Simultaneous breast reconstruction

Surgical Steps in Simultaneous Breast Reconstruction

Before the surgeon can reconstruct the breast, it must first be removed in a process called a mastectomy. This requires the woman being under general anesthesia. After making an incision, the surgeon continues cutting until the entire breast under the skin flap is removed.

The breast is then reconstructed with a tissue expander or a direct to implant reconstruction. The tissue expander allows the surgeon to change the current breast envelope to take the shape of what the patient desires (larger or smaller). The direct to implant is done for patients who want minimal change to their pre-operative breast shape.

When the mastectomy leaves an inadequate amount of tissue on the chest wall to support a breast implant, the surgeon needs to create a flap for wound defect closure and the reminder of the reconstruction will proceed at a later date. The placement of the incisions determines how the surgeon is able to place the implant and the degree of scarring the patient will have after the reconstruction phase of the surgery. Dr. Jackson, along with your general surgeon, will discuss these markings (incision sites) prior to your surgery.

Recovery from the Double Surgery

Most patients spend a day or two in the hospital after a mastectomy and simultaneous breast reconstruction. This is usually with a drainage tube in place that pulls blood and body fluids from the surgical site and pushes them to an external collection device. The nurse will show the patient how to empty it before she leaves the hospital. The greatest amount of discharge takes place during the first 24 hours and will continue to decrease until stopping altogether after about a week or two.

Incisions from the surgery must be kept dry for at least three days. That means patients need to avoid showers and baths for the first three days. A surgical wrap holds the reconstruction in place, which patients should wear continuously until Dr. Jackson directs them to stop. Patients will learn how to change their own dressings and should do this once a day during this time frame. Preferably, another person, such as a loved one, can help with this.

The surgeon will send the patient home with prescription-strength medication for pain. It is important to take this medication and avoid anything with aspirin or aspirin products for at least the first three days since this increases the risk of bleeding. Bruising, numbness, tingling, and general discomfort should disappear after several days.

Performing arm exercises and getting up to walk around can start the day after surgery. However, strenuous workouts must wait several weeks. Patients vary considerably on the amount of time needed to recover. Some are able to return to work within two weeks and others need six weeks or longer at home to recover from a mastectomy and immediate breast reconstruction.