Important Points About the Reconstructive Process
Information and communication is essential when it comes to what may affect your particular implant procedure, your recovery and your results. Be sure to discuss each of these factors with your physician:
- The stage of development of the cancer when it was discovered
- The follow-up treatment that you will require
- Your overall health
- Your chest structure and overall body shape
- Your healing capabilities (which can be affected by smoking, alcohol and various medications) – Smokers, or those exposed to secondhand s smoke, will be advised to eliminate exposure to nicotine immediately to reduce the negative effects on wound healing.
- Prior breast surgeries
- Bleeding tendencies
- Possible shifting of the implant
- Scarring from the incision
- Predisposition to develop a hardened capsule around the implant
– Reconstruction surgery is usually performed on an inpatient basis in an operating room, under general anesthesia, when it begins at the same time as your mastectomy. Patients can expect a 1- 2 night stay in the hospital.
– Some of the stages, such as nipple reconstruction, or placement of the implant after soft tissue expansion, can be done as an outpatient procedure.
– When Dr. Simon is involved in the breast reconstruction process, he will design the incision that will be utilized for the mastectomy or lumpectomy and assist the general surgeon in this portion of the surgery. The incision design will be determined to give each patient the best possible result. For example, in certain breasts, Dr. Simon may design the incision to effectively perform a lifting of the remaining skin and tissues to produce a better, more aesthetically pleasing final result. This type of cooperation between the plastic surgeon and general surgeon is essential to obtaining the best result possible both from the oncology standpoint and reconstruction side.
– Recovery – patients will be required to limit their activity level for approximately 2 weeks after surgery. Patients will typically be instructed that they may return to work after this time period. Most patients will be able to resume more strenuous physical activities, such as exercise, after period of six weeks. Often, patients will also be referred to physical therapy after a mastectomy by the general surgeon.
– Placement: A tissue expander is a balloon-like device made from elastic silicone rubber. To place the expander during a mastectomy, the general surgeon removes skin as well as breast tissue. To create a breast-shaped space for the breast implant, a tissue expander is placed under the remaining chest tissues (muscle and skin).
– The process: It is inserted unfilled or with a small amount of saline, and over time sterile saline fluid is added by inserting a small needle through the skin and into the tissue expander’s filling port. As the tissue expander fills, the tissues over the expander begin to stretch gradually. The tissue expander creates a new breast-shaped pocket for a breast implant. These expansions are performed in Dr. Simon’s office. The process starts within a few weeks of surgery and typically is continued every week or two until completion. The end point of expansion will be determined for each patient by Dr. Simon with consideration of the patient’s goals as far as breast size.