• 31 March 2014

What is a breast reconstruction?

A breast reconstruction is a surgical procedure that is used to recreate the appearance of one or both breasts that have been removed. It is done in order to create the breast shape and size that you had prior to a mastectomy or removal of the breast. Breast reconstructions

can also be performed if you have a lumpectomy, or a procedure to remove only a portion of your breast. The breast reconstruction will not repair any nerve damage done by the mastectomy and therefore the breasts will not have the normal sensations to touch. Typically, there is scarring with both a mastectomy and breast reconstruction surgery.

The reconstruction can take place using your own tissue to build a breast, or it can be an implant. Breast reconstruction also has the ability to repair and rebuild the nipple area in the event that it was also removed during the mastectomy.

Why are women having breast reconstructions in Miami, Florida?

Breast Cancer is a deadly disease that continues to affect lives in Miami, Florida. Over the last six years, there have been over 300 deaths due to breast cancer and almost 1,500 cases diagnosed each year in Miami, Florida. When one has such a tragic diagnosis, it is common to rid oneself of the disease by having a mastectomy performed. A mastectomy is when the entire breast is removed. Following a mastectomy, it is just as common to follow up with a breast reconstruction surgery as part of the recovery and healing process. Through breast reconstruction, no one in Miami, Florida will be able to tell a breast cancer survivor from your everyday, average woman. Surgeons have established a variety of surgeries to fit patient-specific needs. While the diagnosis of breast cancer is devastating and prevalent in Miami, Florida, it is comforting to know that South Florida has the surgeons available to perform breast reconstruction and maintain your femininity after recovery.

When deciding whether or not to have a breast reconstruction, it is important to make the decision based on your own needs. We all cope differently. Whether or not you choose to have a breast reconstruction is 100% up to you and is considered part of the coping process. It is also important to assess your overall health while making the decision. If you suffer from other chronic medical conditions, such as heart disease, obesity, or high blood pressure, it is better to consult with a medical team to determine if a breast reconstruction would complicate the overall steps to recovery.

Though related but done for completely different reasons, many people in Miami, Florida choose to have breast enhancement surgeries like breast augmentations and breast lifts. This is a rising trend among much of South Florida, including Miami for cosmetic purposes. According to the American Society of Plastic Surgeons, breast augmentation procedures have increased by nearly 70,000 surgeries since the year 2000. We have also seen a steady climb in the population of young celebrities making the decision to have breast augmentations. Celebrities such as Christina Aguilera, Fergie, and Heidi Montag are among the younger generation of stars who are doing what they can to stay looking young. Therefore, it is possible that with the rising trend in the media, more and more people are getting the urge to follow in their footsteps.

After pregnancy, many women are starting to crave their pre-baby body in Miami, Florida. This is another huge reason that people are having breast reconstructions. Sometimes, as a result of breastfeeding several children, your breast begin to sag or may require a nip and tuck to make them appear how you would like. Many women are having breast lifts and breast augmentations in order to get the breasts they once had while walking the streets of Miami, Florida.

These trends may in fact also be impacting the number of individuals who choose breast reconstruction because of societal pressures.

What are some risks that I might encounter during or after a breast reconstruction?

Much of the risks you face by undergoing a breast reconstruction in Miami, Florida depend on your current medical condition. Depending on your overall health, some people may be at higher risks for complications than others. An example would be current smokers. Smokers run a much higher risk for complications post operatively. This does not mean that you will never be able to have a breast reconstruction but it does mean that the medical team may opt to postpone the operation until your overall health is in a better condition. However, as with any surgery, there are risks.

When general anesthesia is used, you are put to sleep for the procedure. With this, there are risks, as always, but with correct use of equipment and a good medical team, complications are not expected during breast reconstructions.  Directly related to the breast reconstruction, you may experience bleeding or infection at the sight of the incision. As long as there is proper care, again, severe complications would not be expected. There is also a risk for a loss of sensation in the tissue used for the breast reconstruction. In the event that you have to have a skin flap graft performed, the sensation in the breast will not be present. Also, if you opt to have a silicone implant, there is a risk that you will have firm breasts after the surgery. Contrary to some beliefs, there is no risk for systemic complications with silicone breast implants. It was believed at one time that these breast implants could create further systemic conditions throughout the body, but that myth has been busted.

Regardless of the surgical procedure that is chosen, it is important to remember that you still will continue to age and your body will still continue to change over time. Therefore, your breasts will also continue to change with time. Sometimes, follow-up surgeries are necessary if you wish to maintain the shape and size that is accomplished immediately following surgery.

How can I prepare for a breast reconstruction?

Perhaps the most important part of preparing for a breast reconstruction is guaranteeing your own understanding. It is essential that you have all your questions answered prior to going into a breast reconstruction. Your mind should be at ease, knowing that this is the best option for you at the moment and you are in good hands. Everyone experiences very different emotions during this time so ensuring each step in the procedure is clear to you, you will wake up from surgery having exactly what you were expecting prior to surgery.

In preparation of the surgery, two weeks before the date of the procedure, you must discontinue use of medications that have a blood-thinning effect. These include, but are not limited to certain vitamins, aspirin, ibuprofen, Aleve, and Motrin. Smoking, and nicotine, makes for a risky healing process as nicotine will interfere with the blood flow to the surgical site. Therefore, smoking should be discontinued at least three weeks before surgery, and restricted for at least three weeks after surgery.

Because of the use of general anesthesia, you will not be able to get out on the Miami, Florida roads and drive yourself home after the surgical procedure. So, when preparing for a breast reconstruction, you should have a friend or family member committed to being able to drive you home after you are discharged from the hospital.

What are my options for breast reconstruction in Miami, Florida?

Basically, there are two options offered for a breast reconstruction: implants or autologous reconstruction.

If you choose to do a breast reconstruction using an implant, you then have three options of implants. Usually, the surgeon will be best at determining which type is the right fit for you. The first option is a saline implant that is covered with a silicone shell. The second choice is quite similar and also has the silicone shell. The difference is the inside of the shell; which in this option is a cohesive silicone rather than saline. Thirdly, there is a newer option known as a “gummy bear” implant which is filled with highly cohesive silicone. This option makes for a more natural looking breast down the road. Although it is possible to have the breast reconstruction performed during the same surgery as the mastectomy, typically, it is better to wait until the mastectomy has healed before performing a breast reconstruction. With that said, sometimes, due to personal preference and personal coping strategies, it is better to go ahead and do both surgeries at the same time.

The second option for a breast reconstruction procedure in the Miami area is an autologous reconstruction. Autologous is another word for “autograft” or “self graft”. With that said, an autologous reconstruction is where the mound is formed using your own tissue. The tissue can be removed from a variety of locations including the buttocks, abdomen, back, or inner thighs. Once this tissue is removed, it is constructed into a breast. Since this is your own tissue, some people feel it is the more natural approach to a breast construction.

What can I expect post operatively with a breast reconstruction?

Being part of the Miami, Florida community, I know we are all anxious to get back outdoors to enjoy the beautiful sunshine. But, as with any surgical procedure, it is important to take your time getting back into your daily routine. The recovering from a breast reconstruction varies widely, but for everyone, healing will occur for several weeks after the surgery. You should plan for a one or two day stay in the hospital, but after a day of bed rest, it is acceptable to begin moving around. You should be able to walk independently by the end of the second day post operatively. However, it is crucial to refrain from significant straining or heavy lifting for several weeks. You should not do anything that requires a lot of core body strength or straining at the incision sites while you are recovery. The associated pain should be well managed with the use of prescription medications.

While you are healing from a breast reconstruction, it is important to be aware of the signs of infection so you can personally monitor the incision sites and ensure that healthy healing is taking place. Any significant changes that occur should be relayed to your physician, but there are certain things that require immediate attention. Redness at the site is normal but if the redness begins to spread or begins to radiate heat, you should notify your physician. If you develop a fever, it is also a possible sign of infection and you should seek medical advice. It is also important to take note of any drainage that is coming from the incisions. If the drainage changes color or begins to put off a foul odor, you should tell you physician as this may be an indication of infection.

The fast pace of life in Miami sometimes makes it difficult to adhere to an overall healthy diet, but when recovering from a breast reconstruction, you have a reason to slow down and pay attention to how you are fueling your body. When you are recovery from any surgery, you should provide your body with good nutrients. Your body will need a lot of carbohydrates and proteins in order to promote the best environment for healing. Your body is going to be hard at work trying to recover, and it is your job to give your body the necessary fuel it needs. This also means that you should never skip meals. It may seem like you are eating a lot, but your body needs it during this time.

Another very important key to a successful recovery is adhering to a proper physical therapy regimen. No matter what kind of breast reconstruction surgery you had done, physical therapy is a crucial part of the recovery phase. At first, you may feel quite limited with the movements you can and cannot do, but after time, and strength building, you will be back to your normal self. While working yourself through this process, you must also provide your breast with good bra support. It is recommended to use a supportive bra for at least two to three months before trying something with less support.

How long until I can get out and enjoy Miami’s beaches in my bikini after a breast reconstruction?

It is important to know when you can get back to your normal, daily and weekly activities without difficulty after a breast reconstruction. As mentioned, everyone heals at different rates depending on current medical conditions. You can better your chances of a quick recovery by taking care of your incision sights and by participating in physical therapy as prescribed. Generally, it is expected that you will be able to return to work by four to six weeks into your healing process. This, by no means, is indicating that total healing has taken place. In fact, it is expected that the incision lines will still be a bit raised, red and swollen at this stage. This will take up to several months to dissipate and go back to normal.

Although we all have a different experience and we all have a different form of coping, most people have experienced full acceptance of their new breast or breasts within a year. Usually by the one year mark, most the scarring has gone down and you will begin to feel whole again.

It is important, after a mastectomy and breast reconstruction, to continue with monthly self breast exams and to note anything abnormal immediately. Having a mastectomy unfortunately does not eliminate the reoccurrence of breast cancer.