Breast reconstruction is a plastic surgery that uses multiple techniques that attempt to restore a breast to a near normal shape, appearance, and size following mastectomy. If only one breast is affected, it may be reconstructed alone to match the remaining breast. In addition, a breast lift, breast reduction, or breast augmentation may be recommended for the opposite breast to improve the symmetry, size, and position of both breasts. Dr. Charles Hsu, a plastic surgeon in Beverly Hills, is always honored to be able to help his patients complete their healing with breast reconstruction surgery either during their mastectomy or after their treatment is complete.
Best Candidates for Breast Reconstruction
The patient had a mastectomy or is planning to have a mastectomy
The patient has completed cancer treatment and no longer has any medical conditions
The patient wants to restore their breast and body image
The first and foremost step is to get the cancer treated. However, it is common for patients to come in before their mastectomy to see all the options they will have after. Dr. Hsu will need to know which cancer treatment is being used because different treatments will change the treatment for reconstruction. After giving a thorough examination, Dr. Hsu will discuss how he and the patient the timeline and techniques needed for their breast reconstruction surgery.
The most popular type of breast reconstruction is implant-based reconstruction done either at the time of the mastectomy or later to create the breast mound. This is completed in two stages. Dr. Hsu will place a tissue expander implant in the breast so he can inject a little bit of saline every week or two weeks to gradually stretch out the tissue and skin. Once Dr. Hsu and the patient agree that enough volume exists with the expander, Dr. Hsu will then wait a couple of months to allow the skin to stabilize. The second step of the reconstruction is to take out the tissue expander and put in silicone or saline implants. Dr. Hsu will usually use the same incision site as the mastectomy to minimize scarring.
The second type of breast reconstruction is called natural or flap reconstruction. This is a more extensive operation that will require 2-7 days of hospital stay and is usually done in an academic medical center like UCLA or USC. One method of flap operations Dr. Hsu performs uses the tissue from the abdomen and moves it to create a breast with the patient’s own tissue. Another method is to take muscle from the back and swing it forward to create a breast.
Recovery and Post-Op
After the surgery, Dr. Hsu will wrap dressings around the breasts, which will remain there for the first week during healing. Patients will also need to wear a surgical bra for about a week to aid the healing process. It is not recommended that patients lift their elbows above the shoulders, but the arms can still be used for different things. Every patient will be given specific instructions. These instructions will include how to care for the surgical site following surgery, medications to apply for better healing, oral medications to reduce the risk of infection, and follow-up appointments that will be needed.
From Dr. Hsu
“The most important issue for breast reconstruction patients is really not the plastic surgery—it is the cancer treatment surgery that is performed by the general surgeon before I get involved. The primary focus should be on removing the breast cancer and maximizing the chance of long-term survival for the patient.
Nonetheless, breast reconstruction is very helpful in getting patients to feel more back to normal or whole again. This is what I’ve heard from many of the breast reconstruction patients that I’ve treated. Breast reconstruction has gone through multiple evolutions over the past few decades and there has been a significant increase in the number of reconstructive options. These options should be discussed in detail after a thorough assessment and examination by the surgeon. In my experience, surgery on the opposite side breast is nearly always performed as well, in order to maximize symmetry between the two sides.
Overall, I enjoy breast reconstruction very much because I think that it helps to restore form to patients who often are facing a difficult time, and it is very rewarding.”
Frequently Asked Questions
Nipple Reconstruction during Breast Reconstruction?
After the breast reconstruction procedure is done, patients can also have nipple reconstruction. The nipple is created by lifting up a little bit of skin and folding it upon itself, like origami, and the color can be filled in by a tattoo artist. The idea is to make the nipple look as close as possible to natural nipples, but patients should keep in mind that it won’t be perfectly the same. However, Dr. Hsu tries to make the new nipples as realistic as possible.
What is the chance of Breast Cancer re-occurence after surgery?
The rate of recurrence of cancer after breast reconstruction is very rare. In reality, cancer can spread to the skin and neighboring tissues, but the remaining tissue is so small that it’s not difficult to detect any sign of remaining cancer. As a protective measure, patients should remain in contact with their oncologist and be closely monitored.
Emotional side of Breast Reconstruction surgery?
It’s important that the patient feel ready for the emotional adjustment involved in breast reconstruction. It may take some time to accept the results of breast reconstruction. Breast reconstruction is a physically and emotionally rewarding procedure for a woman who has lost a breast due to cancer or other condition. The creation of a new breast can dramatically improve the patient’s self-image, self-confidence and quality of life. Although surgery can give patients a relatively natural-looking breast, a reconstructed breast will never look or feel exactly the same as the breast that was removed.