Breast reconstruction after a mastectomy – your options. | Oakville Plastic Surgery – Dr. Nancy de Kleer

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Breast reconstruction after a mastectomy – your options.

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. To many, breasts are an external representation of femininity and their loss represents much more than fatty chest tissue. Breast reconstruction surgery can have a significant positive impact on self-esteem. It cannot replace what was loss (in the symbolic sense) but it has the ability to help a woman regain her self-confidence and move past the diagnosis. A breast reconstruction surgery can be one of the missing pieces of the healing puzzle.

BRA Day – October 15, 2014.

October 15, 2014 is Breast Reconstruction Awareness Day or BRA Day. This international one-week event includes a number of locally hosted events, bringing together some of the industry’s leaders in breast reconstruction surgery. Our very own Dr. Nancy de Kleer will be leading the surgical presentation at the Oakville/Mississauga BRA Day event on Tuesday October 21. Learn more about BRA Day and Dr. de Kleer’s participation by reading our previous blog post “October 15, 2014 is Breast Reconstruction Awareness Day | BRA Day.”

Breast reconstruction surgery at Oakville Plastic Surgery.

There are two types of breast reconstruction surgeries: prosthetic implants and autologous reconstruction (patient’s body tissue). 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.

Breast implant surgery – silicone or saline?

There are two main types of breast implants: cohesive silicone gel and saline. Both come in a wide variety of shapes and sizes and suitability will be discussed during your consultation. The main difference between the two is their filling. Silicone implants have a jelly-like consistency – giving them a natural soft feel. Saline implants have a silicone outer shell and are filled to the desired size with saline (salt water) during the surgery. Both implants are safe and approved by Health Canada.

Breast implant surgery – how does the expander work?

As mentioned above, 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; it’s like an empty saline breast implant. After about two weeks (the time it takes for the incision to heal) we will begin injecting small amounts of saline 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.

Breast implant surgery – what to expect?

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.

Autologous reconstruction – what’s the difference?

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). As mentioned above, 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.

Autologous reconstruction – what to expect?

Breast reconstruction with natural tissue is more complicated than a breast implant surgery. Two areas of your body will be undergoing treatment: the breast and the abdomen. 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.

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

The decision to have breast reconstruction surgery is a personal one. We want to make this important decision as comfortable as possible by answering any questions you might have and thoroughly walking you through your treatment options. If breast reconstruction surgery is something you’re considering, seek consultation with a plastic surgeon to learn more about your options.

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