In the past ten years, major achievements have been made in breast reconstruction following mastectomy surgery. No longer do women need to face long, jagged scars that impact their self image. Instead, advanced techniques have given plastic surgeons the tools to rebuild a woman's breast in such a way that her silhouette is once again whole.
Women with breast cancer have two main considerations when considering reconstructive breast surgery -- when to have surgery and what type of surgery to have. All of the options below are available to patients who are good candidates and healthy enough for surgery.
Your breast surgeon and the breast plastic and reconstructive surgeon will help you decide which option is best for you:
A tissue expander will be inserted after mastectomy to keep the breast skin that was saved during the skin sparing mastectomy procedure stretched and supple in preparation for the final reconstruction, which will be done several months after radiation is completed.
A woman's breast can be reconstructed in one of two ways:
Most breast centers are still performing flap surgery the "old fashioned" way if they do not have surgeons with these skills. These older procedures (TRAM Flaps and latissimus dorsi flaps) result in the patient sacrificing either her abdominal muscles or her upper back muscles. While those procedures were the best options decades ago, today we know that there is a higher risk of hernia, weakness, abdominal bulging, and limits on physical activity with these older procedures. There are no physical limitations with the more sophisticated procedures performed at our Breast Center.
Federal and state laws require insurance companies to pay for all or part of the cost of breast reconstruction at any time after removal a patient's breast tissue. This includes any surgery required on the opposite breast for symmetry. Our staff is experienced in working with all major insurers for these procedures. We will work with you to keep your out-of-pocket expenses to an absolute minimum.
Please note: These are general guidelines and may not apply to every patient. Always follow your doctor's specific instructions for care after surgery.
You may be discharged from the hospital after breast cancer surgery with an external drainage device in place. The drain will continuously remove fluid from the surgery site into an external collection device. You will be responsible for emptying it. Your health care provider will show you how to care for your drain before you are discharged from the hospital.
The amount of fluid that is drained over a 24-hour period will gradually decrease. The color of the fluid may also change from a cherry-red to a yellow-red, and then to a straw-colored fluid. Usually the drainage system is removed within one week after surgery.
After breast cancer surgery, your incision should be kept clean and dry for one week after surgery. Because of this, sponge baths are preferable to showers. You may bathe in a bathtub if you are able to keep the area dry. Small pieces of tape (called steri-strips) will remain over the incision site and can be removed between 10 and 14 days after surgery.
Do not go swimming until you have discussed this with your physician at your follow-up appointment.
You will be wearing a special bra (surgi-bra) that holds bandages in place after the surgery. Your doctor will tell you when you are able to stop wearing the bra. You should change the dressings once a day, but your health care provider will show you how to do this.
If possible, it's a good idea to have someone help you change the bandages as you lie in bed.
You will be given a prescription for pain medication after breast cancer surgery. Ask your doctor about taking over-the-counter pain relievers in addition to, or instead of, your prescription pain medicine. Do not take aspirin or products containing aspirin for the first three days after the procedure.
The area may be black and blue right after breast cancer surgery. This will go away in a few days. You may feel numbness, tingling, or discomfort on the inner part of your upper arm or in your armpit. This is normal. With your doctor's approval, try to increase your exercise routine and take a mild pain reliever such as Tylenol. A warm shower may also provide comfort, but remember to wait one week after surgery before taking a shower.
When shaving under your arm or applying deodorant, look in the mirror to avoid irritating the incision.
As the incision heals, it may feel thick and tough. You may massage the area with a mild lotion, vitamin E, or pure lanolin. Avoid highly perfumed lotions and any product containing alcohol, because they may be irritating. After several weeks, the scar will soften.
Exercising is important after breast cancer surgery. To regain mobility, perform these stretching exercises several times every day, starting the day after surgery.
Most women can resume driving 10 to 14 days after breast cancer surgery. Ask your doctor about specific recommendations for your situation.
Regular follow-up exams are very important after breast cancer treatment. Your doctor will continue to check you closely to be sure that the cancer has not returned. Regular checkups usually include exams of the chest, underarm, and neck. From time to time, you may have a complete physical exam, blood tests, mammogram, and a chest X-ray. Your doctor may order scans and other exams as well.
A woman who has had cancer in one breast has a higher-than-average risk of developing cancer in her other breast. You should continue to practice monthly breast self-exam, checking both the treated area and your other breast. Report any changes to your doctor right away.
It is best not have blood drawn, or an injection given, in the arm on the side of your body where you had breast cancer surgery. If it is necessary that blood be drawn -- or drugs given -- in this arm, be sure to tell the health care provider that you have had breast surgery.
When you go home from the hospital after breast cancer surgery, call your doctor if you have:
Last Updated: 7/15/2013