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Author: 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.