The diagnosis is usually sudden, allowing no time for adjustment. A woman may be faced with choosing a body-altering surgical procedure in order to save her life. Since most women compare themselves to a cultural idea of beauty, they may feel self-conscious, awkward and uncomfortable about changing their appearance.
Dr. Roger Orsini performs breast reconstruction procedures for patients in Maryland, Delaware and Washington, DC. Once you have been diagnosed with breast cancer, you should start thinking about your reconstructive surgery.
During your consultation with both Dr. Orsini and your oncologist, you will be explained the type of breast cancer you have and they will review your treatment options with you. You may be shown before and after photographs of patients who have had a similar procedure.
Which surgery is for me?
The type and extent of your breast cancer diagnosis combined with the treatment planned will impact your surgical choices. Many doctors prefer to perform a breast conserving surgery called a lumpectomy when possible. However, in many cases, a mastectomy is the only option. Some women choose to have a mastectomy for prophylactic reasons. Others may require some adjustments to the healthy breast to maintain symmetry. For some, multiple procedures will be required. In addition, some reconstructive options offer superior results when performed at the time of the mastectomy.
There are two basic breast reconstructive procedures: tissue expansion with implants and flap reconstruction.
Tissue expansion followed by implants is the most common procedure. Tissue expanders are like balloons. They are placed beneath your skin and chest muscle following your mastectomy. During the next several months, your surgeon will gradually fill them with a saltwater solution. This will cause them to expand. Once the skin over the breast area has stretched enough, the expander will be removed and replaced with a permanent implant. Implants have the most realistic feel of all reconstructive procedures. Today, implants come in a multitude of sizes and shapes. Saline implants are filled with a saltwater solution and have a silicone shell. Silicone implants are available in controlled test centers.
Flap reconstruction uses tissue taken from other parts of the body to create a flap. The tissue is usually taken from the abdomen, the back or the buttocks. Regardless of which type of flap procedure you and your surgeon choose, this type of reconstruction is more complex than tissue expansion. However, the results can be more natural when your new breast is created entirely from your own tissue.
How many procedures will I need?
Breast reconstruction usually involves multiple procedures performed over time. The first procedure is usually the most complex. Some patients may require an additional procedure to remove the tissue expander and insert the implant. Others will need an additional procedure to complete the nipple and areola reconstruction.
After Dr. Orsini performs your breast reconstruction surgery, you may decide, like many patients, to have an additional procedure to change your natural breast to match the reconstructed breast.
What is recovery from surgery like?
Depending on the surgical option you choose, you may have to stay in the hospital for a few days. Immediately after surgery, you will feel tired and sore. Your new breast(s) will be swollen. Drains and stitches may be in place for about a week. Scars will fade over time. Most discomfort can be controlled with medication. You should avoid any lifting or strenuous activity as well as sexual activity for 3 - 6 weeks following your reconstructive procedure. In addition, you may be asked to wear a binder or girdle during the healing process to decrease the possibility of hernias.
How will I look after my surgery?
It is very difficult for a surgeon to guess exactly how your reconstructed breast will heal. What size or shape it will be when the swelling subsides and the healing is complete is hard to say; sometimes scar tissue and swelling will cause a breast to be misshapen. The use of shells, shapers and push-ups in your bra can restore the most balanced figure possible.