Our goal is to help you feel whole again. When you get a breast cancer diagnosis or learn that you have a hereditary predisposition for breast cancer, such as a BRCA 1 or BRCA 2 or other genetic mutation, we understand how unsettling that can make you feel, especially when you are faced with a double mastectomy. There is no specific technique we use at Elite Plastic Surgery to reconstruct the breast after a preventative mastectomy. Dr. Torabi prefer to discuss each case privately with a patient during a complete consultation in their office in Phoenix, AZ. Most hereditary breast cancer reconstruction patients are candidates for immediate breast reconstruction using natural tissue or direct-to-implant reconstruction since they tend to have a nipple-sparing, or a skin-sparing mastectomy. If you would like more information, or to make an appointment for a consultation, please call our office at your earliest convenience.
OUR SURGICAL REQUIREMENTS
Depending on which type of reconstruction you and your surgeon plan for, breast reconstruction can begin immediately after a mastectomy. Regardless of surgery type, anesthesia will be used to keep you comfortable and sedated throughout the procedure. The operation can last 2 – 8 hours depending on what is used to rebuild the breast tissue. If the breast is made of your own tissue from a donor site on the body, that surgery will be performed first, and then sutured closed. The plastic surgeon will then recreate the breast with the harvested tissue to make the breast mound. If a synthetic implant is used, such as a saline of silicone implant, the surgeon will only perform surgery on the breast(s). Both surgeries will require incision care, and will produce scarring.
Once in recovery, our post-op nursing staff will oversee your care very attentively. As these surgical procedures generally require an in-patient stay, you will be in good hands as you come out of the recovery room. The nurses will continue to monitor your vital signs, blood flow, and make sure fluid does not build up in the surgical areas. Also, you will have pain medication to help you manage the pain.
FOLLOW-UP & CONSIDERATIONS
Once the plastic surgeon has discharged you from the hospital or surgical center, you will be asked to return to his office for a 1-week follow-up appointment. At this office visit, we will check the healing progress of your incisions, discuss your pain management, and check your vital signs and overall health. If at any time after you are released from the hospital that you experience excessive pain, bleeding, infection, fluid build-up, and/or fever, please call our office right away for an appointment.
FAQ ABOUT RECONSTRUCTION
WHAT ARE MY OPTIONS?
Why do patients choose a tissue or Implant-based breast reconstruction?
Tissue or Implant-based breast reconstruction are 2 options available following removal of 1 or both of the breasts. Depending on the patients’ lifestyle and preference, they may choose implants over tissue-based reconstruction or vice versa.
With implant-based reconstruction, the initial recovery is quicker, but it does require multiple revisions and future implant replacement. Tissue-based reconstruction has a slightly longer initial recovery, but usually only requires 1 revision at most. Personalizing patient care is key, therefore breast reconstruction options need to be discussed with your reconstructive surgeon.
WHAT TYPE OF SURGERY?
How is the tissue or Implant-based breast reconstruction done?
Implant-based reconstruction: Following a mastectomy, the surgeon will either insert a gel implant (1-stage reconstruction), or a temporary tissue expander (2-stage reconstruction) into a pocket formed above or below the muscle and remaining skin on the chest wall. In 2-stage reconstruction, more saline solution is gradually added to the tissue expander to stretch the muscle and skin to the desired size. Once the pocket has reached the desired size, the expander is left in place for 2 – 3 months. The pocket is then filled with a silicone gel implant.
Flap reconstruction: Following a mastectomy, the skin and fat are taken from another part of the body and used to create a breast mound. The tissue can be taken from the back, buttocks, and thigh, but is more commonly taken from the abdomen. Depending on the flap used, tissue can either be transferred with its own blood flow, or small blood vessels will need to be reconnected under a microscope to reestablish blood flow to the flap.
HOW IS THE RECOVERY?
What is the recovery time for tissue or implant-based breast reconstruction?
Rather than pain, most patients experience a dull ache for a couple of days following the breast surgery procedure. This is especially true if the implant has been placed underneath the muscle. Analgesics and muscle relaxants are prescribed for use, if necessary, and patients are required to wear a supportive bra day and night. The recovery time for breast surgery is around 2 weeks with some clients experiencing tenderness for up to 4 weeks or more. Strenuous activity should be avoided for a 6-week period, but light activity can begin as early as 4 weeks.
WHAT ARE THE RISKS?
What are the risks associated with tissue or implant-based breast reconstruction?
Your plastic surgeon will discuss any specific risks or complications of breast surgery prior to the procedure. General risks with breast reconstruction are low, but patients must be made aware of minor bruising following the surgery, along with associated swelling and tenderness.
Wound breakdown and infection can be a problem especially in tobacco users, or if aftercare and follow-up treatments are not adhered to properly. This could result in abnormal scarring. Specific, uncommon problems caused by the breast reconstruction surgery can include collection of fluid around the implant, wrinkles or ripples in the skin, loss in sensation in the breast and nipple area, and contraction of the capsule where the implant is placed, tissue hardening, and flap loss. Any concerns or continuing discomfort following breast reconstruction should be addressed with the surgeon as soon as possible.
CALL FOR A CONSULTATION
When faced with having a mastectomy, many women inquire about direct-to-implant breast reconstruction with a plastic surgeon as soon as the find out they need this aggressive type of treatment. When possible, the mastectomy can be scheduled at the same time as the implant placement. If you would like to find out if you qualify for this type of breast reconstruction, call today for a consultation.