The primary aim of breast reconstruction is to restore both breasts, achieving a near-normal shape, appearance, symmetry, and size, particularly after mastectomy, lumpectomy, or addressing congenital deformities.

Is it right for me? 

Breast reconstruction is a personalized and unique procedure, and the decision should be made for yourself, driven by your own desires, rather than to meet external expectations or conform to an idealized image. Consider breast reconstruction if: 

• You are successfully managing your diagnosis and treatment.
• You do not have any additional medical conditions that may hinder healing.
• You have a positive outlook and realistic goals for restoring breast and body image.

It’s important to note that while breast reconstruction can effectively rebuild your breast, the outcomes can vary significantly:

• The reconstructed breast may not replicate the same sensation or feel as the original breast.
• Visible incision lines will persist on the breast, whether from reconstruction or mastectomy.
• Specific surgical techniques may leave incision lines at the donor site, typically in less exposed areas like the back, abdomen, or buttocks.

Your consultation is your time to ask the doctor about the procedure you’re considering, how he thinks it will work for you and any concerns you may have.

Questions to Consider:

• What is the simplest and safest surgery to help me achieve my goals?
• Are other options available?
• What results can I expect, and how long do the typical results last?
• Where will scars be located, and how noticeable will they be?
• Will scars fade over time, and how long will this take?

Your surgeon will:

• Discuss previous surgeries. 
• Assess your overall health, considering any pre-existing health conditions or risk factors.
• Thoroughly examine and measure your breasts, considering size, shape, skin quality, and the placement of nipples and areolas.
• Capture photos for reference.
• Discuss about your options.
• Provide recommendations for a tailored course of treatment.
• Discuss potential outcomes, risks, and any complications associated with breast augmentation.

After your consultation with the physician, you will meet with the practice manager to discuss procedure costs.

The effectiveness and safety of your breast reconstruction hinge on your open and honest communication during the consultation. Expect questions about your health, goals, and lifestyle, and feel free to openly express any emotions, whether it’s excitement or preoperative stress. Your plastic surgeon is here to address your concerns and ensure you feel confident and comfortable throughout the process.

There are several things to do prior to your procedure that will make your recovery as smooth as possible and ease your pre-procedure anxiety.

Your Pre-Op Checklist:

• Make sure you have arranged for someone to drive you to surgery and stay with you for a few nights.
• Consult with your surgeon and adhere to their instructions.
• Take prescribed medications or modify current medication as directed.
• Complete necessary lab tests within 30 days of your procedure.
• Cease smoking, alcohol consumption, and drug use.
• Refrain from taking aspirin, anti-inflammatory drugs, or herbal supplements to mitigate potential bleeding.

Day of Surgery:

• Be on time for your scheduled surgery appointment.
• Bring a companion aged 18 or older.
• Refrain from eating or drinking after midnight prior to your surgery.
• Use antibacterial soap for a thorough body wash before the procedure.
• Opt for loose, comfortable clothing that is easy to put on and remove on the day of your surgery.

Above all, adhering to your surgeon’s pre-surgery recommendations is key to a successful and swift recovery.

Anesthesia:

Medications are administered for comfort during surgery, with choices including intravenous sedation or general anesthesia. Your doctor will guide you to the most suitable option.

Flap Techniques:

• Reposition a woman’s own tissue to create or cover the breast mound.
• Depending on mastectomy or radiation effects, insufficient tissue may require a flap technique or tissue expansion.
• TRAM flap utilizes muscle, fat, and skin from the lower abdomen, either remaining attached or completely detached for breast reconstruction.
• Alternatives like DIEP flap or SIEA flap techniques may transfer skin and fat without using abdominal muscle.
• Other donor sites like buttocks or thighs (SGAP flap, TUG flap, PAP flap) may be considered.

Tissue Expansion:

• Stretch healthy skin to provide coverage for a breast implant.
• Implant-based reconstruction option for women not requiring breast radiation, allowing a less complex recovery.
• Requires gradual filling of the expander with saline over 1-2 months through an internal valve.
• Patient-controlled expansion at home may be possible with newer air-filled devices.
• Second surgical procedure needed to replace the expander if not designed as a permanent implant.

Surgical Placement of Breast Implant:

• An addition or alternative to flap techniques, implants may serve as a temporary placeholder during other breast cancer treatments.
• Saline and silicone implants available for reconstruction.
• Surgeon guidance on the best approach for individual cases.
• Reconstruction with an implant alone often involves tissue expansion.
• Direct-to-implant reconstruction may be an option for specific mastectomy cases.

Reconstructing Nipple and Areola, Breast Revision Techniques:

• Complete breast reconstruction involves various techniques for nipple and areola reconstruction, including folding skin and tattooing.
• Three-dimensional nipple-areolar tattooing may create a realistic appearance.
• Staged revision procedures may enhance outcomes, improving symmetry, using liposuction with fat grafting, and enhancing the donor site’s appearance.

Your plastic surgeon and/or their team will provide detailed explanations of surgery-associated

risks. Consent forms will be signed to ensure your full comprehension of the procedure and potential complications.

Some Flap Surgery Risks:

• Risk of partial or complete loss of the flap.
• Potential loss of sensation at both the donor and reconstruction sites.

Some Breast Implant Risks:

• Breast firmness (capsular contracture) and implant rupture are associated risks.
• Possibility of developing breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), primarily linked to textured implants.
• Association with systemic symptoms known as breast implant illness (BII), which may include fatigue, “brain fog,” muscle or joint pain, and rash.