Breast reconstruction surgery can be nothing short of a miracle procedure for women who have to lose their breasts in a mastectomy. Rather than being left flat-chested, a woman can have natural looking implants that allow her to fill out clothes just like natural breasts did before. This type of surgery is not able to fully replicate the natural appearance of nude breasts, however it can allow for natural-looking breasts in everything from swimsuits to curve-hugging dresses.
The process for breast reconstruction is different than that of other breast surgeries because a mastectomy is involved. This makes breast reconstruction a more complicated surgical procedure than the average breast augmentation. The mastectomy is performed first so that the breast tissue is removed. After that, Dr. Patterson will begin the reconstruction of the breast. While this can all be done in one surgery, breast reconstruction patients will need to make multiple follow-up visits to the office over the coming weeks and months to expand the new breast implants.
There are two major techniques used for breast reconstruction today. By far the most common, and the most effective, is breast implants. A silicone shell is gradually filled with saline via a specialized tissue expander. This gives the muscles and skin time to stretch and adjust. Once the silicone shell is fully expanded to the desired size, the permanent implant is inserted. Implants can be any size that the patient wants. Breast implants are a permanent part of the body and will retain their shape and size for many years.
With the fat transfer technique, the breast is rebuilt using fat grafted from other portions of the body. Typically, fat is harvested from the abdominal area, the thighs, or the buttocks. The fat is then injected into the area where the breast tissue was previously. Fat transfer is less invasive than breast implants, however it may have some significant drawbacks.
Fat transfer has not been studied in any large clinical studies at this time, so the long-term results are largely unknown. It should be noted that injected fat may tend to reabsorb over time, causing some volume loss in the breasts. Extra fat may be injected during the procedure to combat this problem, although it may result in breasts that are initially fuller than desired.
Type of Mastectomy
Dr. Patterson assists the General Surgeon and immediately follows with the first stage of the reconstructive procedure.
There are two different types of mastectomies.
- A Total Mastectomy is the complete and total removal of the breast tissue, nipple, and areola. Lymph nodes in the axillae area are left intact.
- A Nipple Sparing Mastectomy is a technique that is best for women who do not have tumors in the area immediately around the areola. In this method, the breast tissue is removed while the nipple is left intact.
Unilateral or Bilateral Mastectomy
A unilateral mastectomy is a surgery in which one breast is removed, while a bilateral mastectomy is the removal of both breasts. In most cases, only cancerous breasts are removed, however there may be situations in which healthy breasts are removed if the risk of cancer development is deemed to be high.
Types of Breast Implants
Both silicone and saline breast implants are available for breast reconstruction patients. Both implant types are made by Mentor, a leading name in the medical arena today.
- Silicone Implants are made from MemoryGel, an FDA approved substance for breast implants. This patented cohesive gel has a superior ability to retain shape once placed, and it has the most natural feel among the breast implant options. Silicone implants are already filled to a specific level, so the volume can’t be changed once inserted. There are a wide variety of sizing options, and Dr. Patterson can help every patient choose the ideal size.
- Saline Implants are composed primarily of saline that is very similar to that which occurs in the body naturally. This type of implant is generally firmer than its silicone counterpart. Saline implants are first placed in the body and are then filled to the ideal volume.
Benefits of a Breast Reconstruction With Dr. Patterson
A breast reconstruction can restore your appearance in clothes. After a mastectomy, many women feel self-conscious about the fact that they no longer fill out their clothes the way they once did. A breast reconstruction can help a woman to feel feminine again, and in fact can make them feel more like themselves again after a mastectomy. Breast reconstruction can give a woman’s confidence a chance to truly bloom.
Planning Your Breast Reconstruction Surgery
Patients should plan the breast reconstruction surgery with recovery time in mind. Most people need at least one full week of recovery time, so scheduling the surgery when work and personal obligations are not pressing is best.
Preparing For Your Breast Reconstruction Surgery
Preparation for a breast reconstruction surgery should begin at least a couple of weeks ahead of time. Patients will need to have blood tests to affirm that they are healthy enough for the breast reconstruction procedure. Patients should always discuss all the medications that they are currently taking with Dr. Patterson well in advance of the surgery. Some medications, including ibuprofen, aspirin, certain vitamins, and herbal supplements, should be discontinued prior to the breast reconstruction. Patients who smoke should stop smoking prior to the procedure, as well.
Breast Reconstruction is done under general anesthesia. There are several different surgical methods that may be used, including: Reconstruction with TRAM Abdominal Muscle Flap, Reconstruction using a Latissimus Muscle Flap, and Reconstruction using Tissue Expanders.
Dr. Patterson’s specialty is reconstruction using the tissue expander method, a choice which is generally the most successful of the reconstruction methods. In the tissue expander method, a silicone tissue expander is placed between the skin and chest muscle, in the area where the breast tissue once was. This expander is filled with saline incrementally over several weeks or months. Through this process, the skin is stretched gradually until it can accept a permanent breast implant.
Breast reconstruction recovery is best achieved by strict adherence to the post-surgery care guidelines from Dr. Patterson. In general, patients can go back to light activity levels after a couple of days, and can return to work after about one week. For jobs that involve manual labor, patients may need to take two weeks or more away from the job.
Exercise After Breast Reconstruction
Exercise after a breast reconstruction should be approached with great caution. Light exercise is permissible, but moderate and strenuous exercise should be completely avoided for six weeks post surgery. Allow the full six week recovery period to pass so that full healing can take place before the body is placed under stress.
After a breast reconstruction surgery, it is important to follow all of Dr. Patterson’s aftercare instructions.
- Gauze dressings can be removed 24 to 48 hours after surgery. If the incisions have been bleeding, replace the gauze with fresh dressings.
- Heavy compression garments should be worn for two weeks after surgery. Following that, medium compression garments should be used for another month. Supportive sports bras are generally a good option. Compression garments should be worn at all times, except when they are being laundered.
- Avoid showering (or any water exposure) for one full day (24 hours) following surgery. Avoid bathing for three to four weeks after surgery.
- Many patients do experience some discomfort or pain for the first two to four days after surgery. After that, pain will begin to lessen considerably. Pain can be resolved with prescription pain medications or over the counter pain relievers. Use caution with narcotic medications, as they can have side effects including constipation. A stool softener or laxative can resolve this issue. Avoid scratching the incision area, and use an over the counter antihistamine if breasts feel itchy after surgery.
- Surgical tape should remain in place for two to three weeks. Don’t move the tape, as this can expose incisions and inhibit healing. Avoid the use of creams and ointments around the surgical tape.
Dr. Patterson may give you additional specific aftercare instructions following a breast reconstruction surgery. Follow all of the above instructions closely for the optimal breast reconstruction result. Full healing takes time, and the final results can usually be seen around the six weeks post-op mark. Breast reconstruction is major surgery, but it provides a truly major change that patients will find well worth it.