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What is it? Breast reconstruction is one of the most rewarding surgical procedures available today. When you have had your breast removed due to cancer or other diseases, your surgeon can create a breast that can be close in form and appearance to match your natural breast. Right Breast Reconstruction after mastectomy:
What does it accomplish? Breast reconstruction creates a breast that can be close in form and appearance to match your natural breast. What happens during the first consultation? During your first visit, Dr. Adams will evaluate your general health. He will explain which surgical techniques are the most appropriate, based on your desires, your body habitus and the condition of the breast. Dr. Adams will describe alternatives, risks, and limitations of each procedure. After the consultation, you will have the opportunity to view pre and post-op pictures. You will have pictures taken by our professional photographer. These are for your medical record to give you an optimal result. Dr. Adams' assistant, Christy, will give you fee information and work out insurance details. You will also be given a written pre and post op care plan and informed consent to review before signing and ask any further questions. How is it done? Breast reconstruction can be achieved by several surgical procedures; Dr. Adams will discuss your options and the surgical procedure that will give you the best result. Skin expansion is the most common procedure that combines skin expansion and the subsequent insertion of a breast implant. Following your mastectomy, your surgeon will insert a balloon expander beneath your skin and chest wall muscle. A tiny valve that is a part of your expander (under your skin) will require injections with saline (salt-water) that gradually fill your expander over several weeks or months. Once your skin over the breast area has been stretched enough, your expander will be removed in a second operation and a more permanent implant will be inserted. Your nipple and the dark skin surrounding it are reconstructed at a later date. Some patients do not require a tissue expander before receiving an implant, therefore your surgeon will insert your implant following your mastectomy.
Flap reconstruction is an alternative approach to implant reconstruction, when tissue expansion is not a consideration. This involves the creation of a skin muscle flap using tissue from your back or abdomen.
Latissimus flap surgery is when your tissue remains attached to its blood supply, creating a flap, consisting of skin, fat and muscle that will be positioned to make your new breast. This flap will be used from your upper back. This procedure may require either an implant or expansion with an implant.
Tram flap is another method that uses tissue brought up from your abdomen, either leaving it attached to is blood vessels or reattaching it to blood vessels in the chest area. These procedures are more complex than tissue expansion. Scars will be left at both the donor site and on your newly constructed breast. Even though the healing phase takes longer, your results are more natural and you have an added benefit of an improved abdominal contour.
What can I expect after surgery? Recovery time: You will feel tired and sore for 1-3 days following your surgery. You will be expected to stay in the hospital overnight, and will need help at home for several weeks. You will have limited physical activity for about 6 weeks. No lifting over 10 pounds for 4-6 weeks. No aerobic workouts or activities that can increase your heart rate above 100 beats per minute for three weeks. Your breasts need to be protected from stretching activities for at least six weeks to allow the incisions to heal. You will go home with pain medication and antibiotics. You may have drains that will require you to measure and record the fluid twice daily and reported to your surgeon and/or the nurse on your follow-up visit. You will be given information on what and when to report it during your recovery. A surgical bra will serve as the dressing with gauze on your incisions for 2-3 days. You may shower within 2-3 days, or after your drains are removed. You will be seen for follow-up sometime during the first week depending on status of drains. During this visit your post op care will be reinforced and changes made in your care if necessary. How many visits do I have after surgery? You will usually return to your physician' office 3-4 days following surgery for a check up and drain removal if necessary. Then you will return in 7-10 days for suture removal. You will return at approximately 3 weeks, 6 weeks, 3 months, 6 months and one year following your surgery. If you are having tissue expansion you will be returning weekly until the expander is stretched to the optimal size. Frequently following breast reconstruction, surgical revisions or secondary stages are necessary to complete this process. Your follow up visits will be based on your surgery type, recovery and healing. Am I a good candidate? Your visit with your surgeon will determine if you are a good candidate. If you are in good physical and mental health plus your breast surgeon has approved the timing for your breast to be reconstructed. You and your surgeon will discuss which type of breast reconstruction will be best. What does the surgery cost? You will be quoted a price to include your surgeon's, hospital, and anesthesia fees. Breast reconstruction is usually covered by insurance and the surgeon's secretary will assist in coordinating insurance approval and payment. How do I pay for surgery? You will be responsible for your deductible, percentage and co-pay and arrangements will be made with you by the physician's office. Are there scars? Any time an incision is made, a scar results. Your incisions are placed in areas to make your scars least noticeable. Your surgeon will discuss the placement of your incisions during your first visit. Does it hurt? It is not uncommon for you to have discomfort; however, you will have plenty of pain medications for your discomfort after surgery. Please tell us of all your drug allergies. Some pain medication may cause nausea, this should not be considered an allergy. All pain medication will cause drowsiness and therefore you should not drive and or operate equipment while on the medication. Will I be awake during surgery? Breast reconstruction is done under general anesthesia. You will be entirely asleep for this surgery monitored closely by an anesthesiologist. Where is the surgery performed? Your surgery will be performed in the hospital and you will be staying at least 2-3 days, depending on the type of reconstruction done. Are medical photographs taken? Photographs are taken during your first visit with your surgeon. These photos are essential to help your surgeon better assess your breast in planning your surgery. They will also be used for insurance purposes. Photographs will be taken after surgery at about 6 weeks to demonstrate the outcome. What medications should I avoid? You should avoid or be off all diet or over the counter weight medications. The only homeopathic medications are those recommended by Dr. Adams. It is especially important to be off St. John's Wort and Ginseng, which can cause adverse effects during anesthesia. Please stop taking all aspirin-like products, Advil, and ibuprofen as these medications can cause bleeding problems. Please tell Dr. Adams what medications you are on (prescription or non-prescription) to ensure the safety of any surgery.
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For further questions or to schedule a consultation call 214-965-9885 or email Dr. Adams. Dallas plastic surgeon offers plastic surgery procedures - forehead lift, browlift, breast augmentation using saline breast implants, silicone breast implants, cohesive gel breast implants, Gummy-bear breast implants, liposuction, rhinoplasty and more to Dallas, Ft. Worth, Austin, Houston and surrounding areas.
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