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Breast Reconstruction After Mastectomy: Options, Procedure, and Recovery

If you've had a mastectomy due to breast cancer, you may choose to undergo breast reconstruction surgery. This procedure can help restore balance and symmetry between your breasts by replacing skin, breast tissue, and the removed nipple. The extent of reconstruction depends on the mastectomy and the size and location of the removed tumor.

Is Breast Reconstruction Right for You?

Deciding whether to have breast reconstruction is a personal choice that can be difficult to make. You don't have to have reconstruction; you can wear external breast forms or pads, or make no changes at all. However, plastic surgery techniques have improved, offering better results than ever before. Reconstruction can provide psychological benefits and contribute to a sense of wellness for you and your family.

Timing of Breast Reconstruction

The best time for breast reconstruction depends on your preferences, medical conditions, and cancer treatment. You can have it done during the mastectomy or months or years later. If you've started chemotherapy or radiation treatments, reconstruction is usually postponed until they are completed. Your surgeon can help you determine the most appropriate timing for your situation.

Breast Reconstruction Options

There are several breast reconstruction options available:

  • Implants: This involves stretching the skin with a tissue expander and then inserting a silicone-gel or saline implant weeks later.

  • TRAM flap: This procedure uses tissue from your abdomen to create a breast mound. It can be done as a pedicle (tunneling) or free-flap procedure.

  • Other flap procedures: Less common options include using tissue from your back (latissimus dorsi flap).

  • Aesthetic flat closure (AFS): This surgical repair procedure removes or rearranges excess breast skin and fat after a mastectomy to correct contour deformities.

Your surgeon will discuss your options based on your preferences, medical condition, and previous surgeries.

Nipple Reconstruction

Nipple reconstruction is typically an outpatient procedure done with local anesthesia after breast reconstruction. Surgeons can create a nipple using tissue from the back or abdominal flap and then tattoo it to resemble the color of a nipple. A prosthetic nipple is another option.

Recovery and Follow-Up Care

After breast reconstruction surgery, you may experience discomfort, swelling, and bruising for 2 to 3 weeks. Your hospital stay will depend on the type of operation, ranging from 1 to 2 days for implants to 5 to 6 days for flap procedures. Most women return to regular activities within 6 to 8 weeks, but it may take longer before you can do strenuous exercise.

Follow-up care includes regular checkups, wound care, and continuing self-exams and annual mammograms. Breast reconstruction doesn't change the chance of cancer recurrence and generally doesn't interfere with treatment if the disease does return.

Possible Side Effects

Some possible side effects of breast reconstruction include:

  • Infection at the surgery site

  • Pain and discomfort

  • Itching

  • Numbness or tingling

  • Fluid collection under the wound

Contact your doctor immediately if you experience a fever above 100°F, fluid leaking from incision sites, changes in color of the breast or scar area, or increased pain or swelling in the surgical areas.

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