Breast Reconstruction The breasts are an integral part of the way a woman feels and views her body which influences her psyche. Self-esteem and confidence are often built around her body image. After a mastectomy, or other trauma to the chest, a woman may loose her sense-of-self, feel less feminine, and even less desirable. Breast Reconstruction is a surgical procedure designed to restore and rebuild the breasts to a healthy, pleasing contour. Through one of several techniques, the shape, size, and appearance of one or both breasts can be restored. Expected Results from Reconstruction Surgery: A soft, organic feeling breast. Breasts that are symmetry with one another. A pleasant shape and contour to the breast. Volume and fullness in the chest. Nipple/areola reconstruction and placement. Who is a good candidate? Women who have undergone a mastectomy, and are in generally good health, may make excellent candidates for this procedure. Every woman is different, so Dr. Lohner will tailor the techniques of the procedure to the unique needs of the individual patient. At the consultation appointment, Dr. Lohner will review the complete medical and surgical history, determining if this is the right procedure to achieve the intended results. How to begin the journey towards reconstruction surgery: Patients who have an upcoming mastectomy, or have undergone one in the past, should begin researching the process as soon as they can. Patients should explore the potential risks, benefits, and expected outcomes of this procedure online. If this procedure sounds like the right choice, patients should set a consultation appointment at Lohner Plastic Surgery. During the initial appointment with Dr. Lohner, a full assessment of the patient’s medical and surgical history will be completed. A brief physical exam will be performed, and a patient’s aesthetic desires discussed. Dr. Lohner will present all options for the reconstruction, discussing the different techniques used, and the recovery period required for each option. Before/After photos and computer imagery will be used to assist patient with a visualization of the potential results. If this procedure is determined to be the best procedure for an individual patient, Dr. Lohner will create a unique surgical plan, designed to meet her specific needs and desired results. How to prepare for your procedure: At the consultation appointment, the patient will be given special information on the pre-operative and post-operative periods, and detailed recovery instructions. Read through these carefully and contact Lohner Plastic Surgery if there are any questions. To ensure a smooth procedure and stress-free recovery, keep the following points in mind: 1. Stop smoking This can cause delayed wound healing. 2. Avoid aspirin, anti-inflammatories, and herbal supplements These can contribute to excessive bleeding. 3. Arrange for transportation You will need a ride both for when you are discharged and for additional follow up appointments. 4. Fill prescriptions early Have all pain medications and antibiotics at home so you can begin taking them at once. 5. Arrange for assistance You will be extremely sore and tired the first few days, so any assistance will be greatly appreciated. 6. Keep numbers together If an emergency should arise, contact information should be easy to find – for you or a family member/close friend. 7. Gather supplies To ease your recovery, have simple to prepare meals at home. Also stock up on books, magazines, icepacks, and extra pillows. 8. Know what to tell others People around you will know something is going on. Think about what to say to your friends/family about the procedure. 9. Ask questions Contact the office immediately for clarification on anything, large or small, that you are unsure about. 10. Set up follow-up appointments These are vital to appropriate healing and your personal wellbeing, so plan accordingly. The Breast Reconstruction Surgery: There are two widely used methods for reconstruction: Breast Implant Reconstruction and Flap Based Reconstruction. The exact technique used by Dr. Lohner during the procedure will be determined during the consultation appointment. This will depend on the mastectomy, physical condition, and the desired results. The surgical process may require several different surgical procedures, which extend through a several months period, to complete the desired results. Either technique will require an additional surgical procedure to reconstruct and attach the nipple/areola. When only one side of the chest requires reconstruction, women may choose an additional procedure to achieve symmetry, including a Breast Lift, Breast Augmentation, or Breast Reduction on the healthy breast. Breast Implant Reconstruction: Breast Implant Reconstruction is less complex with shorter recovery than Flap Based Reconstruction. A tissue expander is first placed in the implant’s target area. Over the next several weeks, the expander will be gradually inflated with saline. When the skin has stretched enough to accommodate the implant, the expander is removed. The Breast Implant will be placed in position, using standard Breast Augmentation techniques. Flap Based Reconstruction: Flap Based Reconstruction uses a patient’s own skin/tissue to create a contoured breast. A TRAM-flap involves tissue donated from the abdomen. Tissue flaps can also be harvested from the back, buttocks, or thighs. The flap may remain connected to its original blood supply (meticulously moved up through the body). Alternatively, the blood supply of the flap may be reattached during surgery. Recovery After Reconstruction Surgery Patients should expect the recovery period after surgery to take approximately six weeks, as the swelling decreases, and breast shape and position improves. A hospital stay is normally required for several nights, allowing for a safer and more comfortable recovery. The exact recovery process will depend on the technique utilized. Patients normally feel tired and sore for a week or more after surgery. Moderate pain may be experienced. Dr. Lohner will prescribe the appropriate pain mediations to keep paitnents resting comfortably at home. Initially, gauze bandages, a support garment, and/or surgical bra will be worn. This will minimaize swelling and promote proper healing of the breast. Women will often have drainage tubes for a short time after surgery. These will remove any fluid that collects at the incision site, as well as limit additional swelling. The first follow-up appointment will be scheduled a few days after surgery, allowing Dr. Lohner to check on a patient’s recovery progress and remove and replace their bandages. Women normally feel well enough to return to work or school about four to five weeks after surgery. Strenuous activities, exercise, and overhead lifting should be postponed for at least six weeks following the procedure. Visible scarring will occur after the procedure. These are permanent, but will fade over time, and are easily concealed under clothing or swimwear. Ten Questions to Ask Your Surgeon about the Recovery Period: Where will I be taken after my surgery is complete? How many days will I spend in the hospital? How much pain can I expect after my procedure? What pain medications will I be prescribed at home? When will I have my bandages removed? Will I have drains and if so, for how long? When will I be able to bathe or shower after my surgery? When can I resume my normal activities, like work or school? When will I be able to jog or exercise again? How often will I return for follow-up appointments? Dr. Lohner will provide patients with detailed recovery instructions before their breast reconstruction procedure. Carefully read through these instructions and common questions and do not be afraid to ask questions. The Risks of Breast Reconstruction: With any surgery there are potential risks. But having a Board Certified Cosmetic, like Dr. Lohner, is one way to minimize risks and complications of a Breast Reconstruction Surgery. Dr. Lohner has over twenty years of experience attending to women who have undergone a mastectomy and successfully restoring a natural looking and feeling chest. With any surgery there is the potential for complications. The risk for complications can be minimized. Common complications include: delayed wound healing, infection, excessive bleeding, improper formation of scar tissue, asymmetry, and a loss of nipple sensation. Dr. Lohner will discuss the risks of this surgery further, at the consultation appointment. Feel free to ask any questions you may have during your consultation or call the office at any time.