Breast reconstruction is a procedure designed to recreate a natural-looking appearance in one or both breasts following mastectomy. Coping with breast cancer can be a tumultuous and confusing time for many patients who may be unsure how to contend with their diagnosis. The choice to undergo breast reconstruction is extremely personal and while not all individuals affected by breast cancer feel the procedure is right for them, reconstructive breast surgery can help some patients lessen the emotional and psychological impact of a unilateral or bilateral mastectomy.
Dr. Karan Chopra, our compassionate board-certified breast reconstruction surgeon, understands that each patient has unique reasons and goals for their breast rebuilding procedure. He is committed to supporting you during the different stages of your breast reconstruction and walking you through every step of the process.
Considerations Before Breast Reconstruction Surgery
According to medical research, breast reconstruction can have proven psychological benefits for some patients after they have undergone breast cancer removal surgery. Before choosing to undergo breast reconstruction, there are a few things to keep in mind about the process:
- Patients can begin their reconstruction at the time of mastectomy (immediate breast reconstruction) or at a later date (delayed breast reconstruction).
- A recreated breast does not exactly look or feel like a natural breast. Sensation in the breast(s) may come later or disappear altogether after reconstruction. The true goal of reconstructive surgery is to diminish the physical, emotional, and psychological impact of losing one or both breasts.
- Breast reconstruction may require multiple stages or procedures to achieve the best possible outcome.
- Patients should consider whether they are up to making decisions about their breast reconstruction while they are being treated for cancer.
Dr. Chopra will help you understand every aspect of your breast reconstruction after he meets with you in a consultation. If you decide breast reconstruction is right for you, he will develop an effective treatment plan to achieve as close to a natural breast appearance as possible.
Breast Reconstruction Options
There are generally two types of breast reconstruction: autologous reconstruction using your own tissue, or implant-based reconstruction. In certain cases, combining both techniques along with other procedures, such as fat transfer, can help yield the most aesthetic result.
Tissue Flap Breast Reconstruction (Autologous Reconstruction)
Tissue flap reconstruction aims to rebuild the breast mound in one or both breasts by using a patient’s own tissue from another part of the body. The benefits of autologous techniques when compared to using an implant include a more natural look and feel, as well as a long-term result. Unlike an implant, the rebuilt breast(s) should proportionately change with future weight gain/loss and the transferred tissue should last a lifetime.
There are different flaps used during autologous breast reconstruction, such as:
- TRAM: uses muscle, skin, and fat from the abdomen
- DIEP: similarly harvests tissue from the abdomen, but transfers skin and fat only
- Latissimus Dorsi: transplants muscle, skin, fat, and blood vessels from the upper back to the chest, often when patients do not have adequate donor tissue on the abdomen
- SGAP: borrows skin, fat, and blood vessels from the upper buttocks/hips, or “love handles”
- PAP or TUG: relocates tissue from the inner thighs, although TUG flaps consist of fat and muscle while PAP flaps only harvest fat
The best type of graft for your reconstruction will depend on the location of donor tissue available and the desired breast size. Since flaps require healthy blood vessels to successfully restore the breast(s), not all patients are good candidates for tissue-flap reconstruction. Factors that will be taken into account when creating your treatment plan include a past history of tobacco use, diabetes, or poor blood circulation.
Breast Reconstruction With Implants
Implant-based reconstruction uses saline or silicone breast implants to replicate a proportional breast appearance, often resulting in less downtime and discomfort than an autologous procedure since the need to operate on a donor site is eliminated. In a process similar but not identical to breast augmentation, patients work with their surgeon to select the most ideal size, shape, and type of implant(s) for their needs. A tissue expander is sometimes used to stretch the skin and muscle of the chest to make room for the implant(s). If only one breast is being reconstructed, complementary breast surgeries such as a breast lift or reduction can help achieve symmetry between both breasts.
You may consider implant-based reconstruction in cases wherein:
- There is not enough donor tissue to perform flap-based reconstruction
- You prefer less surgery and/or a relatively faster recovery when compared to a tissue flap procedure
- You would like to avoid incisions on other parts of the body
- You do not mind the possibility of future surgery to replace/exchange your implants
- Radiation therapy is not part of your cancer treatment plan
At Gryskiewicz & Chopra Twin Cities Cosmetic Surgery, Dr. Chopra places the implant(s) on top of the chest muscle in a prepectoral breast reconstruction procedure. This can reduce the pain of surgery as well as shorten the time to full reconstruction and recovery when compared to a submuscular placement (under the chest muscle). Studies also show that prepectoral reconstruction can also lead to higher rates of patient satisfaction after the breast(s) is rebuilt.
What is Recovery After Breast Reconstruction Surgery Like?
Each person’s treatment plan to rebuild their breast(s) will differ, so the recovery period will similarly vary from patient to patient based on the techniques utilized. Most individuals can be discharged from the hospital after a few days. Drains are usually placed after the procedure to collect fluid from the incision sites as they heal; Dr. Chopra or a nurse on our team will show you how to empty and care for your drains, as well as your incisions. They will also give you information on how long you should wear any post-operative compression garments. We encourage you to walk around, stand, and ambulate as soon as you can comfortably manage doing so.
Most patients can fully resume normal activity in eight weeks, although it should be noted that autologous reconstruction often requires a slightly longer recovery period when compared to implant-based reconstruction since there are two wound sites that need to heal. You will receive non-opioid pain medication to help you manage any discomfort during recovery. While most swelling should subside after approximately two months, it can take up to one year for all tissues to fully heal. You should avoid exercise, strenuous activity, and heavy lifting for four to six weeks or until Dr. Chopra instructs otherwise. We will monitor your progress through regular follow-up appointments at our Minneapolis practice.
Contending with life after breast cancer surgery can be difficult, but breast reconstruction can make it possible for some patients to restore their self-image and achieve a sense of balance or wholeness after mastectomy/lumpectomy. Please contact our practice to schedule a consultation with Dr. Karan Chopra, or to learn more about your breast reconstruction options.