Breast cancer in itself brings about a whole list of emotional and physical attributes – even without the added cosmetic concerns of a potential breast removal. There is no denying the multi-faceted complexities of undergoing a mastectomy or lumpectomy. Breast reconstruction surgery is performed to replace either one or both breasts that have been removed as a result of a mastectomy. It can be performed at the time of a mastectomy or scheduled at a later date. Dr. de Kleer also corrects lumpectomy defects. Breast reconstruction is an extremely rewarding area of plastic surgery since it can restore a sense of completeness and confidence for cancer survivors.

Treatment

Oakville Plastic Surgery and Advanced Skincare is committed to providing the highest level of care and safety to its patients. Plastic surgeon Dr. Nancy de Kleer will thoroughly assess your condition and take into account important factors such as your medical history, your previous or ongoing breast cancer treatments, available tissues, and your personal preference when selecting the appropriate course of surgical treatment. Surgical procedures are performed in a fully accredited surgical facility. The administration of a general anaesthetic will be discussed and explained prior to your procedure.Our team of highly skilled professionals take every measure to ensure you’re fully informed and prepared for both pre- and post-surgical care.

How it works

There surgical techniques used to reconstruct breasts include: prosthetic implants, autologous reconstruction (patient’s body tissue) and fat injection. Treatment suitability will be discussed during your consultation. Implants will most likely require the use of a tissue expander (a surgical procedure) prior to the implant placement. This expander will help ensure there is room for the implant and promote a more natural-looking result. Autologous reconstruction uses your own body tissue from a donor site (such as the abdomen) to reform the mastectomy site and shape a new breast.

Option 1: Post-mastectomy breast implant surgery

Breast implant surgery post-mastectomy is often composed of two stages: an expander and an implant. A tissue expander is a balloon-like pouch made of silicone that is surgically placed under your chest muscle. After about two weeks (the time it takes for the incision to heal) small amounts of saline will be injected into the expander at one to two week intervals until the desired size is achieved; this can take a couple months depending on the desired implant size.

Because of the complexities and uniqueness of each post-mastectomy patient, the incisions and surgical method may vary. In each case, the breast expander is removed and replaced with the chosen implant. The surgery takes around one to two hours depending on the complexity of the reconstruction. The breast implant surgery itself is an outpatient procedure, meaning you will be able to go home the same-day as your surgery. Recovery for the entire procedure (both tissue expander and implant surgery) can take a couple months.

Option 2: Post-mastectomy autologous reconstruction surgery

There are many advantages to choosing breast reconstruction with natural tissue in terms of the look and feel of your natural breast. The size, fullness and shape of the new breast can be closely matched to your other breast (in the case of a single mastectomy). Autologous reconstruction uses your own body tissue from a donor site (such as the abdomen) to reform the mastectomy site and shape a new breast – this includes skin, fat and muscle along with its blood supply.

Breast reconstruction with natural tissue is more complicated than a breast implant surgery. The areas of your body undergoing surgery will include the breasts and the donor site (usually abdomen or back). This makes for a longer surgery time, longer hospital stay and longer recovery period. Patients are expected to stay in the hospital for a three to five days with a return to normal activities (including work) commencing around week six to eight post-treatment. Because of the complexities and uniqueness of each post-mastectomy patient, the incisions and surgical method may vary. There are a variety of different ‘muscle flap’ techniques that can be used to reform the breast. These will be discussed during you consultation with Dr. de Kleer.

Recovery

Depending on the type of procedure performed, the hospital stay can range from one to five days. Normal activities are generally resumed after a period of six weeks. Redness, bruising and swelling are to be expected for two to three weeks after surgery. Supportive garments and pain medication will help to relieve discomfort and support healing. A mastectomy and reconstruction can result in feelings of numbness and/or tightness where the surgery was performed, which should diminish after a few weeks. There will be surgical scars after a breast reconstruction procedure, but every measure is taken to minimize their visibility. Dr. de Kleer will help you establish reasonable timelines and expectations for recovery.

For more information about breast reconstruction surgery, we encourage you to visit the Canadian Collaboration on Breast Reconstruction.

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