When a woman receives the diagnosis of breast cancer, she and her family begin a confusing and overwhelming whirlwind tour of doctors’ offices and opinions. One decision that should be considered is whether she wants to undergo reconstruction of her breast or breasts.
Breast cancer is a complex problem with many options for treatment. Because of this, no two women have the same reconstructive needs. The general goal of breast reconstruction is to create an aesthetically pleasing breast that improves self-image and confidence. This goal can be accomplished by utilizing a number of surgical techniques.
At this time, federal law mandates that all insurance companies pay for breast reconstruction after mastectomy. Also included in this mandate is work on the opposite breast to improve the symmetry between the two sides.
At The Waldorf Center, we are large proponents of breast reconstruction awareness, and we are ready to help you through this difficult time in your life and support you in making some of these complex decisions. Throughout the process we hope to maintain, or to recreate, a positive body image for you, allowing you to move forward in life with confidence.
We believe you need to be well-informed about the reconstructive procedure in which you are interested, including the pre- and post- operative expectations. At your initial consult, the physician will meet with you about your concerns and personal goals. Feel free to bring in images of looks that you do or don’t like to help us understand your aesthetic tastes and goals. The surgeon will then examine you and offer her opinion on how to achieve your goals based on best practices.
Choosing a surgeon is an intensely personal decision. We encourage you to take time to question the physician and her team. We believe the formation of a personal bond is an integral part of the surgery and healing process.
Breast reconstruction typically involves a series of operations. Depending on the technique used, there may be one or more procedures to create and shape the ‘breast mound’ of the reconstructed breast. Symmetry procedures may also be performed on the opposite breast as needed. Finally, a reconstructed nipple is created during a minor procedure. The nipple reconstruction is later tattooed to create the surrounding areola.
To create the breast mound, the surgeon may utilize the patient’s own tissues and/or tissue expanders and breast implants. The most common tissues used to reconstruct a breast involve moving skin, fat, and muscle in the form of a “flap” from the back (latissimus dorsi flap) or from the lower abdomen (transverse rectus abdominis myocutaneous flap or TRAM). Breast reconstruction with tissue expansion is also an option. This option utilizes a temporary implant which stretches healthy skin over time to provide coverage for a breast implant. The decision on which path to take is determined by a number of factors. You and your physician will have an involved discussion to decide the best reconstruction path for you.
Most women are candidates for immediate breast reconstruction, which means the first stage of their breast reconstruction can be performed at the time of their mastectomy. This is often a positive way to continue moving on with life, while combining two operations. Some women decide to undergo a delayed breast reconstruction. This means that the first stage of their breast reconstruction would begin after fully healing from the mastectomy. Again, these decisions can be made with the help of your oncologist, surgical oncologist, and plastic surgeon.
The initial reconstructive surgery usually takes 2 to 4 hours of time, and is performed with general anesthesia. Most breast reconstruction patients will spend 1 or more nights recovering in the hospital before going home.
The time to recover will depend on the extent of reconstruction. Most women find they are able to resume a non-strenuous work or home schedule within 2 weeks. Most can return to strenuous activity levels in 8 weeks.
Breast surgery, as with all surgical procedures, carries a certain amount of risk. It is important that you understand these risks, and the possible complications or adverse events associated with surgery. Your surgeon will discuss the surgical risks with you during your consultation and pre-operative appointments.
Contact The Waldorf Center for Plastic Surgery in Portland, Oregon
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