Breast Cancer

Post-mastectomy and reconstruction
After a mastectomy, some women may choose to wear a prosthesis (artificial breast). Others may decide to have breast reconstruction, perhaps at the same time as the mastectomy. There are several methods to rebuild the breast after mastectomy and each method must be tailored to the individual patient's needs. The type of surgery depends on whether you choose a flap, expander or implant. The simplest operation is to place an implant behind the remaining muscle and create a mound that resembles a normal breast.

If you had a great deal of tissue removed, more skin can be created with a tissue expander. This is a balloon that is placed beneath the muscle and skin. Over several weeks this is made larger by almost painless injections of saline. After several months the expander is replaced by a permanent implant.

Another approach is flap surgery. It uses tissue from your back, thigh or abdomen to rebuild the breast. This tissue is moved into its new position, leaving a defect at the donor site. It is more major surgery, but if you had radiotherapy, which causes severe scarring, a flap may be the only alternative.

Whichever method is used, additional surgery is needed if you want to have the nipple and areola rebuilt. The scar from breast reconstruction depends on the method used. For expanders and implants no new incision is used, because the original mastectomy scar is reopened. If a flap is used you will have a scar at the site where the flap is removed (the donor site) and another around the flap on the breast.

All surgery results in scars and all scars take time to fade. It is usually red and raised for the first month or two after the operation. Recovery takes one-two weeks. Most women are back to work within a week or two, although some recoveries may take much longer.

Regardless of whether you have a mastectomy alone or the added reconstructive surgery, there is a period of time after the surgery when you can expect a certain amount of pain and limited mobility. Recovery times vary depending on what surgery you have had and your overall health.