments over the breasts. You will need to stay in the hospital for one to six days, depending on your individual situation. Any discomfort you have can be managed with medications from your doctor.
Once you get home, you will need to take it easy for several weeks. You will notice bruising and swelling that worsens immediately after the surgery, but should begin to fade after a few days. It should be gone by about eight weeks. You should be up and around after about six to eight weeks, but you will need to continue avoiding strenuous activity until cleared by your doctor (patients who get flap procedures generally have longer recoveries). You should also speak with your doctor about when you can start wearing normal bras again, which will vary from patient to patient.
Keep in mind that breast reconstruction recovery isn't just physical. You may have an emotional reaction to your new breasts, and there might be a period of adjustment. Talk to your doctor about how you are feeling both physically and mentally.
When Can I See My Final Results?
The results of a breast reconstruction will be mostly visible after about two months. The swelling and bruising will have gone down by then. However, your breasts will continue to shift and settle into their new positions for up to a year after that.
What Are the Risks of a Breast Reconstruction?
A breast reconstruction surgery comes with risks, though they depend on what kind of surgery you get. Flap procedures come with a risk that you may have skin sensation changes in the donor site and the chest. There's also a risk of muscle weakness in the donor site.
If you have implant reconstruction, there is a risk that the implant will develop capsular contracture, or hardening. Both forms of surgery come with risks that accompany all surgeries: infection, bleeding, and reactions to the anesthesia. Your doctor will discuss the risks with you in detail during your consultation.
Will My Insurance Cover a Breast Reconstruction?
Your insurance should cover your breast reconstruction if it is due to a mastectomy, though the details of your plan may vary. Call your insurance company to inquire about your plan.
Dawn Gibbs writes for NOVA Plastic Surgery, a state-of-the-art plastic surgery office in Northern Virginia. Dr. Fadi Nukta is our board certified plastic surgeon. Call (703) 574-2588 for more information.
Article Source: http://ezinearticles.com/?Breast-Reconstruction&id=7307676
