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Chapter 9
Questions For You and Your Plastic
Surgeon
1. Does breast reconstruction interfere
with other treatments (for example, chemotherapy or
radiotherapy)?
Both treatments can start fairly soon after the reconstruction;
however, a slight delay may be necessary to allow the surgical
wounds to start healing. Neither therapy is made less effective
by the breast reconstruction.
Radiotherapy for cancer prior to the breast reconstruction can
affect the quality of the remaining skin. This may mean you will
need a tissue transfer or tissue expansion operation.
2. Does the breast implant cause cancer?
No. Medical research to date does not indicate that the implant
causes cancer.
3. Will a recurrence of breast cancer be
hidden after the breast is reconstructed?
Normally, a local recurrence is first seen in the skin of the
chest or the scar tissue left behind after the operation. Both
of these areas can usually be seen or felt by your doctor during
your follow-up examinations. Tissue transfer techniques may be a
slight hindrance to physical examinations, as new skin and
muscle are brought to the chest. Continued follow-up
examinations by your physician will help to detect any changes.
4. Will my reconstructed breast feel
normal?
The gel or saline-filled implant matches the breast tissue that
has been removed in weight, size, and consistency. The breast
may remain soft or become firmer than the day it was restored
due to capsule formation. Fat within tissues transferred may
atrophy or become thinner causing a change in breast
consistency. Keep in mind that breasts normally feel slightly
different from side to side and from woman to woman.
The new breast skin will feel normal to the touch, but some
areas may feel numb. This is due to the mastectomy which removed
or cut many of the nerves leading to the breast. Likewise, the
new nipple and areola will look and feel normal to touch, but
lack in most sensitivities.
5. Will the new breast look exactly like
the one which was removed?
No, it would be almost impossible to exactly copy the removed
breast, but in many cases a close match can be obtained.
6. Is the recovery period lengthy or
painful after reconstructive surgery? |
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Depending upon the method used, various physical restrictions
may be placed upon you. In general, no strenuous activities can
be performed for at least three weeks from the time of the
reconstruction to allow for initial healing to take place. Most
women notice some stiffness and soreness in the operated areas,
which is short-lived and usually relived by mild painkillers and
local therapy (e.g., stretching). When combined with the
mastectomy, the sub-muscular implant or tissue expansion
reconstruction does not cause additional discomfort. Tissue
transfer may cause additional discomfort in the donor site.
Any further limitations, as well as individual information on
what to expect after the operation, should be fully discussed
with your surgeon before the reconstruction.
7. Do I need nipple and areola
reconstruction?
The final stages or finishing touches are entirely up to you.
Many women are very satisfied to have just the breast mound,
while others feel that the nipple/areola transforms the mound
into a visual breast. There is no need to make this decision
until the breast has settled in.
8. Is it always necessary to alter the
opposite breast?
Once again, you are an active participant in the decision to
operate upon the other breast. In many instances uplifting,
reducing, or enlarging this breast will allow for better
symmetry between the two breasts.
9. With immediate reconstruction, is the
hospital stay prolonged over that of the mastectomy alone?
The recovery time is usually about the same; however, this will
depend upon the type of reconstruction and if there are any
associated complications.
10. Is the breast implant easily broken or
damaged?
Both the gel and saline-filled implants are surrounded by a
strong silicone envelope. Under normal conditions they do not
break. In the rare case of the implant leaking, rupturing or
deflating, it may be substituted for a new one, usually without
affecting the previous results.
11. Does capsule formation around the
implant or expander have any effect on the reconstruction?
Every man-made prosthesis is surrounded by scar tissue. This is
the body’s way of isolating it. In some cases the scar tissue
becomes overabundant causing the implant to feel harder than
normal. If firmness or distortion of the breast becomes a
problem, then the capsule can be surgically broken.
12. What is the most common type of breast
reconstruction?
The placement of an implant below the chest muscles after the
mastectomy can give very pleasing results if there are adequate
healthy tissues present. Individual selection for this and every
other type of restoration procedure is critical. The options
available for your particular situation should be thoroughly
discussed before the reconstruction takes place.
13. Will I ever view the reconstructed
breast as my own?
Studies show that within months of the surgery women begin to
assimilate their new breast into their own body image and soon
thereafter feel it is their own.
14. Do my expectations about the breast
reconstruction play a role in my satisfaction level?
Definitely. Having a realistic idea of what to expect and
knowing that the new breast will never be an exact duplicate of
the one removed will assist in your satisfaction.
15. Are most women pleased with their
results and if given the opportunity would they do it again?
The vast majority say that they would undergo either immediate
or delayed reconstruction again. Having the ability to wear
normal clothing and not constantly being reminded of the cancer,
by a flattened chest, has helped them adjust to the mastectomy.
16. Will I still be able to have a breast
reconstruction if I did not consult a plastic surgeon before my
mastectomy?
The availability of breast reconstruction does not depend on the
length of the interval between the mastectomy and your decision
to have reconstruction. It is determined by your health and the
quality and amount of tissues remaining after the mastectomy. A
discussion with your surgeon beforehand, however, will enable
planning of the breast reconstruction and possibly allow for
immediate reconstruction.
17. Is breast reconstruction available
from the National Health Service?
Yes. If you have had or are going to have a mastectomy as cancer
treatment, you are entitled to a free breast reconstruction from
the National Health Service. Alternatively, if you prefer, there
are surgeons who will do reconstructive surgery privately.
One must be responsible for one’s own well being. I hope that I
have assisted you in your quest and that you will continue to
seek out those answers that will benefit your recovery.
Jeffrey S. Rosenthal, M.D.
Chief, Section Plastic Surgery Bridgeport Hospital
Private Practice-Cosmetic Surgery
Diplomat, American Board of Plastic Surgery
Copyright© 1986 Written BACUP (England) Modified 2008 Norma F.
Pfriem Breast Care Center |
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