Breast cancer patients may opt to undergo breast reconstruction surgery. This surgery can occur during or after a breast cancer surgery, including mastectomy or lumpectomy.
The goal of reconstruction is to recreate normal breast shape and appearance after breast cancer surgery.
Types of Breast Reconstruction Surgery
There are two main types of reconstruction surgery: breast implants and flap reconstruction.
- Implant surgery adds silicone or saline breast implants to the chest tissue to create a new breast shape.
- Flap surgery — also called autologous tissue reconstruction — uses the body’s fat and skin to recreate the breast shape.
Depending on how extensive your breast cancer surgery is, you may need to have one or both breasts reconstructed. You may also have one breast reconstructed and the other breast modified for symmetry. You may also need further surgeries for the other breast or nipple reconstruction.
If you and your surgeon decide on breast implant surgery, it may be a multiple-step process. The surgeon may place tissue expanders during the initial surgery to stretch the skin, then replace them with implants.
Your specific recovery and risks vary based on the type of surgery you have. Here are some things to expect after surgery and during recovery.
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Breast Reconstruction Recovery
Right after surgery, you can expect to stay in the hospital for a few days. Have someone available to take you home from the hospital and stay with you for a few days after that.
You may have a drain in place to remove fluid while the breast heals. Your care team will teach you how to care for the wound and use the drain before leaving the hospital.
Once home, you will likely feel tired and sore. During breast reconstruction surgery recovery, plan to take a good amount of time off work. About two weeks is good for implant-based surgery. Women who have flap reconstruction may need about four weeks to return to work.
For autologous surgery, the area where the surgeon took the fat (usually the stomach) will also need time to heal.
You may need to take it easy for about six to eight weeks before returning to exercise or more demanding activities. Avoid heavy lifting or lifting your arms over your head during this time. You may need physical therapy to regain function after major breast cancer surgery.
After surgery, it takes time before you can wear an underwire or firm cupped bra again. Your doctor will advise you on the best bra to wear.
Returning to Normal
Even as you feel better, the breast may still have bruising or swelling for a month or two after surgery. And it can take a couple of years for the scars to fade. The goal of reconstruction surgery is to help you feel normal, but healing and recovery will take some time.
It may also take some time to adjust to the new breasts and feel like they’re a part of you. Breast implant surgery can also lead to a loss in sensation, which may not come back. This loss could be hard to cope with if your breasts were previously an erogenous zone.
Talking to a mental health professional can help you process and cope during recovery from breast cancer.
Breast Reconstruction Surgery Risks
As with any major surgery, breast reconstruction carries some risks. Smoking increases these risks. It’s important to stop smoking before surgery and avoid smoking during your recovery period.
These are the most common risks during or soon after surgery:
- Reactions to anesthesia
- Uneven breasts
- Loss of nipple sensation
Implants carry specific risks:
- Capsular contracture. This complication happens when scar tissue forms around the implant, making the breast feel hard. You may need surgery to remove the scar tissue or have the implant replaced.
- Damage to the implant. Injury to the breast can cause the implant to leak or rupture. The implant texture can also change over time. Depending on your age at surgery, you may need to replace the implants during your lifetime.
Follow your care team’s guidance throughout the recovery process for the best healing.
If you have only one breast reconstructed, you may have asymmetry that develops over time. Weight loss or gain will affect the natural breast, but not an implant, for example. Also, age-related sagging will affect a natural breast, but not the reconstructed breast.
Keep in mind that breast reconstruction isn’t always a one-and-done procedure. You may want or need to have additional breast surgeries later. These may include changing the implants, getting a breast lift, or other procedures.
Breast reconstruction surgery is one of many steps toward a return to normalcy for many women with breast cancer. But it’s a process. It can take three to six months before the swelling goes down and the breast shape to finalize.
Work closely with your care team to ensure you get the results you want and to adjust to this change.
About Plastic Surgery
Plastic surgery is an option for both cosmetic and reconstructive needs, and the UPMC Department of Plastic Surgery can help with both. Whatever improvement you seek, we can create an individualized treatment plan to help you achieve your desired results. Through our research and clinical trials, we have used cutting-edge techniques in our treatments for more than 70 years. We also have one of the largest academic plastic surgery departments in the United States and operate one of the region’s top centers for restorative medicine.
Plastic surgery is an option for both cosmetic and reconstructive needs. The UPMC Department of Plastic Surgery can help with both. We will work with you to create an individualized treatment plan to help you achieve your desired results. Through our research and clinical trials, we have used cutting-edge techniques in our treatments for more than 70 years. We also have one of the largest academic plastic surgery departments in the United States and operate one of the region’s top centers for restorative medicine. Our goal is to improve your quality of life. Find a provider near you.