Breast Surgery: Reconstruction Following Mastectomy

If you’ve had a mastectomy, you might want to have breast reconstruction to help your breast recover its natural shape and appearance. You can choose to have this operation done at the same time as your breast removal surgery, or you can wait and have it done later.

Before your breast reconstruction surgery

There are things that you can do before your breast reconstruction to help you get better as quickly as possible. Your breast surgeon will discuss things you can do beforehand to help speed up your recovery after surgery.

  • If you smoke, it’s a good idea to quit before your operation. This will help speed up healing and cut your risk of certain infections and hernia.
  • If you’re overweight you might need to lose a bit of weight before your surgery. This will reduce your risk of complications and can help you recover more quickly.
  • Strengthening your abdominal muscles is a good way to lower the risk of hernia. Aim to build up to 30 sit-ups a day.

What happens during breast reconstruction?

There are a few types of breast reconstruction surgery. How the surgery is performed depends on which type you have, but you will probably have a general anaesthetic. This means you’ll be asleep for you operation and won’t feel any pain.

Prosthetic breast reconstruction

Uses prosthetic implants to give your breasts the right shape and size. Usually, prosthetic reconstruction is a shorter and more straightforward option than fat transfer reconstruction.

Body tissue breast reconstruction

Body tissue breast reconstruction uses body fat, muscle or both to create shape and volume. Because the tissue is natural, it means that the breast looks and feels more natural than prosthetic implants. Using living tissue has other benefits too, like rejuvenating your skin and bringing in a healthy blood supply. Because the cells are from your own body, there’s no risk of an allergic reaction or your immune system rejecting the implant. Your surgeon will talk to you about which part of your body it might be best to take the tissue from, weighing up the pros and cons of each option with you.

Lymph node transfer

This is a relatively new treatment that can help control lymphoedema – a condition caused by the build-up of fluid in your tissue. Normally, your lymph nodes help to drain fluid. So if you’ve had lymph nodes removed from your armpit during breast cancer treatment, you have a greater risk of getting lymphoedema. In lymph node transfer, spare lymph nodes with a blood supply can be transferred from around your groin to your armpit. This procedure can be done at the same time as your breast reconstruction operation. BMI Healthcare is one of only a few places to offer this new treatment. Every patient we’ve given a lymph node transfer has noticed an improvement in their lymphoedema symptoms and in their quality of life with very few side effects.

Reshaping your breast

Your breast surgeon will try to make your new breast match the shape of your remaining one. Some women choose to have surgery on both their breasts so they match as best as possible. It can take a few months for your breast to settle into its final shape and size. Once it’s settled, you can have a nipple reconstruction too. Your surgeon may take part of your nipple from your other breast and attach it to your other one, then tattoo colour onto the skin.

Recovering from breast reconstruction surgery

How long you need to stay in hospital after your surgery will depend on the type of breast reconstruction you had. You might only need to stay in hospital for around three days, but it usually takes around six weeks for your wound to heal fully. Bigger operations that involved taking tissue from your back or tummy might mean your hospital stay is closer to a week.

Pain management

When you first wake up from your operation, you’re likely to feel a bit sore. You can take painkillers to control your discomfort. You might need to take these for a few weeks but generally people whose pain is well controlled recover more quickly.

Building up your activity

It’s important that you continue to rest when you go home. You shouldn’t do any strenuous activities or housework like vacuuming or heavy lifting. If possible, have someone around for the first few days to help you with tasks like this. Then slowly build up your activity again. Your physiotherapist will show you some gentle exercises to help you build up your strength and mobility again.

Caring for your skin

Some people find their wound feels itchy, but it’s important you don’t scratch it. When your wound’s fully healed, you might need to massage the skin over your breast with body oil or cream at least once a day. If you had tissue taken from another part of your body to reshape your breast, you should moisturise this area too.

Massaging your skin like this helps to1:

  • keep it supple and conditioned
  • stop scar tissue from sticking to the healing tissue underneath
  • speed up the healing process
  • soften your scars.

Side effects and complications

Breast construction is a common procedure after a mastectomy. It’s a generally safe operation, but as with all surgery there are some possible problems. These include:

  • infection, which will need treating with antibiotics
  • bruising and bleeding
  • fluid under your wound
  • chronic pain
  • keloid scars.

Paying for your treatment

You have two options to pay for your treatment – your costs may be covered by your private medical insurance, or you can pay for yourself.

Check with your private medical insurer to see if your diagnostic costs are covered under your medical insurance policy.

If you are paying for your own treatment the cost of the procedure will be explained and confirmed in writing when you book the operation. Ask the hospital for a quote beforehand, and ensure that this includes the consultants’ fees and the hospital charge for your procedure.

1 Macmillan, Recovery after breast reconstruction http://www.macmillan.org.uk/information-and-support/treating/surgery/having-breast-reconstruction

For further information or to book a consultation or treatment, please get in touch with our cancer enquiries team: Call us on 0800 157 7747

Content last reviewed: by Mr Ekambaram Babu, Consultant Breast Surgeon, in October 2014

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