Recovery time for the second step of surgery, which entails inserting the permanent implant and removing the tissue expanders, often ranges from one to two weeks. The placement of the permanent implant is the end outcome of this surgical procedure. It is common practice to require patients who have had a mastectomy to take six to eight weeks off work before free-flap reconstruction can be performed.
Remember that every breast reconstruction procedure is tailored to the specific needs of the candidate. What works for one person undergoing breast cancer treatment, mastectomy, and reconstruction may not work at all for another person undergoing the same treatment. A number of factors, including age, health, body type, and personal preferences, should be considered while determining the best course of action for reconstruction.
It is crucial for patients to work together with their healthcare team to create a personalized treatment plan that meets their specific needs and goals. By acknowledging and valuing the individuality of each person’s journey, we can better assist and empower patients undergoing breast reconstruction.
/78653239-56a733f83df78cf77293495e.JPG)
2nd Stage Breast Reconstruction Recovery
Welcome to the second stage of breast reconstruction recovery! You’re on your way to getting back to you.
If you’ve been through the first stage, you probably have some questions about what’s next. Here are some answers that might help get you started:
-Your incisions will be healing and may be a little tender for a while longer, but they shouldn’t be painful anymore. Your surgeon will likely advise you not to lift heavy objects or do repetitive exercises like push-ups or bench presses for at least six weeks after surgery, but after that point, many women can return to their normal activities without restriction.
-You’ll likely have some numbness around your nipples and breast area; this is normal and should improve over time. Some women also experience swelling in this area as well as pain when they touch their breasts or nipples. If either of these symptoms persists, please contact your surgeon immediately so they can advise you on next steps.
-You may notice some discharge coming from your nipple or chest wall incision sites; this is normal and will go away within two weeks or so.
SURGICAL REQUIREMENTS
The second stage surgery will follow after the initial breast reconstruction, and the surgical technique will be dependent on which type of revision surgery is needed to recreate and reshape shape your breast(s).
This breast reconstruction surgery may require an overnight stay at the hospital or surgical center. Second stage surgery can also be completed at a later date, and/or postponed if the patient needs to have radiation therapy, or if her health declines before the scheduled surgery.
IN RECOVERY
Once you have had your second stage surgery, our recovery room nurses will help you manage your pain, monitor your progress, and maintain your incision care. You will also be shown how to care for your incisions properly to limit the amount of scarring from the surgery.
Rather than pain, most patients experience a dull ache for a couple of days following the breast surgery procedure. This is especially true if the implant has been placed underneath the muscle. Analgesics and muscle relaxants are prescribed for use, if necessary, and patients are required to wear a supportive bra day and night. Average procedure time is 2-3 hours with a recovery period of 1 – 6 weeks (including periods of breast tenderness). We have built our practice around evidence based improvements, assessed at the time of your follow-up visits. Strenuous activity should be avoided for a 6-week period, but light activity can sometimes begin as early as 4 weeks.
FOLLOW-UP & CONSIDERATION
Your plastic surgeon will discuss any specific risks or complications of breast surgery prior to the procedure. General risks with breast reconstruction are low, but patients should be made aware of minor bruising following the surgery, along with associated swelling and tenderness. Wound breakdown and infection can be a problem especially in tobacco users, or if aftercare and follow-up treatments are not adhered to properly. This could result in abnormal scarring. Specific, uncommon problems caused by the breast reconstruction surgery can include collection of fluid around the implant, wrinkles or ripples in the skin, loss in sensation in the breast and nipple area and contraction of the capsule where the implant is placed, tissue hardening, and flap loss. Any concerns or continuing discomfort following breast reconstruction should be addressed with the surgeon as soon as possible.
Plastic and Reconstructive Surgery
A Breast Reconstruction Remarkable Day
What happens during breast reconstruction surgery is procedure specific. The timing of breast reconstruction, whether it’s done right after a mastectomy or years later, is another consideration.
Two procedures, spaced several months apart, are typically necessary for immediate implant reconstruction following a mastectomy. The initial procedure involves your reconstructive plastic surgeon inserting an expander beneath the patient’s skin and onto or under the muscles that make up the chest wall. To aid in the drainage of fluid from surgical areas, your surgeon may install drains. An hour or two may pass during surgery. A day or two in the hospital is about right.
Even though free-flap breast reconstruction surgery consists of two parts, the processes are performed simultaneously. Reconstructive plastic surgery involves transferring tissues from the patient’s lower belly, buttocks, or thigh to the patient’s chest following a mastectomy. To aid in the drainage of fluid from surgical areas, your surgeon may install drains. A unilateral operation can take four to eight hours, whereas a bilateral operation can take much longer. Three days in the hospital is about right.
We transfer you to an intermediate care floor after surgery; this floor provides treatment that is between that of a standard surgical unit and that of an intensive care unit. Throughout your hospital stay, a nurse will check on you hourly for the first 48 hours, and then every two hours after that.
A New, Less Painful Breast Implant Procedure
Manahan and her colleagues perform a state-of-the art procedure called pre-pectoral breast reconstruction. It reduces pain and provides a speedier recovery compared with traditional reconstruction by placing implants or tissue expanders on top of the pectoral muscles. Since the muscles aren’t cut or stretched, you can return to your normal daily activities sooner. “Our patients are doing yoga and have full range of motion within the first month after the procedure,” Manahan says.
The pre-pectoral procedure is the most minimally invasive breast reconstruction option. Your doctor can perform a mastectomy by removing breast tissue through a small incision underneath the breast. Through this incision, a tissue expander can be placed on top of the muscle to create a breast mound. Later, your doctor can remove the expander through the same incision and insert an implant.
A Natural Alternative to Breast Implants
Although using implants lets you recover faster, not everyone likes the way they look or the prospect of needing future surgeries to replace them if they rupture. A natural alternative involves using fat and tissue from another area of your body to fill in your breasts.
In the past, doctors removed muscle, fat and skin from the abdominal wall, the back, the inner thighs or the buttocks and moved it to the chest to form breasts. This procedure was painful and had a long recovery. But now an updated technique lets you use your own tissue with less pain and faster healing. During this surgery, called a perforator flap procedure, your surgeon moves only skin, fat and tissue — not muscle — to your chest area. Not everyone is a candidate for this procedure, depending on anatomy and previous surgical history, but it’s a good option for some women.
Using your own tissue creates a more natural look. And you can also have a tummy tuck, thigh lift or buttock lift at the same time if you have tissue removed from those areas.
Traditional Breast Reconstruction
The majority of breast reconstruction procedures involve breast implants. In this traditional reconstruction procedure, saline or silicone implants are placed below the pectoral muscles, forcing them to stretch to accommodate the implants. “This method works for a good deal of people, but many women experience pain as well as decreased range of motion in the shoulder,” reports Manahan. “Over time, chest wall deformities from the implants can form as well.”
What to Consider Before Breast Reconstruction
There are several things you need to consider when reviewing reconstructive breast cancer options, says Manahan. What procedure is best for you depends on many factors, such as:
- Overall health
- Activity level
- What you do for a living?
- Whether you want to have children after surgery
- If you have the extra tissue needed for a natural reconstruction,
- How much post-surgery downtime are you comfortable with.
If you’re going to have a lumpectomy or mastectomy, consult with a plastic surgeon in addition to your breast surgeon. A plastic surgeon can provide guidance on the various breast reconstruction procedures and work in partnership with your breast surgeon to give you the look you want.
It’s okay to take your time to come to a decision, says Manahan. “You might not know if you want implants, or whether you want to use belly or thigh tissue, or if you’re going to need radiation. But you can still move forward with the mastectomy. We can insert a tissue expander to hold a breast-like form under your skin. Then, when you’re ready, we can remove the expander and reconstruct your breasts with either implants or your own tissue. What’s important is knowing there are many options for breast reconstruction, and consulting with your surgeon to find the best choice for you.”
Everyone and every body is different, reminds Manahan, and every patient has different preferences and goals. “We hope that the many choices we have to offer for breast reconstruction will allow us to tailor each reconstruction to each individual patient.”