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Breast reconstruction surgery

Published by Bupa's health information team, July 2008.

This factsheet is for women who are planning to have breast reconstruction surgery, or who would like information about it.

Breast reconstruction surgery is done to help regain the original shape and appearance of breasts after complete or partial breast removal (mastectomy).

Your care will be adapted to meet your individual needs and may differ from what is described here. So it's important that you follow your surgeon's advice.

About breast reconstruction surgery

Your breast reconstruction surgery can be done immediately after having a complete or partial breast removal (mastectomy), or at a later date.

Your breasts can be reconstructed using breast implants or tissue from another part of your body. The surgery usually involves more than one operation. During the first operation your breast shape and size is restored. A second operation may involve nipple reconstruction (if it's been removed during a mastectomy) and you may have further treatment to tattoo the areola area of skin (the area of dark tissue surrounding the nipple) at a later date. You may also need an operation to change the size of your natural breast so that both breasts are similar in shape.

This factsheet gives information about the initial operation done to restore the shape and size of the breast.

Preparing for your operation

Your surgeon will explain how to prepare for your operation. For example, if you smoke, you will be asked to stop as smoking increases your risk of getting a chest and wound infection, which can slow your recovery.

You may be asked to bring in a soft, supportive bra without under-wiring to wear after surgery. Your surgeon will advise you about the most suitable type of bra beforehand.

Breast reconstruction surgery usually requires a hospital stay of several days. The length of your stay will depend on the extent of your surgery and how you feel afterwards.

Breast reconstruction surgery is usually done under general anaesthesia. This means you will be asleep during the operation.

You will be asked to follow fasting instructions. Typically, you must not eat or drink for about six hours before a general anaesthetic. However some anaesthetists allow occasional sips of water until two hours beforehand.

At the hospital your nurse may check your heart rate and blood pressure, and test your urine.

Your surgeon will explain the procedure and ask you to sign a consent form. This confirms that you understand the risks, benefits and possible alternatives to the procedure and have given your permission for it to go ahead.

Your surgeon will measure your unaffected breast and assess its shape and the position of the nipple. Your surgeon may mark the position of the surgical cuts on your operated breast. Photographs may be taken, so that the results of surgery can be compared with your original appearance and you may have a mammogram (X-ray of your breasts).

About the operation

There are several techniques available for the procedure. Some surgeons use a combination of methods to get the most acceptable result. Depending on the method used, your operation can take from one to eight hours.

Breast implant

Usually a silicone breast implant is used. This is placed either directly under the skin or deeper behind the muscle on which the breast lies. An implant can be used to replace breast tissue, especially if the breast skin and nipple are preserved during the mastectomy.

Once the implant has been adjusted to the correct shape and position, the skin cut is closed with stitches. For more information about breast implants, see Related topics.

Tissue flap reconstruction

Tissue is taken from other parts of the body and used to reconstruct the breast. There are two types of tissue flaps used for breast reconstruction.

When breast reconstruction is complete, the cuts are closed with stitches (which may be dissolvable) and your breasts are wrapped in a special supportive dressing.

Fine plastic tubes may be left in your breast for up to 48 hours afterwards. These allow blood and fluids to drain into a bag.

What to expect afterwards

You will need to rest until the effects of the anaesthetic have passed. You may need pain relief to help with any discomfort as the anaesthetic wears off. You may have a drip in your arm to keep you hydrated and give you painkillers and antibiotics.

When you feel ready, you can begin to drink and eat, starting with clear fluids.

You may have a catheter (a fine tube) to drain urine from your bladder into a bag. This will usually be removed when you are ready to get out of bed and walk around.

Your surgeon will visit you to assess your progress and answer any questions you may have about the operation.

Your nurse will give you advice about getting out of bed, bathing, diet and gentle exercises.

You will go home with bandaging in place and you will be given a date for a follow-up appointment.

Dissolvable stitches will disappear in seven to 10 days. Non-dissolvable stitches are removed seven to 14 days after surgery.

Recovering from breast reconstruction surgery

If you need pain relief, you can take over-the-counter painkillers such as paracetamol or ibuprofen. Always read the patient information that comes with your medicine and if you have any questions, ask your pharmacist for advice.

General anaesthesia temporarily affects your co-ordination and reasoning skills, so you must not drive, drink alcohol, operate machinery or sign legal documents for 48 hours afterwards. If you are in any doubt about driving, please contact your motor insurer so that you are aware of their recommendations, and always follow your surgeon's advice.

Follow your surgeon's advice about driving. You shouldn't drive until you are confident that you could perform an emergency stop without discomfort.

You may be asked to wear a support bra for four to six weeks after the operation. This helps to stop the weight of the breasts pulling on the healing wounds. Your breasts will feel sore and you will have swelling for a few weeks. Using extra pillows when sleeping can help reduce the swelling around your breasts.

If you develop any of the following symptoms contact your GP as you may have developed an infection:

At your follow-up appointment, your surgeon will give advice about when you can resume your usual activities and return to work.

It may take several months before your reconstructed breast settles into its new shape.

What are the risks?

Breast reconstruction surgery is commonly performed and generally safe. However, in order to make an informed decision and give your consent, you need to be aware of the possible side-effects and the risk of complications of this procedure.

Side-effects

These are the unwanted but mostly temporary effects of a successful treatment, for example feeling sick as a result of the general anaesthetic.

Side-effects of breast reconstruction surgery include:

Complications

This is when problems occur during or after the operation. Most women having breast reconstruction are not affected. The possible complications of any operation include an unexpected reaction to the anaesthetic, excessive bleeding or developing a blood clot, usually in a vein in the leg (deep vein thrombosis, DVT).

Complications specific to breast reconstruction surgery are uncommon but can include:

It's possible that you may not be completely satisfied with your appearance after the operation.

The exact risks are specific to you and differ for every person, so we have not included statistics here. Ask your surgeon to explain how these risks apply to you.

Further information

Related topics

Sources

This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.

Publication date: July 2008.