Building hope after mastectomy: Breast reconstruction

What is Breast Reconstruction (B.R.)?

The complete or partial rebuilding of the breasts of a woman, who has previously had a mastectomy to treat breast cancer, is called breast reconstruction. The reconstructed breasts are created similar to normal breasts, in shape and size. In case you have undergone a double mastectomy, you can choose to recreate both breasts.

Why undergo breast reconstruction?

There are various ways in which breast reconstruction improves the quality of life for former patients of breast cancer. Breast reconstruction nullifies the need to wear a breast form, a false breast or prosthesis and also strengthens the sense of femininity in the mind of the woman. While there can be many reasons for choosing B.R., the main idea is that it lessens the trauma that a patient goes through, after the operation (mastectomy) and allows her to get back to her normal life, more comfortably. However, it’s perfectly normal if some of you feel that you do not desire to undergo a further procedure after your mastectomy and decide to use breast forms instead. What matters is that you do what you feel is right for you.

Facing reality

You must understand that your breasts will feel different, after you get them reconstructed. They would not have any sensation and may not move like your natural breasts. Your doctors will do their best to make sure that your breasts suit you; and if you are getting only one breast reconstructed, they will try to ensure that both look alike; however, there is a possibility that the shape, size or position of the breasts may not be perfect. While most of the women are delighted after the surgery, there are others who feel upset and disappointed.

“Someday, we'll control breast cancer. We'll know how to prevent it or turn it off, and mastectomy will become obsolete. Until then, reconstruction is our best antidote to losing a breast.”- an excerpt from the book 'The Breast Reconstruction Guidebook: Issues and Answers from Research to Recovery'.

Weighing the pros and cons

The pros: If you get a breast reconstruction, you do not need to wear prosthesis and you’re body would look much like it did, before the mastectomy. The arrival of reconstructed breasts is often accompanied by oodles of confidence and an increased feeling of sexuality.

The cons: The surgery would need you to stay at hospital and then inside your home for longer, to ensure proper healing. Breast reconstruction is not a one-time thing; you might need to undergo two or three surgeries within a year, to get your breasts to look alike. It is also possible that you may not be very happy with the outcome of the surgery. Also, as mentioned earlier, you will not have any sensations in your new breasts.

Choosing the time

During a mastectomy, either the whole breast or a certain part of breast tissue is removed. You can seek and receive breast reconstruction immediately and in sync with your mastectomy. If you want to give yourself some time to decide, you can do it in the next few months or even years (delayed reconstruction). Know that breast reconstruction will not increase the probability of recurrence of the cancer and the ability to trace any cancerous tissue in your new breast, is same after the breast reconstruction, as after the mastectomy.

Knowing the techniques for Breast Reconstruction

Make sure that you are informed about the different ways in which the breasts can be reconstructed. Often, there is more than one operation involved in breast reconstruction. This will take place over a span of 6 to 12 months. You will have to go through a separate operation if you decide to rebuild a new nipple for your breast. Your reconstructed nipples will reach their final shape by this time. If you have had only a part of your breast removed (lumpectomy), then you could choose not to undergo a full breast reconstruction. There are ways in which you can better the shape of your breasts after the operation. Check out the options available at various hospitals and approach the one which you feel most comfortable about. Before you give your consent, get as much information as you can, about the form and extent of surgery you will undergo, the merits and demerits of the B.R and possible complications or side effects it might have.

Types of Breast Reconstruction

There are three types of B.R:

1. Reconstruction using a breast implant: When you use a breast implant alone, it will be placed below your skin and muscle in such a manner, that it creates a breast-like shape.
2. Reconstruction using your tissue: While using your own tissue, your new breast will be made from skin, muscle or fat obtained from another part of your body. This operation is more complicated than the former one.
3. Combination of both an implant and your tissue: The combination of both the above methods, involves constructing the shape of the breasts using both the skin and implant.

Which technique should you choose?

Your doctor will recommend the method of B.R. most appropriate for you. It will be determined by the following factors:

1. The amount of breast tissue removed
2. The healthy tissue present on your breast and other parts of the body (which could act as donor sites)
3. The method practised during the treatment of the cancer (radiotherapy etc.)
4. The size and shape of your breasts
5. Most importantly; your likings.

Needless to say, the general condition of your health and body will also play a significant role in deciding which technique to use.

Recovery after the Breast Reconstruction

Immediately after the surgery, your reconstructed breasts will be blanketed with dressings. It is also possible that the wound is clenched with plastic strips, which will be removed, once the wound heals. Once the dressings are removed, you can lightly wash the wound with fresh and clean water. When you dry the region, simply caress the wound softly; do not rub. After the wound heals completely, you can shower and bathe normally. You should use slightly warm water and non-perfumed soap to cleanse and wash the wound. Talk to your doctor about all this, before you leave the hospital.

First look: Initially, your reconstructed breast might seem larger than your natural breast. This is because of the inflammation that usually occurs after the surgery. Gradually, over a few weeks or months, the breast will get smaller.

Skin care:Do not scratch on the skin in the wound region, even if it feels itchy. The itchiness will diminish as your recovery proceeds. It will take about 6 to 7 weeks for the wound to completely heal.

Recovery time: Depending on the type of B.R. surgery you’ve undergone, your recovery period in the hospital will vary. If you have had an immediate reconstruction, you might have to stay for longer. You will feel pain the region after the surgery for a few weeks. The degree of pain varies from patient to patient. You can get pain-killers prescribed, in case you feel intense pain. Your recovery will involve physiotherapy, which will ease the discomfort you might feel on the side where the surgery has been performed.

Care-taking: It is normal to feel really tired during the first few weeks of staying home after surgery. Have someone around to take care of you for a few days. After about 5 to 6 days, you can begin to perform light activities. Do not do any straining work, like heavy-lifting, until you get your surgeon's permission.

Post-recovery concerns: Once your wound heals completely, apply a non-cosmetic body cream on the skin in the wound region and the donor site, once a day. This will keep your skin moisturized and healthy. If you have scars on your skin, do not worry; they will slowly fade away. The duration for this, depends on your skin type (usually, 18 months to 2 years).