Breast Reconstruction Before and After

May 11, 2012

A breast reconstruction is the creation of natural-looking artificial breasts using plastic surgery. Having a breast reconstruction is a big decision which women face after a mastectomy (removal due to breast cancer). When you are diagnosed with cancer, it’s scary. On top of dealing with possible death, you have much to learn about the condition, its treatments and the many decisions to make. Of course, you will want to fight the disease. Do you have radiation therapy or not? Which method of reconstruction is best? DIEP flap, SGAP Flap, Tram Flap or another technique? It’s humiliating losing your hair after chemo but now you are also faced with losing your breasts. It’s one of the worst things a woman can go through. Luckily, there is hope and many patients recover. Yet again, dealing with a loss of breasts is easier than having to face the fact that the cancer won’t go away.

You will be both excited and scared about getting your new boobs. You can have a new breast reconstructed from your own tissue grafted from another part of your body, known as a fat transfer. Alternatively, you can have breast implants inserted, the same ones used for breast augmentation surgery. If you’ve experienced weight loss due to the cancer or from the stress of the situation, you may not have enough tissue for a natural reconstruction. In these difficult times, it’s important to lean on your family and friends for all the support they can give. Once you have your new breasts, celebrate and buy yourself a nice bra, or even better, a well-deserved holiday.

Before and after photo

Before and After Photo: Breast Reconstruction #1

Photo #1

Alexandra from Santa Fe had to have a double mastectomy due to her breast cancer. She had a DIEP flap breast reconstruction five years after her breasts were removed.

Before and After Photo: Breast Reconstruction #2

Photo #2

Barbara lost her left breast due to a cancer. She had it reconstructed with the Tram flap technique. She’s very happy to have both breasts again. Wearing an external prosthesis became bothersome and demeaning for her.

Why do women get their breasts restored?

Having one or both breasts cut off is a woman’s nightmare. Even the most well-adjusted women can find it disturbing when their doctor mentions a mastectomy. About 50% of women who have the breast removed end up having a reconstruction. This can be done simultaneously with the removal or even years later. The decision to have the chest reconstructed comes down to many factors. The scar left over after a mastectomy can be a constant reminder of the cancer. Getting new boobs can have huge emotional benefits including being able to leave the cancer behind and move on with one’s life.

Femininity is another big factor for women. Without a fuller chest, women can feel inadequate and less feminine. After a reconstruction women feel empowered once again, taking back their pride and feminine aura. Having to deal with prostheses (false breasts) and special bras can also be demeaning and constrictive. Women who rely on the fake boob are restricted in what they can wear. Some dresses and even bikinis are out of the question. You don’t want to end up like grandpa Simpson who loses his false boob on the dance floor and the German audience calls out “Das is not einen boobie!”.  What about fitting into a wetsuit for surfing? It causes women much embarrassment and social angst. The psychological benefits of having the operation are massive.

The great thing about reconstruction is that it doesn’t interfere with the cancer treatment, whether it be chemotherapy, radiotherapy or hormone therapy. Also, it does not affect further cancer checkups so recurrence can still be detected just as easily.

More breast reconstruction before and after photos >>>>

Before the procedure

You should be giving though as to when to have a reconstruction even before you have a mastectomy. This is because it’s possible for you to have your breasts redone during the same operation (while under the same anesthesia). You go to sleep with breasts in place and you wake up with new, altered breasts. This way you never see your chest being flat, with scars and without and boobs. Sometimes this is better for women to deal with psychologically. Also, it reduces the recovery time and avoids the need for two operations. Even though it sounds better, this simultaneous operation isn’t carried out often because it requires two surgeons; a cancer surgeon and a plastic surgeon. Also, some surgeons would prefer their patient to wait a few months after the removal to see how the chest heals. Not all clinics will offer concurrent operations.
If you’ve already had all or part of your breast/s cut out, then you can take all the time you need to consider getting a reconstruction. You should at least research the options which are available. One thing you need to decide is whether to get breast implants or not. Using an implant for breast reconstruction is simpler than the various flap procedures, however flap operations do produce better results. Artificial implants are the same ones they use for breast augmentation. Where there’s not enough skin left over, an expander implant can be used. This is where the surgeon inserts a hollow sac with a valve which is gradually filled with saline over several months, allowing the skin to stretch naturally. Once it’s sufficiently stretched, a fixed-volume implant can be inserted instead of the sac.

When using your own tissue, there are several options. These include the DIEP, TRAM, rectus abdominus, free gluteus and the latissimus dorsi flap methods. Each have their own benefits and disadvantages. Read up about how these are performed and talk to your doctor about which reconstruction method would be most appropriate for you.

Risks

The risks involved with breast reconstruction include infection, build up of fluid, blood clots, blood loss and tissue necrosis. Post operative pain is normal, however you could end up living with long term pain, something which you’ll need to speak with your doctor about. Another scary complication is losing the flap or the implant altogether. Implants can end up rupturing, rotating, moving or even a capsular contracture. This will require implant removal which can be quite upsetting after all the effort you went through. Some women also experience delayed healing or even an infection. A further possible risk is lymphoedema, where surgery causes scarring on the lymph nodes and therefore blocks the drainage system. This can cause painful swelling in the arm.

What you need to realize with breast reconstruction, is that your breasts won’t look the same after the operation. This will depend on how much tissue needs to be removed (whether the whole breast or just a part) and the method of reconstruction.  Also, it could take up to a year for the reconstructed breast to settle in place and for the scarring to soften. You need to be emotionally  prepared for this. However, nearly all women appreciate the huge benefits of getting their breasts back and this greatly outweighs any appearance of asymmetry, deformity and scarring.

Recovery time

The average recovery time is around six weeks. You should be able to return to normal activities within two to four weeks. However, this will depend on how extensive the procedure was and your overall health. If you’re overweight, unhealthy and had two breasts removed and then reconstructed in the one procedure, then your time for healing will be  much longer than if you’re young and fit and are having a reconstruction due to a prior mastectomy. The recovery process is always longer if you’re combining removal with reconstruction in the one operation.

Another aspect which adds to the recovery time  is the type of reconstruction. If you’re using breast implants, your body will heal quicker rather than using donor tissue from your body. This is because the donor site also needs to heal, which is more impact on you body as a whole.

After the procedure

Because the breast tissue is artificial, you will have little or no feeling in the transferred skin. A breast reconstruction cannot restore the function or sensitivity of your breasts and nipples. It’s done for aesthetic and psychological reasons. During the recovery process, you will have swelling, bruising, pain, tenderness and even numbness in the surrounding tissues. The pain will last about a week, during which you can take pain-relieving medication. Your surgeon will give you instructions for caring for your new breasts. This may involve gentle daily massages to stimulate circulation.

A surgical bra or compression garment will help your recovery process by reducing swelling and helping to keep the shape of your breasts. Don’t cheat by using under wire bras or ones that don’t give you any support. To describe what they’re like, think sports bras rather than hose Genie Bras. You should be able to buy post-op bras from your surgeon’s clinic and if not, they will no doubt be able to recommend an appropriate supplier.

The emotional state of women after a breast reconstruction makes the operation worthwhile. Getting their breasts back means they don’t need to use breast prostheses or buy special bras. Their body image and sexual empowerment is retained or significantly improved. Without their breasts, women can feel less feminine and can certainly fall into depression.

Cost

The average breast reconstruction cost ranges between $8,000 to $12,000 depending on the type of reconstruction and whether it’s combined with the mastectomy procedure.  Insurance companies will cover most of the cost. You will  need to buy the medical compression bras. One aspect you can save on is the necessity of wearing false breasts (prostheses) and needing special double layered bras to insert them.

Opinions

I was 35 when I had a double mastectomy. It was a very emotionally challenging time for my. My husband was very supportive throughout the whole process. I didn’t feel like much of  a woman after I had my breasts removed. Before it happens to you, you just cannot imagine what women go through with cancer treatment. Life after the removal was very different. I was very restricted in what I could wear and trying to fill a bra with silicone implants was just demeaning. I decided to have my breasts surgically restored using the expander method. I took months for me to see the results but gradually I was becoming more confident with my body again. I now have size B cups again. The operation brought me back into life and I’m very thankful to my surgeon.

Submitted by Kellie on May 12, 2012.

YouTube video

This YouTube video offers a three minute slideshow of Dr Franklyn Elliott’s patients. It shows a multitude of techniques such as the right and left circumareolar lift and reconstructions, right vertical lift and left free TRAM, bilateral pedicled tram and how the patients look 3 months, 7 months to a year and a half after surgery.

More before and after photos

 

Before and After Photo: Breast Reconstruction #3

Photo #3

Belinda had to have a mastectomy and opted for a GAP flap to reconstruct her breasts. After the surgery her breasts look more lifted and the areolae are smaller.

Before and After Photo: Breast Reconstruction #4

Photo #4

Alena’s breasts after lumpectomy reconstruction. She decided that removing the tumor had left her left breast deformed and wasn’t happy with the way it looked. The reconstruction has greatly improved her shape and now both breasts look symmetrical.

Before and After Photo: Breast Reconstruction #5

Photo #5

Hayley was diagnosed with breast cancer and opted to have one of her breasts removed. She had this reconstructed and also had breast implants inserted. After the op, she went back to have the nipples and areolas done. She’s very satisfied with the way they look now.

 


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