Breast Reconstruction

Breast Reconstruction (Mastectomy)

Breast cancer is the second most common cancer in the United States after skin cancer. It is estimated that as many as one in eight women will experience invasive breast cancer at some point in their life.

Partial or full breast removal (lumpectomy or mastectomy) is just one of the treatment options for women who are suffering from breast cancer. A full mastectomy is also an elective procedure for some women, who are at significantly increased risk of developing breast cancer and choose it as a preventative measure.

For many women, their breasts are a significant part of their identity. Breasts are considered a mark of femininity, help to balance out a woman’s curves and give them the freedom to wear particular styles of clothes. They can also enhance a woman’s confidence.

Breast reconstruction can restore the shape and confidence of a breast cancer survivor, or those who have undergone trauma to the breast area. Dr. Malcolm Lesavoy is a board-certified plastic surgeon with the knowledge, skill, and experience to deliver breast reconstruction surgery to patients in Beverly Hills and the surrounding area.

Types of Breast Reconstruction

  • Implant Reconstruction: Implant reconstruction involves placing silicone or saline implants under the skin. Silicone implants are pre-filled and available in a range of sizes, while saline implants are inserted empty and then filled to the desired size.
  • Flap reconstruction: Flap reconstruction uses tissue from another part of your body to construct your new breasts. The tissue usually comes from areas where there is excess fat such as the buttocks, stomach or thighs. Flap reconstruction is usually considered to be more complicated of a technique, and carries a higher grade of scarring than implant reconstruction.
While most mastectomy patients are medically appropriate for reconstruction, many at the same time that the breast is removed, the best candidates are women whose cancer, as far as can be determined, seems to have been eliminated by mastectomy.

Still, there are legitimate reasons to wait. Many women who are coping with the diagnosis of cancer aren’t comfortable weighing all the options yet. Other women simply don’t want to have any more surgery than is absolutely necessary. Some patients may be advised by their surgeons to wait, particularly if the breast is being rebuilt in a more complicated procedure using flaps of skin and underlying tissue. Women with other health conditions, such as obesity, high blood pressure, or smoking, may also be advised to wait.

In any case, being informed of your reconstruction options before surgery can help you prepare for a mastectomy with a more positive outlook for the future.

You can begin talking about breast reconstruction as soon as you’re diagnosed with cancer. Ideally, you’ll want your breast surgeon and Dr. Lesavoy to work together to develop a strategy that will put you in the best possible condition for reconstruction.

After evaluating your health, Dr. Lesavoy will explain which reconstructive options are most appropriate for your age, health, anatomy, tissues, and goals. Be sure to discuss your expectations frankly with Dr. Lesavoy. Dr. Lesavoy will be equally frank with you, describing your options and the risks and limitations of each. Post-mastectomy reconstruction can improve your appearance and renew your self-confidence – but keep in mind that the desired result is improvement, not perfection.

Dr. Lesavoy should also explain the anesthesia he will use, the facility where the surgery will be performed, and the costs. In most cases, health insurance policies will cover most or all of the cost of post-mastectomy reconstruction. Check your policy to make sure you’re covered and to see if there are any limitations on what types of reconstruction are covered.

Your oncologist and Dr. Lesavoy will give you specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding certain vitamins and medications.

While making preparations, be sure to arrange for someone to drive you home after your surgery and to help you out for a few days, if needed.

You are likely to feel tired and sore for a week or two after breast reconstruction. Most of your discomfort can be controlled by medication prescribed by Dr. Lesavoy.

Depending on the extent of your surgery, you’ll probably be released from the hospital in two to five days. Many reconstruction options require a surgical drain to remove excess fluids from surgical sites immediately following the operation, but these are removed within the first week or two after surgery. Most stitches are removed in a week to 10 days.

Scars at the breast, nipple, and abdomen will fade substantially with time, but may never disappear entirely.

It could take up to six weeks for you to recover from a combined mastectomy and reconstruction or from a flap reconstruction alone.

If implants are used without flaps and reconstruction is done apart from the mastectomy, your recovery time may be less.

Reconstruction cannot restore normal sensation to your breast, but in time, some feeling may return. Most scars will fade substantially over time, though it may take as long as one to two years, but they’ll never disappear entirely. The better the quality of your overall reconstruction, the less distracting you’ll find those scars.

Follow Dr. Lesavoy’s advice on when to begin stretching exercises and normal activities. As a general rule, you’ll want to refrain from any overhead lifting, strenuous sports, and sexual activity for three to six weeks following reconstruction.

Very often, your reconstructed breast may feel firmer and look rounder or flatter than your natural breast. It may not have the same contour as your breast before mastectomy, nor will it exactly match your opposite breast. But these differences will be apparent only to you. For most mastectomy patients, breast reconstruction dramatically improves their appearance and quality of life following surgery.
If you only have cancer in one breast, then you may have chosen to have a single mastectomy, which only removes the affected breast. Single breast reconstruction is extremely common.

Dr. Lesavoy has the skill and experience to be able to reconstruct your new breast, so it looks and feels symmetrical to your natural one.

Nipple reconstruction takes place in a separate surgery that usually occurs a few months after your breasts have been reconstructed.

This gives them time to heal into their new, permanent shape, so you can be sure that the nipple placement looks natural. Nipple reconstructions are usually performed by manipulating a small part of the skin on your newly reconstructed breast.

Unfortunately, a mastectomy severs the nerves that provide sensation to the breasts. This means that your reconstructed breast and nipples will not have any feeling. However, they will look and feel completely natural.

Many women are understandably devastated by the loss of their breasts and want to undergo reconstructive surgery as soon as possible.

While it is possible to have reconstructive surgery at the same time as a mastectomy, you might be advised to wait until your treatment program is complete, if you require additional cancer treatment such as chemotherapy or radiotherapy.

Dr. Lesavoy will always strongly recommend that you take the advice of your oncologist before deciding to have your breast reconstruction surgery.

If you have had, or are schedule for, a lumpectomy or mastectomy, you don’t have to live without your curves forever. A breast reconstruction can restore your shape and help you feel feminine, sexy, and like yourself again. Want to learn more about the benefits of breast reconstruction with Dr. Lesavoy? Schedule a consultation today at 888-537-2869.

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