Surgery and Recovery

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Surgery

The surgery will be performed in a hospital, at an ambulatory surgery center, or at an office-surgical center. Your surgeon will use a skin marker to confirm the incisions and make other marks to guide the surgery. To make sure you are comfortable, you will receive general anesthesia (you are asleep and pain-free) or intravenous sedation (you are easy to awaken and pain-free) during your procedure. If general anesthesia is planned, you should not eat or drink for 8 to 12 hours before your surgery is scheduled.

When you awake from surgery, you will have gauze or bandages over your incision and a support bra or elastic bandage to reduce swelling and secure the reconstructed breast. A small, thin tube or tubes (surgical drains) will be under your skin to help remove excess fluid or blood from the surgery site. Ask your doctor about bathing, showering, how to measure the fluid, and keep the drain clean. Be sure you understand how to take care of the drains and incisions.

Your doctor will prescribe pain medicine and antibiotics. Make sure your pain is controlled. You may have a pain pump that allows you to press a button to receive narcotic pain medication through a vein for one to three days after surgery. Sometimes, your surgeon will use a “pain ball” (non-narcotic) which slowly deflates, dripping pain medicine and a local anesthetic to the reconstructed area. Visits to your plastic surgeon will be scheduled to remove the drains and make sure that you’re recovering well. You cannot drive when you are taking narcotic pain medication, so you should plan for someone to drive you.

Recovery

The shape and position of the new breast will improve as swelling decreases. Over time, some sensation may return to the reconstructed breast; but, it is hard to re-create the look and feel of a natural breast. Most women are pleased with their new breast silhouette after reconstruction.

Your surgeon should take the time to explain and discuss the complications and time commitments related to the reconstruction procedures you are considering, as well as methods to prevent problems. Ask questions so that you fully understand the risks before making your choice.

Surgery, in general, can pose a number of risks (infection, bleeding, blood clots, pain, reactions to medications or general anesthesia, etc.). However, each person is unique and reacts differently. Ideally, problems can be avoided or well managed. Stay on top of changes that you experience and stay in touch with your doctor if you are concerned about something that doesn't look or feel right.

These things can happen and can be corrected with the help of your surgeon:

  • Swelling, redness or infection
  • Painful scars or excess scar tissue distorting the new breast
  • Stitching that opens before healing
  • Problems with drains (pooling blood and fluid at the mastectomy site)
  • Necrosis (circulation problems causing the skin around the implant to die)
  • Saline leakage
  • Cosmetic problems

Resources for Support

Talking with people who really understand what you are going through has the potential to help improve your ability to cope, regain control over your situation, and give you a sense of security.

Part of the challenge is accepting that you need support, and that it’s okay. The following organizations can connect you with support groups, helpful resources, one-on-one counseling, online bulletin boards, or with other women who can speak from experience about breast cancer treatment or reconstruction.

You may also want to seek information and support from:

  • www.myhopechest.org: a foundation dedicated to finding resources for women who wish to undergo reconstruction after cancer
  • www.breastreconstruction.org: a comprehensive online resource focused on breast reconstruction
  • www.cancer.org: the American Cancer Society, with active bulletin boards and in-depth online resources
  • www.breastcancer.org: covering many aspects of breast cancer and its treatment, including information about reconstruction
  • www.fertilehope.org: helps cancer patients facing the risk of infertility

www.plasticsurgery.org: The American Society of Plastic Surgeons offers before/after photo gallery of breast reconstruction.
www.breastcancer.org: Illustrates different breast reconstruction surgery types with a photo gallery of women and their stories about their reconstruction experience (search “photos”).
www.facingourrisk.org/photogallery: Facing Our Risk of Cancer Empowered has a password-protected photo gallery of real women who share their experiences and a discussion board open to anyone.
www.youngsurvival.org: Young Survival Coalition has ongoing dialogues by women about reconstruction, among other issues, in their open bulletin board. YSC also offers an important list of Questions and Answers about breast reconstruction on their site as well as access to the SurvivorLink program.