Reconstruction

What is breast reconstruction?

Following a mastectomy or lumpectomy, many women are choosing to look into options for breast reconstruction.  Most aspects of this surgery are covered by the benefits of OHIP.

There are two types of reconstruction:

  • Using tissue expanders and breast implants.
    Or
  • Transferring a patient’s own tissue (typically from the lower abdomen or the back) to the chest wall to reconstruct a breast.

Breast reconstruction is a process that often takes 1 year from consultation to completion.  There are multiple stages to surgery including revisions, nipple creation, and tattooing an areola. Dr. Eckhaus will discuss with you whether you are a candidate to undergo breast reconstruction at the time of mastectomy.  Breast reconstruction can also be done at any time thereafter. To improve breast symmetry, a balancing surgical procedure (i.e. breast lift, breast reduction, or augmentation) is often done on the opposite breast.

Your initial consultation will focus on the many factors involved in this decision and determine what available options best meet your individual objectives. 

The Surgery

Because there are so many options for breast reconstruction surgery, it is difficult to make generalizations regarding all the surgical details.  Below is a brief surgical overview for two common options.

Tissue expander/breast implant surgery:

This is usually completed in two stages. 

The first stage involves placing a balloon-like empty tissue expander under the chest wall muscles.  Three to four weeks after surgery the expander is filled with saline (in small amounts over 4 or 5 visits to the outpatient clinic over 2-3 months) to allow slow stretching of the tissue.  This stretching ultimately creates an appropriately sized pocket for the final breast implant. 

The second surgery is performed four to five months after the first procedure, and involves the exchange of the initial tissue expander for a permanent breast implant.

Each surgical procedure is performed under a general anesthetic and takes 1.5-2 hours. Unless a mastectomy was done at the same time, there is no overnight stay required.

Breast reconstruction involving a patient’s own tissue:

This may be achieved in one or two stages, depending on the specifics of the individual case.  The detail of this procedure is reviewed at length in your consultation.  These procedures are done under general anesthetic and take between 3-5 hours.  You will require a 1-2 night stay in hospital.

 

After Your Surgery

Tissue expander/breast implant surgery:

Some things to expect following your surgery:

  • If a mastectomy was performed at the same time, there will be drains in place to remove excess fluid. 
  • A compression garment is worn for two weeks and the dressings are changed daily. 
  • Patients typically require 1 week of downtime after each stage.

Breast reconstruction involving a patient’s own tissue:

Some things to expect following your surgery:

  • Drains will be put in place to remove excess fluid. 
  • Following a 1-2 night stay in hospital, homecare nurses are organized to manage the drains and daily dressings. 
  • Patients typically require 4 weeks of downtime.

**The details of the post-operative care will vary depending on the procedure and therefore will be discussed in detail at the time of your consultation.