Breast reconstruction is performed on women who have lost one or both breasts to mastectomy, or who lack breasts due to congenital or developmental abnormalities. The goal of breast reconstruction is to create a breast and nipple that resemble the natural breast as closely as possible in shape, size and position. A long as a woman is healthy, age is not a factor in whether she is a good candidate for breast reconstruction. However, women with health problems such as obesity and high blood pressure, and those who smoke, are advised to wait rather than have breast reconstruction immediately following mastectomy.
Types of Breast Reconstruction
Breast reconstruction is performed in several steps, and there are essentially two types. Which one is used depends on whether there is enough tissue on the wall of the chest to cover/hold an implant. Whichever type is used, a woman's breast surgeon and plastic surgeon should work as a team during reconstruction.
It is essential that a patient have reasonable expectations about the results reconstruction provides.
Recovery from Breast Reconstruction
Recovery varies widely based upon the type of procedure used for breast reconstruction, as well as whether reconstruction immediately follows mastectomy. Hospital stays range from 1 to 6 days. Patients are tired and sore for 1 to 2 weeks, and recovery takes 3 to 6 weeks. Compression garments are typically worn, and stitches are taken out in a week to 10 days. A surgical drain may be left in place to prevent a buildup of fluid in the reconstructed breast; if so, it is removed within 1 or 2 weeks.
Risks of Breast Reconstruction
In addition to the risks associated with surgery and anesthesia, those related to implant/tissue-expansion breast reconstruction include infection around the implant, implant leaks and ruptures, and implant deflation or shifting. Risks related to autologous breast reconstruction, depending upon the technique used, include fat necrosis, abdominal weakness, hernia and a mismatch between chest tissue and donor tissue.
Correcting reconstructive problems typically requires additional surgery.
Results of Breast Reconstruction
A reconstructed breast will not look the same as the original breast. And although a surgeon attempts to match the size, shape, position and other attributes of the remaining breast, an exact match is not possible. To achieve symmetry, the remaining breast may be operated on to make it bigger or smaller, or to lift it.
In addition to not looking the same as the original, a reconstructed breast has little sensation, although there may be more when autologous tissue rather than an implant is used.