Your Breast Reconstruction Surgery
When choosing breast reconstruction surgery, it’s important to understand how it works and how the process will affect your daily life.
Preparing for Breast Reconstruction Surgery
About Your Surgery
Breast reconstruction is typically performed in three separate stages. Each stage is generally performed three months apart. From start to finish, breast reconstruction at El Camino Health takes approximately six months to complete.
When a breast is removed due to cancer, the first stage of reconstruction can be delayed or performed at the same time as the initial cancer surgery. For immediate first-stage reconstruction, your El Camino plastic surgeon collaborates with your surgical oncologist for optimum safety and cosmetic results. For delayed reconstructions, surgery is performed entirely by plastic surgeons. Recovery from the first stage may take anywhere from two to six weeks, depending on the operation performed.
The goal of the second stage is to finalize the shape and size of the breast. Stage two surgery can be completed as an outpatient procedure, with no overnight hospital stay required. In the case of a unilateral (one breast) reconstruction, the goal is to match the remaining breast. Sometimes, a “symmetry operation” is needed, in which the uninvolved breast must be lifted, reduced or enlarged to match the reconstructed breast.
If you've opted for synthetic implant reconstruction, the second stage is when the tissue expander is exchanged for the final silicone. At this stage, your surgeon will remove any excess tissue.
During the second stage, your surgeon can perform autologous fat grafting to enhance the contour of your breast and improve overall symmetry. For women who’ve opted for complete autologous fat grafting for reconstruction, there may be several small operations needed to optimize the final outcome. At El Camino Health, these operations are performed as outpatient procedures and have a relatively easy recovery.
The third stage, nipple-areola complex (NAC) reconstruction, isn’t performed until the final breast shape and size are achieved. This is an outpatient procedure that can usually be done under local anesthesia. Once the nipple reconstruction fully heals, the areola is tattooed during an in-office procedure.
The first stage of breast reconstruction is always the biggest procedure with the longest recovery. Most women feel tired and sore for several weeks after surgery, and your doctor may prescribe medications to ease discomfort. Your plastic surgeon will give you specific instructions for postsurgical care. Depending on the surgery, you may go home from the hospital with a surgical drain in place. If so, you'll get instructions on how to care for the drain. You may also need to wear a special bra while you heal. Refrain from overhead lifting, strenuous sports and sexual activity for four to six weeks after reconstructive surgery. Most women can resume normal activity within eight weeks.
You should plan to take some time off work and other daily activities after each stage of surgery. Recovery time varies according to the method of reconstruction used and your overall health. After the first stage of surgery, most women need one or two weeks to recover. Stages two and three may be safely performed as an outpatient procedure and have shorter and easier recovery times — anywhere from five to 10 days.
Results of Your Surgery
For many women, breast reconstruction symbolizes the return to wellness at the end of a difficult journey. Some say they finally feel like themselves again. However, breast surgery may require a period of emotional adjustment.
It can help you feel more satisfied with your final results when you know what to expect in terms of:
- Bruising and swelling. Be prepared for postsurgical bruising and swelling that may take as long as eight weeks to go away.
- Scarring. Most of the scarring will fade over time, but some scars may remain.
- Appearance. It’s important to remember that a reconstructed breast won't look or feel exactly the same as a natural breast. In addition, your remaining natural breast may change shape with age and weight changes, making the reconstructed breast look or feel less natural.