Breast cancer is the most common cancer among females in Australia. This cancer mostly affects women after the age of 40. Source: Health Insite
Breast Reconstruction After Mastectomy
What is breast reconstruction? Breast reconstruction is a type of surgery for women who have had a breast removed (mastectomy). The surgery rebuilds the breast so that it is about the same size and shape as it was before. The nipple and the darker area around the nipple (areola) can also be added. Most women who have had a mastectomy can have reconstruction. Women who have had only the part of the breast around the cancer removed (lumpectomy) may not need reconstruction. Breast reconstruction is done by a plastic surgeon.
The choice to have breast reconstruction is yours to make.
Today, the emotional and physical results are very different from what they were in the past. Much more is now known about breast cancer and its treatment. New kinds of treatment as well as improved reconstructive surgery mean that women who have breast cancer today have better choices.
Women with breast cancer may choose surgery that removes only part of the breast tissue. This may be called breast conservation surgery, lumpectomy, or segmental mastectomy.
How much for a Breast Reconstrucion Aftern Masectomy in Sydney
I contacted a few doctors and I was explanied that prices vary.
You may choose to go private or it could be covered by Medicare if you
Some women have a mastectomy, which means the entire breast is removed. Many women who have a mastectomy choose reconstructive surgery to rebuild the shape and look of the breast.
The American Cancer Society recommends that if you are thinking about having reconstructive surgery, it is a good idea to talk about it with your surgeon and a plastic surgeon experienced in breast reconstruction before your mastectomy. This lets the surgical teams plan the treatment that is best for you, even if you want to wait and have reconstructive surgery later.
Why have breast reconstruction?
Women choose breast reconstruction for many reasons:
•To make their breasts look balanced when they are wearing a bra
•To permanently regain their breast shape
•So they don’t have to use a form that fits inside the bra (an external prosthesis)
You will be able to see the difference between the reconstructed breast and the remaining breast when you are nude. But when you are wearing a bra, the breasts should be alike enough in size and shape that you will feel comfortable about how you look in most types of clothes.
Warning!!! Your body image and self-esteem may improve after your reconstruction surgery, but this is not always the case. Breast reconstruction does not fix things you were unhappy about before your surgery. Also, you may not be happy with how your breast looks and feels after surgery. You and those close to you must know the facts about what to expect from reconstruction.
You can choose to have an immediate or delayed breast reconstruction
Immediate breast reconstruction is done at the same time as the mastectomy. An advantage to this is that the chest tissues are not damaged by radiation therapy or scarring. This often means that the final result looks better. Also, immediate reconstruction means less surgery.
After the first surgery, there still may be a number of steps that are needed to complete the immediate reconstruction process. If you are planning to have immediate reconstruction, be sure to ask what will need to be done afterward and how long it will take.
Delayed breast reconstruction means that the rebuilding is started later. This may be a better choice for some women who need radiation to the chest area after the mastectomy. Radiation therapy given after breast reconstruction surgery can cause problems.
Decisions about reconstructive surgery also depend on many personal factors such as:
•Your overall health
•The stage of your breast cancer
•The size of your natural breast
•The amount of tissue available (for example, very thin women may not have enough extra body tissue to make flap grafts)
•Whether you want reconstructive surgery on both breasts
•Your insurance coverage for the unaffected breast and related costs
•The type of procedure you are thinking about
•The size of implant or reconstructed breast
•Your desire to match the look of the other breast
Other important things to think about•Some women do not want to think about reconstruction while coping with a diagnosis of cancer. If this is the case, you may choose to wait until after your breast cancer surgery to decide about reconstruction.
•You may not want to have any more surgery than needed.
•Scarring is a natural outcome of any surgery, but cell death (called necrosis) of the breast skin, the flap, or transplanted fat can happen. Immediate reconstruction may be more likely to result in necrosis. If this happens, more surgery is needed to fix the problem and can deform the new breast shape.
•Not all surgery is a total success, and you may not like the way it looks.
•You may be concerned if you tend to bleed or scar.
•Healing may be affected by previous surgery, chemotherapy, radiation, smoking, alcohol use, diabetes, some medicines, and other factors.
•Would you prefer to have reconstruction before or after you complete your cancer treatment?
•Breast reconstruction restores the shape, but not feeling, in the breast. With time, the skin on the reconstructed breast can become more sensitive, but it will not feel the same as it did before your mastectomy.
•Surgeons may suggest you wait for one reason or another, especially if you smoke or have other health problems. Many surgeons say that you must quit smoking at least 2 months before reconstructive surgery to allow for better healing. You may not be able to have reconstruction at all if you are obese, too thin, or have blood circulation problems.
•The surgeon may recommend surgery to reshape the remaining breast to match the reconstructed breast. This could include reducing or enlarging the size of the breast, or even surgically lifting the breast.
•Knowing your reconstruction options before surgery can help you prepare for a mastectomy with a more realistic outlook for the future.
Types of breast reconstruction
Several types of operations can be done to reconstruct your breast. You can have a newly shaped breast with the use of a breast implant, your own tissue flap, or a combination of the two. (A tissue flap is a section of your own skin, fat, and muscle which is moved from your tummy, back, or other area of your body to the chest area.)
Questions you may ask yor plastic surgeon before deciding on having a Breast Reconstruction Plastic Surgery.
•Can I have breast reconstruction?
•When can I have reconstruction done?
•What types of reconstruction could I have?
•What is the average cost of each type? Will my insurance cover them?
•What type of reconstruction do you think would be best for me? Why?
•How many of these procedures have you (plastic surgeon) done?
•What results can I expect?
•Will the reconstructed breast match my other breast?
•How will my reconstructed breast feel to the touch?
•Will I have any feeling in my reconstructed breast?
•What possible problems should I know about?
•How much discomfort or pain will I feel?
•How long will I be in the hospital?
•Will I need blood transfusions? If so, can I donate my own blood?
•How long it take for me to recover?
•What will I need to do at home to care for my incisions (surgical wounds)?
•Will I have a drain (tube that lets fluid out) when I go home?
•How much help will I need at home to take care of my drain and wound?
•When can I start my exercises?
•How much activity can I do at home?
•What do I do if my arm swells (this is called lymphedema)?
•When will I be able to go back to normal activity such as driving and working?
•Can I talk with other women who have had the same surgery?
•Will reconstruction interfere with chemotherapy?
•Will reconstruction interfere with radiation therapy?
•How long will the implant last?
•What kinds of changes to the breast can I expect over time?
•How will aging affect the reconstructed breast?
•What happens if I gain or lose weight?
•Are there any new reconstruction options that I should know about?
Resources for patients with breast cancer considering a Breast Reconstruction
National Breast Cancer Foundation
National Breast and Ovarian Cancer Centre
Australia Society of Plastic Surgery
American Society of Plastic Surgeons (ASPS)
Web site: www.plasticsurgery.org
For information about breast reconstruction, tips on getting ready for surgery, and referrals to a board certified plastic surgeon.
Breast Cancer Network of Strength
Web site: www.networkofstrength.org
Offers peer support, as well as breast health and clinical trials information
American Society of Plastic Surgeons. Breast Reconstruction. Accessed at: www.plasticsurgery.org/Patients_and_Consumers/Procedures/Reconstructive_Procedures/Breast_Reconstruction.html on August 25, 2009.
Breastreconstruction.org. Accessed at: www.breastreconstruction.org
www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/GuidanceDocuments/ucm071228.htm#85 on August 25, 2009.
Books you may want to read:
Ananthakrishnan P, Lucas A. Options and considerations in the timing of breast reconstruction after mastectomy. Cleve Clin J Med. 2008;75 Suppl 1:S30-3.
Andrades P, Fix RJ, Danilla S, Howell RE 3rd, et al. Ischemic complications in pedicle, free, and muscle sparing transverse rectus abdominis myocutaneous flaps for breast reconstruction. Ann Plast Surg. 2008;60(5):562-7.
Boehmler JH 4th, Butler CE, Ensor J, Kronowitz SJ. Outcomes of various techniques of abdominal fascia closure after TRAM flap breast reconstruction. Plast Reconstr Surg. 2009;123(3):773-81.
Burstein HJ, Harris JR, Morrow M. Malignant Tumors of the Breast. In DeVita VT, Hellman S, Lawrence TS, Rosenberg SA (eds) Cancer Principles and Practice of Oncology, 8th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2008.
Crowe JP, Kim JA, Yetman R, Banbury J, et al. Nipple-Sparing Mastectomy: Technique and Results of 54 Procedures. Arch Surg. 2004;139:148-150.
Djohan R, Gage E, Bernard S. Breast reconstruction options following mastectomy. Cleve Clin J Med. 2008;75 Suppl 1:S17-23.
Farhadi J, Maksvytyte GK, Schaefer DJ, Pierer G, Scheufler O. Reconstruction of the nipple-areola complex: an update. J Plastic, Reconstructive & Aesthetic Surgery. 2006;59:40-53.
Gerber B, Krause A, Dieterich M, Kundt G, Reimer T. The oncological safety of skin sparing mastectomy with conservation of the nipple-areola complex and autologous reconstruction: an extended follow-up study. Ann Surg. 2009;249(3):461-8.
Guerra AB, Metzinger SE, Bidros RS, Gill PS, Dupin CL, Allen RJ. Breast reconstruction with gluteal artery perforator (GAP) flaps. Annals of Plastic Surgery. 2004;52(2):118-125.
Kim SM, Park JM. Mammographic and ultrasonographic features after autogenous myocutaneous flap reconstruction mammoplasty. J Ultrasound in Medicine. 2004;23(2):275-282.
Kufe, DW, Pollack, RE, Weichselbaum, RR, Bast, RC, Gansler, TS, Holland, JF, Frei, E. Cancer Medicine, 6th ed. Hamilton, Ontario: B.C. Decker; 2003.
Namnoum JD. Expander/implant reconstruction with AlloDerm: recent experience. Plast Reconstr Surg. 2009;124(2):387-94.
Petit JY, Veronesi U, Orecchia R, Luini A, et al. Nipple-sparing mastectomy in association with intra operative radiotherapy (ELIOT): A new type of mastectomy for breast cancer treatment. Breast Cancer Res Treat. 2006;96(1):47-51.
Petit JY, Veronesi U, Rey P, Rotmensz N, et al. Nipple-sparing mastectomy: risk of nipple-areolar recurrences in a series of 579 cases. Breast Cancer Res Treat. 2008 Mar 22.
Resnick B, Belcher AE. Breast Reconstruction. American Journal Nursing. 2002;102:26-33.
Spear SL, Parikh PM, Reisin E, Menon NG. Acellular dermis-assisted breast reconstruction. Aesthetic Plast Surg. 2008;32(3):418-25.
Taylor CW, Horgan K, Dodwell D. Oncological aspects of breast reconstruction. The Breast. 2005;14:118-130.