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|Breast Reconstruction With Implant|
|Copyright © Nucleus Medical Media, Inc.|
Reasons for Procedure
- Reactions to anesthesia
- Fluid or blood-filled cysts in the healing breast tissue
- Abnormal scarring
- Painful and/or restricted arm and shoulder motion
- Uneven appearance of breasts, due either to position or size
- Implant may harden, rupture, or leak
- Implant may make cancer detection (through mammogram and/or self-exam) more difficult
- Newly reconstructed breast will not have nerve sensation
- The need to have more surgeries, including having the implants removed
- Bleeding disorder
- Chronic illness or debilitation (such as heart disease, lung disease)
- Prior radiation therapy to the chest wall (which may make healing more difficult)
What to Expect
Prior to Procedure
Your doctor may do the following:
- Physical exam
- Blood tests
- Electrocardiogram (ECG, EKG)
- Make sure you talk to your doctor about the medications you are taking, including over-the-counter drugs and supplements (such as ginkgo, vitamin E). Some medications, like aspirin, may need to be stopped for one week before surgery. You may also need to stop taking blood-thinning medications like warfarin or clopidogrel before surgery, since they increase the risk of bleeding.
- Arrange for a ride to and from the procedure.
- Arrange for help at home after the procedure.
- The night before, eat a light meal, and do not eat or drink anything after midnight.
- You may be asked to shower the morning of your procedure. You may be given antibacterial soap to use.
Description of the Procedure
- A pedicle flap remains attached to the original blood supply under the skin from the abdomen.
- A free flap is completely cut away from its original location and reattached to blood vessels in the chest area using microsurgery. New advanced techniques may decrease complications and recovery time.
- Gluteal-free flap procedure (less common)—Tissue is taken from the buttocks and reconstructed to form a breast shape. New advanced techniques may decrease complications and recovery time.
- Latissimus dorsi flap (common)—Skin and muscle is taken from the upper back and tunneled under the skin to the front of your chest.
Immediately After Procedure
How Long Will It Take?
How Much Will It Hurt?
Average Hospital Stay
- Managing pain and nausea—You might require anti-nausea and pain medicines. You may be nauseated for a few hours after surgery and may not be able to eat normally. Therefore, you may continue to receive fluids and sugar through an IV. For several days after surgery, you may need to eat a lighter, blander diet than usual.
- Preventing blood clots—You may be given special compression stockings to wear after surgery. These help to decrease the possibility of blood clots forming in your legs. You will also be encouraged to walk.
- Improving lung function—You may be asked to use an incentive spirometer. This is a device that helps you breathe deeply. It is important to breathe deeply and cough frequently to improve lung function after general anesthesia.
- Showering or bathing—Ask your doctor about when it is safe to shower, bathe, or soak in water.
Call Your Doctor
- Signs of infection including fever and chills
- Redness, swelling, increasing pain, excessive bleeding, or discharge at the incision site
- Pain that you cannot control with the medications you have been given
- Nausea and/or vomiting that you cannot control with the medications you were given after surgery, or which persist for more than two days after discharge from the hospital
- Implants grow hard or you believe that they are leaking
- Joint pain, fatigue, stiffness, rash, or other new symptoms
- Pain and/or swelling in your feet, calves, or legs, sudden shortness of breath or chest pain
American Cancer Society http://www.cancer.org
Canadian Breast Cancer Foundation http://www.cbcf.org
The Canadian Society of Plastic Surgeons http://www.plasticsurgery.ca
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Cancer information. Memorial Sloan-Kettering Cancer Center website. Available at: http://www.mskcc.org/mskcc/html/11917.cfm. Accessed October 1, 2009.
Nahabedian MY. AlloDerm performance in the setting of prosthetic breast surgery, infection, and irradiation. Plast Reconstr Surg. 2009;124(6):1743-1753.
Namnoum JD. Expander/implant reconstruction with AlloDerm: recent experience. Plast Reconstr Surg. 2009;124(2):387-394.
Reconstruction. Breastcancer.org website. Available at: http://www.breastcancer.org/. Accessed October 14, 2005.
Sabiston DC Jr. Textbook of Surgery. 15th ed. Philadelphia, PA: WB Saunders Co.; 1997.
Silicone gel-filled breast implants: updated safety information. US Food and Drug Administration website. Available at: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm260235.htm. Published June 22, 2011. Accessed July 1, 2011.
Spear SL. Surgery of the Breast: Principles and Art. 2nd ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2005.
7/1/2011 DynaMed's Systematic Literature Surveillance. http://www.ebscohost.com/dynamed. FDA provides updated safety data on silicone gel-filled breast implants. US Food and Drug Administration website. Available at: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm260235.htm. Published June 22, 2011. Accessed July 1, 2011.
- Reviewer: Michael Woods, MD , Michael Woods, MD
- Review Date: 09/2013
- Update Date: 09/30/2013