All Plastic Reconstructive Surgery
carries some uncertainty and risk
Virtually any woman who must lose her breast to cancer can have it rebuilt
through reconstructive surgery. But there are risks associated with any
and specific complications associated with this procedure.
In general, the usual problems of reconstructive surgery, such as bleeding, fluid collection,
excessive scar tissue, or difficulties with anesthesia, can occur although
they're relatively uncommon. And, as with any surgery, smokers should be advised
that nicotine can delay healing, resulting in conspicuous scars and prolonged
recovery. Occasionally, these complications are severe enough to require a
If an implant is used, there is a remote possibility that an infection will
develop, usually within the first two weeks following
reconstructive surgery. In some of these
cases, the implant may need to be removed for several months until the infection
clears. A new implant can later be inserted.
The most common problem, capsular contracture, occurs if the scar or capsule
around the implant begins to tighten. This squeezing of the soft implant can
cause the breast to feel hard. Capsular contracture can be treated in several
ways, and sometimes requires either removal or "scoring" of the scar tissue, or
perhaps removal or replacement of the implant.
Reconstruction has no known effect on the recurrence of disease in the breast,
nor does it generally interfere with chemotherapy or radiation treatment, should
cancer recur. Your surgeon may recommend continuation of periodic mammograms on
both the reconstructed and the remaining normal breast. If your reconstruction
involves an implant, be sure to go to a radiology center where technicians are
experienced in the special techniques required to get a reliable x-ray of a
breast reconstructed with an implant.
Women who postpone reconstructive surgery may go through a period of emotional
readjustment. Just as it took time to get used to the loss of a breast, a woman
may feel anxious and confused as she begins to think of the reconstructed breast
as her own.
Planning your surgery
You can begin talking about reconstruction as soon as you're diagnosed with
cancer. Ideally, you'll want your breast surgeon and your plastic surgeon to
work together to develop a strategy that will put you in the best possible
condition for reconstruction.
After evaluating your health, your surgeon will explain which reconstructive
options are most appropriate for your age, health, anatomy, tissues, and goals.
Be sure to discuss your expectations frankly with your surgeon. He or she should
be equally frank with you, describing your options and the risks and limitations
of each. Post-mastectomy reconstruction can improve your appearance and renew
your self-confidence -- but keep in mind that the desired result is improvement,
Your surgeon should also explain the anesthesia he or she will use, the facility
where the surgery will be performed, and the costs. In most cases, health
insurance policies will cover most or all of the cost of post-mastectomy
reconstructive surgery. Check your policy to make sure you're covered and to see if
there are any limitations on what types of reconstruction are covered.