Breast Reconstruction Surgery

Breast reconstruction surgery is aimed at restoring the shape, symmetry and appearance of the breast after a mastectomy or lumpectomy. The journey to recovery after breast cancer can be emotionally challenging and this surgery serves as a beacon of hope for those seeking to regain normalcy. It's not just about aesthetics, but also about healing and getting past the disease. To consult with top-notch doctors about your options for breast reconstruction after mastectomy, contact Pristyn Care today or book an appointment for a comprehensive examination.

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What is Breast Reconstruction?

Breast reconstruction is a surgical procedure performed on women who have undergone a mastectomy or lumpectomy due to breast cancer. The objective of this breast reconstruction surgery is to recreate the breast to near normal shape, appearance and symmetry. The process involves using implants or body tissue to build up a breast mound. Performing this surgery does not interfere with future treatments or surveillance for breast cancer recurrence.

It’s an outpatient procedure which means you won’t have to stay in the hospital post-surgery. The surgery duration may vary based on individual bodies and the type of reconstruction method used. Similar to any surgical procedure, it comes with its share of risks and complications, but the end goal is to help women regain their body image and enhance their quality of life following breast cancer treatment.

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What Are The Types Of Breast Reconstruction?

There are several types of breast reconstruction surgeries, each catering to the different needs and circumstances of patients. Based on your individual needs, your doctor may recommend one of these:

Implant-Based Reconstruction: This technique uses saline or silicone implants to recreate the breast tissue. It often involves a two-stage process where a tissue expander is first placed under the skin or chest muscle which is then gradually filled with saline during periodic visits to the doctor. Once the chest tissue has healed enough, the expander is replaced with a permanent implant.
Flap Reconstruction: In this technique, the patient’s own body tissue is used to form a new breast. The tissue which includes skin, fat and muscle is taken from areas like the abdomen, thigh, back or buttocks. This method can be further divided into two types:
- Pedicled Flap: The tissue is cut from its blood supply but retains some attachments allowing it to be tunneled under the skin to the chest area.
- Free Flap: The tissue gets completely detached from its blood supply and then reattached to blood vessels in the chest area using microsurgical techniques. This method is often used in bilateral diep flap breast reconstruction.

Diagnosing Breast Cancer Before Breast Reconstruction Surgery

Before you undergo breast reconstruction surgery following a mastectomy, it’s crucial to diagnose the stage and extent of breast cancer. This involves a combination of different tests and procedures, including:

Physical Examinations: The doctor performs a physical examination checking for any lumps or abnormalities in both breasts and underarms.
Mammograms: These special X-rays of the breast help in detecting early signs of breast cancer that might not be noticeable during a physical examination.
Ultrasound Scanning: This is an imaging test that uses sound waves to create a picture of the breasts. It’s particularly helpful in distinguishing between solid tumours and fluid-filled cysts.
Magnetic Resonance Imaging (MRI): This scan uses a magnet and radio waves to create detailed images of the breast. It’s often used for women who are at high risk of developing breast cancer.
Biopsy: In this procedure, a sample of suspicious breast tissue is removed and analysed in a laboratory. It’s the only definitive way to confirm if cancer is present.

What Is The Procedure for Breast Reconstruction Surgery?

Breast reconstruction surgery is a significant step in the journey towards recovery following a mastectomy. Here’s an overview of what you can expect during this procedure:

Assessment of Eligibility: Not every patient is suitable for breast reconstruction. Your doctor will assess your overall health, the stage of your cancer, and your personal preferences to determine whether you’re a candidate.
Implant Reconstruction: This involves inserting saline or silicone breast implants beneath your skin or chest muscles. It usually requires two stages – firstly, placing a tissue expander that will be gradually filled, then implanting the permanent implant.
Flap Reconstruction: In this method, your own tissue, typically from your abdomen, back or thigh, is used to recreate the breast shape. The tissue flap is surgically attached to your chest with its own blood supply intact.
Recovery: The duration varies based on the type of procedure. It generally involves 1-2 days in hospital for implant-based reconstructions and about 5-6 days for flap reconstructions.

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Who Is The Right Candidate For Breast Reconstruction Surgery?

Determining whether you are a suitable candidate for breast reconstruction surgery involves considering several factors. Here are a couple of things the doctors would consider:

Health Status: Your overall health, including your ability to withstand surgery and recovery, is a crucial determining factor. Any pre-existing conditions that could potentially complicate the procedure will be factored into this decision.
Cancer Stage: The stage and nature of your cancer will also influence whether you’re an appropriate candidate for breast reconstruction. For instance, if your cancer is advanced or aggressive, immediate reconstruction may not be recommended.
Personal Preferences: Your personal wishes and lifestyle also play a significant role in determining your eligibility for this surgery. If you prefer not to have additional surgeries or are comfortable with your appearance post-mastectomy, you may opt against reconstruction.

What Are The Benefits Of Breast Reconstruction?

Breast reconstruction surgery is a transformative process, offering numerous benefits to women who have undergone a lumpectomy or mastectomy. Here are some of the key advantages:

Restores Confidence: Breast reconstruction after mastectomy helps restore the shape, size, and symmetry of the breasts, significantly improving body image and self-esteem.
Customisable Approach: The procedure can be tailored to meet each patient’s unique needs and objectives, facilitating a personalised treatment plan.
No Need for External Prosthesis: It eliminates the necessity for an external breast prosthesis or specialised bras, making daily life more comfortable.
Balanced Appearance: Especially if only one breast was affected by cancer, breast reconstruction surgery can help create a proportionate and balanced appearance.

How To Prepare For Breast Reconstruction?

Preparing for breast reconstruction surgery requires careful planning and a series of consultations. Here’s how you can prepare:

Consult a Plastic Surgeon: Before your mastectomy or lumpectomy surgery, schedule an appointment with a board-certified plastic surgeon experienced in breast reconstruction.
Discuss Options: Discuss all your reconstruction options including timing (immediate vs. delayed) and techniques (implants, flap surgery, fat transfer).
Health Check: Ensure you are generally healthy, a non-smoker, and have realistic expectations about the results.
Follow Pre-surgery Instructions: Adhere to your surgeon’s instructions before the operation, such as dietary guidelines and medication adjustments.

What Are The Recovery Tips and Precautions To Follow After Breast Reconstruction?

Recovering from breast reconstruction procedure necessitates patience and adherence to post-operative care guidelines. Below are some tips for ensuring a smoother recovery:

Expect Extended Recovery: Healing might take longer than anticipated. Potential complications like infection, bleeding, or tissue death can occur.
Physical Therapy: This may be recommended to improve strength and range of motion in the chest area after surgery.
Perform Breast Self-exams: Although the reconstructed breast may have diminished sensation, self-examinations can still be conducted.
Time Your Radiation Therapy: If radiation therapy is needed post-reconstruction, it’s crucial to schedule it strategically to avoid additional complications.

Potential Risks Or Complications Associated With Breast Reconstruction

Breast reconstruction, like any surgical procedure, involves potential risks and complications. These may include:

Sensation Changes: Changes in breast sensation or feeling can occur following the surgery.
Poor Wound Healing: There could be issues with wound healing, fluid accumulation, infection, or bleeding post-surgery.
Tissue Death: Necrosis, or tissue death due to insufficient blood supply, is a possible risk.
Abdominal Wall Weakness: If tissue is taken from the abdominal area for a technique like bilateral diep flap breast reconstruction, there could be potential wall weakness or hernia.
Additional Surgeries: There might be a need for more surgeries to correct problems related to breast reconstruction.

What Is The Cost Of Breast Reconstruction In India?

Breast reconstruction surgery is a procedure often undertaken by women who have undergone a mastectomy due to conditions such as breast cancer. In India, the cost of the surgery can significantly vary, typically ranging from Rs. 100,000 to Rs. 500,000. This wide range is influenced by several factors, some of which include:

Type of Surgery: There are different types of breast reconstructions like flap reconstruction and implant-based reconstruction. Flap reconstruction, which uses the patient’s own tissue to rebuild the breast, can cost between Rs. 30,000 to Rs. 100,000, while implant-based reconstruction may cost between Rs. 100,000 to Rs. 300,000.
Hospital Facility: The choice of hospital or clinic can greatly affect the cost of breast reconstruction surgery. Top-tier hospitals equipped with advanced technology and experienced surgeons might charge more as compared to smaller healthcare facilities.
Location: The cost of surgery might change based on the city or town. Metropolitan cities usually have higher-priced hospital setups as opposed to smaller towns or cities.
Surgeon’s Expertise: A surgeon’s experience and expertise play a significant role in determining the cost of the surgery. Surgeons with a high level of expertise and experience generally charge more for their services.

Is Breast Reconstruction Covered Under Insurance?

Yes, breast reconstruction surgery is covered under various health insurance policies in India. The government-sponsored Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) scheme includes coverage for breast reconstruction surgery for eligible beneficiaries, including women who have undergone mastectomy due to breast cancer.

However, the coverage and inclusions may vary based on the specific insurance plan and the hospital’s empanelment under the AB-PMJAY scheme. Some private insurance schemes also offer coverage for breast reconstruction procedures. However, it is vital to verify such coverage and any exclusions directly with your insurance provider.

It is important to remember that aside from mastectomy due to cancer, other medical situations requiring breast reconstruction might not be covered under certain insurance policies. Therefore, it is imperative to thoroughly understand the terms and conditions of your insurance policy and consult with your insurance provider prior to undertaking the surgery.

FAQs

1. What is the role of a breast reconstruction surgery after a mastectomy?

Breast reconstruction surgery after a mastectomy is an operative procedure aimed at restoring the shape and size of the breasts, to closely resemble your original breast form. It’s part of the overall treatment plan for individuals who have undergone a mastectomy, helping them regain self-confidence and maintain body symmetry.

2. What is bilateral diep flap breast reconstruction?

Bilateral Deep Inferior Epigastric Perforator (DIEP) flap reconstruction is an advanced form of breast reconstruction surgery. Here, skin and fat are taken from the lower abdomen to create a new breast mound, without cutting into abdominal muscles. This procedure can be opted for when both breasts need to be reconstructed and patients have sufficient tissue in their abdomen.

3. What is the timeline for completing a breast reconstruction surgery?

The timeline depends largely on the individual’s health, the type of mastectomy performed, and whether or not additional cancer treatments such as chemotherapy or radiation therapy are needed. Immediate reconstruction can be done at the same time as mastectomy, or delayed reconstruction might be chosen, commencing weeks, months or even years later.

4. Can I opt for breast reconstruction surgery after lumpectomy?

Yes, you can have breast reconstruction surgery after lumpectomy which is often referred to as ‘partial mastectomy’. The extent of surgery would depend on how much breast tissue was removed during lumpectomy.

5. How long does it take to recover from breast reconstruction surgery?

Recovery varies depending on the type of procedure performed and each individual’s overall health status. On average, it could take anywhere from 6 weeks to several months.

6. Will my reconstructed breasts feel different after the surgery?

Yes, reconstructed breasts will likely feel different from natural breasts, as the sensation in the skin and nipple area could be lessened due to nerve damage during mastectomy or reconstruction surgery.

7. Will I be able to breastfeed after breast reconstruction surgery?

The potential for breastfeeding depends on the extent of the mastectomy and the type of reconstruction surgery performed. If the milk ducts and nipples have been saved during mastectomy, breastfeeding could be possible, but generally it’s a challenge.

8. Can I have areola and nipple reconstruction as part of my breast reconstruction surgery?

Yes, nipple and areola reconstruction is often the final phase of breast reconstruction. This can be done using various methods including tattooing or surgical reconstruction using skin from other parts of your body.

9. How should I choose my plastic surgeon for a breast reconstruction surgery?

Choosing a skilled and experienced plastic surgeon who specialises in breast reconstruction is crucial. Look for a certified surgeon who communicates openly, understands your expectations, and can explain your options clearly.

10. How will the scars after a breast reconstruction surgery look like?

Scarring after breast reconstruction surgery is normal. The extent of scarring will depend on the individual’s healing process and the type of procedure performed. Over time, these scars will fade though they won’t disappear completely.

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