Breast Reconstruction Surgery for Cancer Patients

I’d like to delve into a topic that holds both personal and professional significance for me: breast reconstruction surgery for breast cancer patients. My mother’s own journey with breast cancer has given me a unique perspective on the challenges and decisions faced by many women. 

Breast Reconstruction: A Personal Connection

My mother’s breast cancer diagnosis was a pivotal moment in our lives. While she’s currently doing well, she wasn’t a candidate for breast reconstruction. Instead, she uses a prosthesis, which can be cumbersome, especially during the sweltering summer months. Her experience has deepened my empathy and understanding for patients navigating similar paths.

Exploring Your Reconstruction Options

When considering breast reconstruction, I present my patients with two primary approaches: using implants or their own tissue. Both methods come with their advantages and challenges.

1.Implant-Based Reconstruction: This procedure is relatively quicker, often taking about three to four hours, especially if done concurrently with the mastectomy. Both the breast surgeon and the plastic surgeon collaborate in this process. The timing of this surgery can vary based on your breast cancer treatment stage.

2. Tissue-Based Reconstruction: This method, which uses your own tissue, is more time-intensive. For an average patient, the surgery can span six to eight hours, especially if performed alongside a mastectomy.

Recovery Insights

Post-surgery hospital stays differ based on the chosen method. Tissue-based reconstructions typically require about a three to five day  hospitalisation, while implant-based procedures might need one to three days. The duration also depends on your mobility post-surgery and our assessment of when it’s safe for you to return home.

Recovery from an implant-based reconstruction usually spans two to three weeks, and you might still have drain tubes post-operation. On the other hand, tissue-based reconstruction has a more extended recovery period due to additional scars from the donor tissue sites.

As for resuming activities like driving, tissue-based reconstruction patients might need three to four weeks before comfortably getting in and out of a car unassisted. Implant-based reconstruction patients often find this transition quicker, given the overall faster recovery.

Weighing the Implications

Choosing the right reconstruction procedure is a deeply personal decision, influenced by various factors, including potential long-term effects and future surgeries.

Implants, being foreign objects, won’t mimic natural breast tissue behaviour. For instance, they won’t change with weight fluctuations, potentially making them more noticeable. In contrast, tissue-based reconstructions behave more organically, adjusting with weight gains or losses. However, some patients might lean towards implant-based reconstructions due to the quicker recovery and fewer scars.

Implications for Initial & Subsequent Surgeries

Implant-Based Surgery: What to Expect

Implant reconstruction often aligns with the mastectomy, allowing for a silicone implant to be inserted during the operation. However, in some scenarios, we might first introduce a tissue expander to gently stretch the skin, preparing it for a silicone implant in the future. This approach means two surgeries instead of one. Factors like radiation therapy or chemotherapy can influence the implant’s timing and the potential need for future surgeries.

Post-implantation, a scarring process called capsular contracture might develop around the implant, possibly necessitating further surgeries. Typically, in cancer patients, this may occur  five to ten years after the initial implant placement. It’s essential to understand that while many patients might require revision surgery within this timeframe, individual experiences vary.

Tissue-Based Surgery: A Different Approach

Tissue-based reconstruction usually begins with a significant operation, followed by smaller procedures to refine the breast’s appearance, addressing minor imperfections. Creating a new nipple is an additional step, performed after the primary breast formation. This reconstruction unfolds in multiple stages. Some patients opt for tissue-based surgery to avoid multiple operations later in life.

Choosing the Right Path for You

Deciding on the best surgical approach is deeply personal. Some individuals lean towards implant-based reconstruction, valuing a shorter hospital stay and a swift procedure. This choice often resonates with those eager to resume their daily routines, whether it’s returning to work, caring for their families, or managing their businesses.  If you are a relatively lean individual, there may not necessarily be enough tissue from donor sites to create a new breast, making an implant the most favourable option for you.

Conversely, others gravitate towards tissue-based surgery, preferring a natural approach without the prospect of future revision surgeries.

Your reasons for choosing one method over another are uniquely yours. Remember, you’re not alone in this journey. As your surgeon in this process, I’m here to help you determine the best fit for your body and desired outcomes. Our shared goal is to ensure you’re content with your decision.

If you’re contemplating breast reconstruction surgery or planning your mastectomy and wish to explore future options, I’d be honoured to discuss this with you. Let’s embark on this journey together. To connect with me, please request a consultation.