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Author: Breast Reconstruction Associates

10 Things to Consider before Undergoing Breast Reconstruction Surgery

There is an overwhelming amount of information on the internet about breast cancer related topics. When you are newly diagnosis with breast cancer, trying to digest this high volume of information can feel like trying to drink from a fire hydrant. The checklist below provides a good starting point for things to consider when deciding your treatment plan.

  1. Research. It is common to want to rush the process along when you are given the shocking news of a breast cancer diagnosis. While this is very understandable, it is also very important for you to take enough time to understand all of your options. A discussion with your doctors will provide you with answers and reputable resources to reference.
  2. Talk to your doctor. With the emerging popularity of social media, patients frequently get information from online support groups and other patient forums. Although having the support of others going through breast cancer is amazing and can be very helpful, it is also very important to remember that every patient’s situation is unique and you are only able to see part of the picture online. Questions specific to your care should be addressed directly with your doctor and their team for the most accurate information
  3. Make the best decision for you. Breast reconstruction surgery is a personal decision, and several factors play into it. It can be helpful to bring your spouse, family, or support system with you to your consultation so they also understand your options and expectations. It is helpful to weigh the options with your support system, but ultimately you must make the best decision for YOU in your current situation.
  4. Plan ahead. After any type of surgery there is an obligatory recovery period. The length of your recovery varies depending on the type of work you need to resume. Be sure to discuss the details of your expected recovery and post-op restrictions with your surgeon so you can plan accordingly with your support system and your employer.
  5. Can I pick my breast size? The size of your breast reconstruction is dependent on your pre-operative body habitus. Part of your consultation with your reconstructive surgeon will involve discussing what your ideal breast size is (bigger, smaller, or in line with your current size). After examining you, your surgeon will be able to discuss your expected breast size and the likelihood of meeting your expectations. Your surgeon may show you photos of patients with a similar body habitus to help you get a better idea of what you will look like.
  6. Know your timeline. Our goal at Breast Reconstruction Associates is to complete your reconstruction in as few surgeries as possible. Ask your surgeon how many surgeries they anticipate for you, and what the expected timing of each of surgery will be. Timing of reconstruction may have to be adjusted to prioritize the cancer treatment specific to your care.
  7. What will I look like? Looking at photos of other patients who have had the surgery can go a long way in allaying your fears. At Breast Reconstruction Associates, we often look at photos together with patients to give them an accurate visual of the scars patterns they will have.
  8. Ask questions. Nothing is off the table – make a list of all the questions you have and go over all of them with your doctor.
  9. What about your nipples? Even with a mastectomy, some patients have the option of keeping their nipples; this is called a nipple sparing mastectomy. Depending on the location of your tumor, and the position (ptosis) of your nipples, your breast surgeon and plastic surgeon will assess and determine if you are a candidate for a nipple sparing mastectomy. If you are not able to keep your nipples, there are other great options to complete your reconstruction like nipple reconstruction or 3D nipple areola tattoos.
  10. What is the goal of reconstruction? It is important to discuss realistic expectations with your plastic surgeon, and to understand the difference in reconstructive surgery and cosmetic surgery. The goal of reconstruction is to restore what cancer took away from you; to rebuild your breasts and be able to fit clothing evenly without the need to use a prosthesis. While it is a life-changing experience, it is often emotional during the transition. It takes time and perspective to accept and love your new reconstructed self. Don’t be embarrassed or afraid to discuss your emotions through your healing process.

In summary, take some time to learn about your options before moving forward. For more information, visit Breast Reconstruction Associates.

Get Your Breast Reconstruction Questions Answered

Even if you think you are prepared for breast reconstruction surgery, more often than not, you will still have questions for your surgeon. This is very understandable since patients are normally taking a lot and are feeling stressed during that period. 

For most patients, the diagnosis of breast cancer comes as a surprise with many associated uncertainties. Even patients who are considering delayed or prophylactic mastectomies and reconstruction have a lot of information to take in when making their reconstruction choices. At Breast Reconstruction Associates, we have been caring for patients like you since 2014. We want you to feel comfortable and informed about what autologous breast reconstruction can offer you. Here are a few of the most common patient questions we receive to help you further process and understand your decision to undergo breast reconstruction.

Q: How much pain can I expect after surgery?

A: Most patients experience a very tolerable degree of post-operative pain. Our pain medication regimen which is aligned with the Enhanced Recovery After Surgery (ERAS) protocol has proven remarkably effective. After surgery, most patients are able to do their regular activities of daily living and sleep with mild-moderate discomfort. The majority of our patients are no longer needing regular pain medications after 2 weeks.

Q: What will my breast size be?

A: During the initial reconstruction surgery, it is possible to control the width and the height of the flap when creating a breast. The depth, or projection, of the flap is largely dependent on the depth, or projection, of the abdominal tissue. Your surgeon should be able to estimate how close to your current breast size you will be after surgery at your consultation. It is possible to make adjustments to size and shape after the initial reconstruction surgery if needed.

Q: Will I have drains after surgery?

A: You can expect a drain in each breast that is operated on and 1-2 drains in your abdomen after surgery. Typically, patients will go home with all of their drains in place. While inpatient, your nurse will educate you regarding the emptying, recording of drainage and general care of your drains before you go home. Once at home, our team is available to address any questions or concerns that may come up. Most patients have their drains removed 1-2 weeks after surgery.

Q: What kind of bra should I wear after surgery?

A: You will be given a hospital-issued post-surgical bra after surgery. This eliminates the need to purchase a bra prior to reconstruction. After surgery, you may be fitted for a compression bra in our office for proper sizing and comfort.

Q: When can I start exercising again?

A: After surgery, we ask that you limit your activities to light walking, no core muscle use, and lifting weight less than 10 pounds. Once you are 4 weeks post-op, you may start cardio activities such as using the stationary bike or the elliptical machine. After this point, let your surgeon guide you as to how and when to get back into more strenuous activities. In general, most patients are free of restrictions and may use their core muscles again 12 weeks after surgery.

If you have additional questions, make a list! We are happy to be your resource for breast reconstruction information. Contact one of our offices in Fort Worth, Austin or Oklahoma City for more information or to schedule a consultation.

How Common is Breast Cancer?

Breast cancer is the most common malignancy affecting American women with one in eight women diagnosed during their lifetime (12.5% risk). There are several risk factors that can affect a woman’s risk, some of which are modifiable while others are out of our control.

Modifiable Risk Factors:

  • Body Mass Index (BMI) – Weight can significantly increase a woman’s risk for developing breast cancer as adipose aka fat tissue stores estrogen. Being overweight or obese increases estrogen exposure as well as cancer risk. It is important to maintain a healthy BMI to not only lower your breast cancer risk, but also decrease the risk of cancer recurrence if you are a breast cancer survivor. Your diet plays into this as well so it is important to eat a balanced, nutritious diet and avoid processed foods.
  • Alcohol consumption – This is an exponential risk factor in that the more alcohol you consume, the higher the risk of developing breast cancer. You should limit your intake to less than 3 to 4 drinks per week.
  • Tobacco use – As with most malignancies, nicotine use increases breast cancer risk. It also inhibits wound healing, so it is important to quit all nicotine products before undergoing surgical management.
  • Physical Activity – A sedentary lifestyle can increase your risk for breast cancer as well. Ideally, you should increase your exercise routine to 300 minutes per week, but risk reduction is observed at 150 minutes per week.
  • Hormone Replacement Therapy – Combination HRT (estrogen/ progesterone) increases breast cancer risk. Most women must stop these medications once diagnosed. It is especially important to perform routine self-breast exams and screening mammograms while taking HRT.

Non-modifiable Risk Factors:

  • Age – Breast cancer is an aging woman’s disease with a majority of cases diagnosed after the age of 50.
  • Gender – Women are overwhelmingly more affected by breast cancer than men, but men constitute 2% of all breast cancer diagnoses each year so it is important for men to practice breast awareness as well.
  • Genetics & Family History– Certain genetic mutations can increase a woman or man’s risk of developing breast cancer. Most people are aware of the BRCA1 and BRCA2 genes, but there are several other genes that increase this risk as well (CHEK2, PALB2, ATM to name a few). Even if genetic testing is negative for these mutations, patients are still considered to be at a higher risk than the general population if they have a family history of breast cancer.
  • Lifetime Estrogen Exposure – Starting menstruation before the age of 12, menopause at a later age, and delaying childbearing after the age of 30 or not having any children all lead to increased estrogen exposure and ultimately breast cancer risk.
  • Atypical breast cells – Not every breast biopsy is malignant; many are benign like fibroadenomas or cysts. There are some biopsies considered high risk lesions like atypical ductal and lobular hyperplasia and lobular carcinoma in situ.

While breast cancer rates have been increasing over the years, the good news is that more and more women are surviving this diagnosis. This is largely due to increased patient awareness and early detection as well as improved and increasing treatment options. If you have been diagnosed with breast cancer or a genetic mutation and are considering breast reconstruction surgery, reach out to us at our Fort Worth, Austin or Oklahoma City offices. At Breast Reconstruction Associates, we are committed to our patients’ overall health and reconstructive goals.