Breast Reconstruction Procedure
Survivors of breast cancer have many options to consider when it comes to a breast reconstruction procedure. Some of the surgery options for breast reconstruction patients include:
- Breast Reconstruction with Implants
- Breast Reconstruction with tissue flap
- DIEP flap (Deep Inferior Epigastric Artery Perforator)
- SIEA flap (Superficial Inferior Epigastric Artery Flap)
- TRAM flap (Transverse Rectus Abdominis Muscle Flap)
- SGAP flap (Superior Gluteal Artery Perforator Flap)
- IGAP flap (Inferior gluteal artery perforator flap)
- Latissimus Flap
Breast reconstruction is technically demanding and requires additional training in microsurgical technique as well as muscle sparing flap dissection techniques. Therefore it is important to choose a board certified plastic surgeon who is very experienced.
Before Breast Reconstruction Procedure
- Medicines that contain aspirin or ibuprofen should not be taken during the two weeks prior to breast reconstruction surgery.
- Eat a healthy diet before and after surgery. This will help speed your breast reconstruction recovery time.
- Do not eat or drink the night before breast reconstruction surgery, unless instructed differently by your anesthesia provider.
- Do not wear make-up, contact lenses, jewelry, etc.
- Plan on staying in the hospital for two to four days after the surgery.
The Procedure
Breast reconstruction surgery typically takes four to six hours depending on the extent of procedure. The following description provides a basic overview of how the DIEP flap procedure is performed. Depending on the technique used by your surgeon, some of the steps described below may not apply to your type of surgery. For example, with a SGAP flap, fat and skin is taken from the buttocks whereas with the DEIP or SIEA flap it is taken from the abdomen.
During DIEP flap surgery, patients are given general anesthesia. Lower abdominal skin and fat are used in the reconstruction. The blood vessels are attached to blood vessels in the chest using an operating microscope and high magnification.
- After the patient is anesthetized, the surgeon follows the blood vessels through the abdominal muscle.
- The abdominal muscles are preserved in their original anatomic position.
- The abdominal tissue is removed from the body and transplanted to the area of the breast.
- The blood vessels are attached to blood vessels in the chest using an operating microscope and high magnification.
- Stitches are used to close the incisions, which may also be taped for greater support. A gauze bandage may be applied over your breasts to help with healing.
After Surgery
After the procedure, you will need to stay in the hospital for two to five days. Some patients may experience some numbness, bruising, swelling or discomfort at the incision sight. This is normal and will pass with time. Incision site pain is usually minimal, and can be controlled with medication, if necessary. Breasts will be bruised, swollen, and uncomfortable for at least a day or two. Plan on getting plenty of rest and allowing your body to heal.
Patients may also experience under-sensitivity, oversensitivity, or numbness in the breast skin. These symptoms usually fade as the swelling subsides over the next six weeks or so. In some patients, however, it may last a year or more, and occasionally may be permanent.
Breast skin may be very dry following surgery. You may apply a moisturizer several times a day, but be careful not to tug at your skin in the process, and keep the moisturizer away from the suture areas.
Breast Reconstruction Recovery
Most patients are back at work within two to four weeks after surgery but should continue to take it easy for six weeks. Any rigorous activities should be put on hold for several months. After that, most patients can start to resume these activities slowly. Throughout the healing period you should also avoid lifting anything over your head. Your breasts will probably be sensitive to direct stimulation for a few weeks so you should avoid much physical contact.