Breast reconstruction is the rebuilding of a breast tissue in women commonly after removal of a breast cancer. It involves using autologous tissue or prosthetic (implant) material to construct a natural-looking breast. Often this includes the reformation of a natural-looking areola and nipple. This procedure involves the use of implants or relocated flaps of the patient's own tissue.
The primary part of the procedure can often be carried out immediately following the mastectomy. As with many other surgeries, patients with significant medical comorbidities (high blood pressure, obesity, diabetes) and smokers are higher-risk candidates. Patients expected to receive external beam radiation as part of their adjuvant treatment are also commonly considered for delayed autologous reconstruction due to significantly higher complication rates with tissue expander-implant techniques in those patients.
Breast reconstruction is a large undertaking that usually takes multiple operations. Sometimes these follow-up surgeries are spread out over weeks or months. If an implant is used, the individual runs the same risks and complications as those who use them for breast augmentation but has higher rates of capsular contracture (tightening or hardening of the scar tissue around the implant) and revisional surgeries. At the same time as reconstruction it may be desirable to augment or reduce the size of the opposite breast to make the overall result of the surgery as symmetrical as possible. If restoration of the nipple and surrounding dark pink skin or areola is desired, additional surgery can be performed at a later date. Depending on the extent of your surgery, you will be released from the hospital in two to five days. Sutures generally will be removed within two weeks of surgery.
Although we make every effort to keep scars as inconspicuous as possible, they are the inevitable result of mastectomy and breast reconstruction. Scars will not fade completely but in most cases, will be acceptable in time.
The reconstructed breast may feel firmer and look rounder or flatter than your natural breast. Most likely, it will not have the same contour as your breast before mastectomy, nor will it exactly match your opposite breast. Reconstruction cannot restore normal sensation, but in time some feeling probably return to the breast area.