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Breast reconstruction
Breast reconstruction is a type of surgery for women who have had a breast removed (Mastectomy). The surgery rebuilds the breast so that it is about the same size and shape as it was before. The nipple and the darker area around the nipple can also be added.
 
Immediate or delayed breast reconstruction is done at the same time as the mastectomy. An advantage to this is that the chest tissues are not damaged by radiation therapy or scarring. This often means that the final result looks better. Also, immediate reconstruction means less surgery.

Delayed breast reconstruction means that the rebuilding is started later. This may be a better choice for some women who need radiation to the chest area after the mastectomy. Radiation therapy given after breast reconstruction surgery can cause problems.
Decisions about reconstructive surgery also depend on many personal factors such as:
 
  • Your overall health
  • The stage of your breast cancer
  • The size of your opposite breast
  • The amount of tissue available (for example, very thin women may not have enough extra body tissue to make adequate sized grafts)
  • The size of implant or reconstructed breast

Breast reconstruction aims at restoring the shape of the breast though the feeling is not restored. With time, the skin on the reconstructed breast can become more sensitive, but it will not feel the same as it did before your mastectomy.
Procedure:

Anesthesia: It is performed under local anesthesia with sedation or general anesthesia.

Duration of procedure: Depending on the choice of reconstructive option:

  • If Implants are used it takes around 1- 2 hours.
  • If flap is used it takes around 2- 3 hours.
  • If free TRAM flap is used it takes around 4 – 5 hours or more.
 
The reconstructive options:

1.Implants: If there is enough good and durable skin cover then replacement of the breast with an implant is often the easiest and the preferred option. The most common implant is a saline-filled implant. It is a silicone shell filled with salt water (sterile saline). Silicone gel-filled implants are another option for breast reconstruction.

2.Tissue Flaps + Implant: Latissimus Dorsi Flap is taken, if there is not enough skin to cover the implant.

3.Tissue Flap: If the patient desires a natural tissue breast reconstruction then the following flaps can be used:

  • Latissimus Dorsi Added Fat Flap
  • TRAM (Tranverse rectus abdominal muscle flap).It can be a free flap or pedicle flap. Inpatient/Outpatient procedure: It is an inpatient procedure. Depending on the type of surgery, you will have to be in the hospital for1 to 7 days.
 
Inpatient/Outpatient procedure:
 
It is an inpatient procedure. Depending on the type of surgery, you will have to be in the hospital for1 to 7 days.
 
Recovery:
  • You are likely to feel tired and sore for a week or 2 after implants, and longer after flap procedures.
  • You should be up and around in 6 to 8 weeks. If implants are used without flaps, your recovery time may be shorter. Some things to keep in mind:
  • Reconstruction does not restore normal feeling to your breast, but some feeling may return.
  • It may take up to about 8 weeks for bruising and swelling to go away.
  • Follow Dr.Sharma’s advice on when to begin stretching exercises and normal activities.
  • You will have to avoid any overhead lifting and strenuous sports,for 4 to 6 weeks after reconstruction.
Duration Of Result:
 
Permanent. May be distorted if radiotherapy follows.
 
 
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