Breast reconstruction surgery helps recover sense of wholeness after mastectomy
A woman with a breast cancer diagnosis will face intensive treatments on her journey to stop cancer. For some women, cancer treatment requires a body-changing mastectomy surgery.
Breast reconstruction after mastectomy is an important medical treatment available to women to help them restore an altered breast and regain feminine body identity. “Breast reconstructive surgery after mastectomy gives women options that help them recover a sense of wholeness for their body,” said Mark Gelfand, M.D., a plastics and reconstructive surgeon with Legacy Medical Group-Reconstructive Surgery.
Women whose treatment requires a mastectomy have a range of concerns. “Women are worried about deformity, scarring, the loss of their breast, and what they will look like afterwards,” he said. “An important part of my work is to reassure my patients that they have options available for breast reconstruction to make them feel whole and look good,” he said.
Breast reconstruction can be performed immediately after mastectomy or at a later time. “Most women in my practice want to have breast reconstruction right after the mastectomy,” said Dr. Gelfand. There are medical considerations and individual reasons to delay breast reconstruction. “Some women choose to delay breast reconstruction because they are worried about too much surgery at once, are concerned about the pain and recovery time, or they may be overwhelmed with too many decisions,” said Dr. Gelfand.
Surgical advancements have improved the approach taken with mastectomy surgery. Breast surgeons performing mastectomy are incorporating cosmetic surgery techniques–with the goals to save skin, hide the scars, and save the nipple. “The cosmetic goals with mastectomy, after removing malignant tissue, is to preserve as much skin and natural breast structure as possible,” said Gelfand.
Breast reconstruction normally requires two or three surgical procedures to complete. The initial surgery involves shaping the breast through mount reconstruction. The second stage—about three months later—is a symmetry procedure that focuses on making the breast symmetrical and to modify shape and size. If needed, a final stage is nipple reconstruction or nipple tattoo.
The approach for mount reconstruction involves either the use of a woman’s own tissue and fat taken from her abdomen or a tissue expander to create space for breast implant. The overall approach—whether to use a woman’s own tissue or an implant—depends on medical considerations and a woman’s preference on what will work best for her.
The two approaches have different recovery and healing time because of the type of surgical techniques used and impacts to the body. Dr. Gelfand finds that most women prefer implants because it’s a less intensive surgery with faster recovery. “Most of my patients prefer a shorter hospital stay and can’t take a lot of time off work for recovery from reconstruction surgery,” said Gelfand. Hospital stay with implant surgery on average is one to two days and recovery is days rather than weeks. He may guide clients with medical challenges or who are older toward implants because it’s the safest surgery for them.
A patient’s medical condition, the type and stage of breast cancer, and other cancer therapy requirements may make it medically necessary for a woman to have breast reconstruction using her own natural tissue, known as natural tissue flap technique.
Advancements in reconstruction surgery have improved recovery and reduced complications and impacts at the donor site of the abdomen. “The greatest improvement in flap reconstruction technique allows surgeons to spare all the muscle in the abdomen and just take the skin and fat for mount reconstruction, said Dr. Gelfand.
The natural-tissue approach for breast reconstruction is a more complex surgery than implant procedure because of the interventions that are necessary to remove tissue and fat from the belly to mold the new breast. The hospital recovery stay after surgery is four to five days on average. Recovery and healing from own-tissue surgery takes longer—about two to four weeks—because of the intensity of the procedure, for surgical site pain to subside, and for the tissue healing in the breast and abdomen.
Whether the approach is implants or own tissue, reconstruction surgery gives women options to recover a sense of wholeness and have natural looking breasts. “Most women want to have natural looking breasts after mastectomy, and reconstruction surgery provides options that gives a woman the breast structure and look that they desire,” said Gelfand.
Learn more about breast reconstruction options at Susan G Koman Breast Cancer Foundation.
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