Dr Richie Gupta, Fortis Hospital, India answers the most pertaining and frequently asked questions (F.A.Q) Reconstructive surgery for breast after mastectomy. Have a look at the interview below:
Q1. How safe is Breast Reconstructive Surgery post Mastectomy?
Ans: Mastectomy is often done for breast cancer. For early-stage cancer, we can supplant the surgery in such a manner that as soon as the breast is removed, it can be reconstructed in the same sitting, so that as soon as the patient wakes up, she doesn’t bear the burden of breast loss at all. In later stages of cancer, we often have to wait for a period as determined by the oncologist so that if there is no recurness, one can go ahead with the reconstruction at a later date.
Q2. What are the types of Breast Reconstructive Surgery?
Ans: The surgery can be done in three different ways:
- Implant Surgery: Sufficient skin envelope is available and an implant can be placed in that area or an expander implant can be done where the skin can be expanded and then the implant can be placed.
- Flap Surgery: Body’s own tissue from the abdomen, back or buttock areas is used to create a breast mound in the place of the breast that has been excised.
- Fat Injection Technique: Body’s own fat from the abdomen, back or buttock areas is used and is injected into the area from where the breast was removed. This procedure takes around 4-5 sittings at monthly intervals before you can achieve a reasonable shape. With Fat Injection Technique, one can achieve an average size breast. With Flap Surgery, especially from the abdomen, one can achieve normal size breast. Implant surgeries can give the best results as one can choose the size of the implant to be as close as the size of the opposite breast. So size wise, it’s possible to get as close as possible. Shape-wise, normal breast is teardrop shaped while the implant is circular shaped but some matching can be done either by modifying the normal breast or in secondary surgery on the implanted breast.
Q3. Can there be infections due to scars post surgery?
Ans: With surgery, there is a slight risk of infection. As flap loss may occur but that depends on the type of surgery.
Q4. What is the recovery process after Breast Reconstruction Surgery?
Ans: The recovery process after Breast Reconstruction Surgery:
- Fat Injection Surgery: Hospital stay is not required, the patient can get the fat injection and go home immediately.
- Breast Implant Surgery: We usually retain the patient overnight for giving Intravenous Antibiotics to prevent infection.
- Flap Surgery: Patient may require 2-4 days of hospital stay because she has 2 sides which need healing – one from where the flap was taken and one where it was implanted.
Q5. What set of pain medications are to be administered post surgery?
Ans: Generally, after surgery, there is a need for injectable painkillers but that is needed for only 1-2 days. After that, it is manageable on tablets that are to be taken routinely. And yes, local doctors can take care of the patient in the long run.
Q6. How soon can I return to the office?
Ans: It depends on the type of reconstruction that is done.
- Fat Injection Surgery: You can probably return to work the next day itself.
- Breast Implant Surgery: 5-7 days before returning to work. Any rigorous exercise should be deferred for 3-4 weeks.
- Flap Surgery: 2-3 weeks before returning to work. Any rigorous exercise should be deferred for 4-6 weeks.
Q7. Advice for International patients travelling for Surgery
Ans: My advice would be to send as much information (photographs/ clinical data) as you can to the treating surgeon. Based on that only, the surgeon will decide upon the type of reconstruction needed.