Breast Reconstruction After a Mastectomy

Today’s advancements in breast reconstruction surgery techniques offer women more natural-looking results that are not only aesthetically pleasing, but also help renew self-confidence and esteem.

In 2017, more than 252,000 women will be diagnosed with invasive breast cancer in the United States and, according to national statistics, a staggering 12 percent will develop breast cancer during the course of their lifetime. Despite major breakthroughs in cancer treatments, increasing numbers of women with cancer in just one breast are opting for a double mastectomy with immediate breast reconstruction – even those who are prime candidates for a more conservative lumpectomy.

A 2016 analysis shows that one in eight U.S. women with invasive cancer in one breast now choose prophylactic bi-lateral mastectomies to reduce the risk of recurrence in the other breast.

Breast reconstructions after mastectomy show positive outcomes

In quality-of-life evaluations for breast cancer survivors, researchers have found that breast reconstruction surgery after a mastectomy, whether immediate or delayed for some months, vastly enhances a woman’s sense of well-being and wholeness. The surgery may also help diminish chest pain and tightness linked to radiation treatments. Moreover, breast reconstruction surgery is fully covered by medical insurance.

Breast reconstruction timeline

Breast reconstruction can be performed immediately – right after a mastectomy or lumpectomy, or it may be done several months or even years later. Surgeons may recommend waiting until radiation and chemotherapy treatments have finished to achieve optimal results. This is because radiation can alter the appearance, feel and texture of a reconstructed breast. Some studies suggest that reconstructed breasts can reduce the efficacy of radiation therapy. In situations like these, patients may be advised to wait 6, 8 or even 12 months before having breast reconstruction surgery.

Women who undergo a mastectomy to reduce a statistically high risk of breast cancer (as was the case with Angeline Jolie), usually have immediate reconstruction with either saline or silicone implants alone or in combination with tissue transplanted from another body part.

The timing and type of breast reconstruction method used is an important aspect that should be discussed with your breast cancer surgeon, oncologist and plastic surgeon.

What to expect following breast reconstruction

Whether reconstruction is done using an autologous or “flap” method or solely with breast implants, patients should understand that their new breasts will not look or feel like their original ones. And like any surgical procedure, there are potential complications to take into consideration. Bleeding, infection, edema, blood clots and adverse reactions to anesthesia are immediate risks.

Women who have reconstruction with breast implants will face the long-term risk of capsular contracture, where hard scar tissue forms, and implant rupture.

Compared to reconstruction with saline or silicone implants, flap reconstruction with autologous tissue (harvested from the stomach, thighs or back) is a longer surgical procedure. Possible risks with this method include partial or complete loss of sensation of the breast tissue, and necrosis of the transplanted tissue.

Breast reconstruction recovery

Post-operative swelling and discomfort are normal after breast reconstruction, and may continue for several weeks. Elastic compression garments can help reduce inflammation while healing continues. Depending on the reconstruction technique, patients may be sent home with small tubes to drain off excess fluid. Oral medications are often prescribed to help reduce risk of infection and manage pain.

The skin over the reconstructed breasts will regain some sensation over time, though it may never be exactly as it was before surgery.

Although surgical scars will never completely disappear, they will fade considerably within one to two years. Strenuous activities and overhead lifting should be avoided for up to 6 weeks after reconstruction surgery. Recovery time will vary from one patient to the next, but most women are back to their normal routines within two months of breast reconstruction surgery.