Delayed Breast Reconstruction
Restoring Your Breasts To A Natural And Radiant Shape, Appearance And Symmetry Following A Mastectomy Procedure With Breast Reconstruction
Restoring Your Breasts To A Natural And Radiant Shape, Appearance And Symmetry Following A Mastectomy Procedure.
Like many women, you chose not to have breast reconstruction at the time of your mastectomy or lumpectomy. You may have made this decision based on the specifics of your cancer treatment, concerns about the procedural outcome, or a desire to avoid additional surgeries. Additionally, you may not have known about all your options — studies have shown that most women are not properly informed of their reconstructive choices.
It is important to know that you can change your mind about breast reconstruction at nearly any time. Modern delayed breast reconstruction procedures and techniques can offer aesthetically pleasing results in most circumstances, even if you were told that you were not a candidate in the past.
Learn about your options and receive personalized recommendations by scheduling a consultation with us. Radiance Plastic Surgery welcomes patients from Calgary, Edmonton, Red Deer, Canmore and Banff areas of Alberta as well as throughout Canada.
DELAYED BREAST RECONSTRUCTION AT RADIANCE PLASTIC SURGERY
Breast Reconstruction Benefits
REDUCES THE PSYCHOLOGICAL IMPACT OF MASTECTOMY
ELIMINATE THE NEED FOR THE EXTERNAL PROSTHESIS
INCREASE SELF-CONFIDENCE
IMPROVES QUALITY OF LIFE
Delayed Breast Reconstruction – What Is It?
Breast reconstruction can be performed at different times, depending upon what works best for your case. Delayed breast reconstruction is a surgery that is performed many weeks, months, or years after a mastectomy.
The decision to perform a reconstruction surgery immediately or at a later time may depend upon several factors, such as:
- Your medical condition
- Your breast cancer stage
- Your lifestyle and preference
- Additional treatment measures, such as chemotherapy or radiation required to treat breast cancer.
Although immediate breast reconstruction is the preferred method of reconstruction, it might not be possible or available at the time of Mastectomy. Some surgeons recommend patients to hold off on reconstructive surgery until after chemotherapy and radiation therapy are completed prior to having breast reconstruction as these therapies can cause the reconstructed breast to change in appearance, texture, colour, and to lose volume.
Specifically, radiation therapy has been known to cause unpleasant changes to implant reconstruction. Cancers that are greater than 5 centimetres in size and that have advanced to the lymph nodes are more likely to require radiation therapy post-surgery.
Delayed Breast Reconstruction At Radiance Plastic Surgery
Dr. Laliberte is a delayed breast reconstruction specialist, providing incredible guidance and support throughout the process and providing beautiful, natural results. While mastectomy is a traumatic experience for any woman, breast reconstruction is an alternative for women of any age whose health is good enough to tolerate a general anesthetic.
There are two basic ways of reconstructing a breast or both breasts:
- Breast Implants
- Using your own tissue
As with all plastic surgery procedures, there are multiple techniques available for reconstructing the breasts after mastectomy. In helping patients to decide which technique is best suited to their particular case, Dr. Laliberte takes many factors into account, such as your age, weight, lifestyle, family and work. Each individual patient’s circumstances can impact the decision as to what type of reconstruction best suits them but the important thing to remember is that almost all woman are candidates for delayed breast reconstruction and in order to know what option is best for you, you must first be presented with all the options available.
There are many benefits of delayed breast reconstruction but because many plastic surgeons don’t perform all different types of breast reconstruction, many women are only given a select few options for their reconstruction. Because Dr. Laliberte specializes in the most advanced methods of breast reconstruction, especially DIEP flap and other natural tissue options, his patients get the opportunity to decide for themselves what option they prefer.
Whether you are preparing to undergo mastectomy or have already undergone mastectomy, schedule a confidential consultation with Dr. Laliberte at his Canmore, Alberta plastic surgery practice. Dr. Laliberte will detail the specific advantages associated with each method of delayed breast reconstruction and advise you as to the method that will provide the best, longest-lasting and most aesthetically pleasing results in your particular case.
Delayed Breast Reconstruction – Is It Too Late?
It’s never too late to reclaim your breasts through reconstruction. Delayed reconstruction can be performed at any time, even decades after your mastectomy. If you’re concerned about age affecting your reconstruction experience, you should know that older and younger women tend to experience the same benefits from breast reconstruction and the same risk of complications.
While many women choose to undergo immediate reconstruction at the time of their mastectomy, it is not an option for everyone. Whatever your reason for forgoing reconstruction in the past, you should know that delayed reconstruction is a viable option that can allow you to achieve the results you desire.
Delayed Breast Reconstruction Am I A Candidate?
Breast reconstruction is a highly individualized procedure. You should do it for yourself, not to fulfill someone else’s desires or to try to fit any sort of ideal image.
You may be a candidate for breast reconstruction if:
- You are able to cope well with your diagnosis and treatment
- You do not have additional medical conditions or other illnesses that may impair healing
- You have a positive outlook and realistic goals for restoring your breast and body image
Although breast reconstruction can rebuild your breast, the results are highly variable.
- A reconstructed breast will not have the same sensation or feel as the breast it replaces
- Visible incision lines will always be present on the breast, whether from reconstruction or mastectomy.
- Certain surgical techniques will leave incision lines at the donor site, commonly located in less exposed areas of the body such as the back, abdomen or buttocks.
Delayed reconstruction can be a life-changing procedure if your mastectomy impacted your feelings of femininity or wholeness. It is also a good solution if you are searching for an alternative to cumbersome breast forms and prosthetics.
Delayed Breast Reconstruction – The Consultation
During your breast reconstruction consultation, be prepared to discuss:
- Your surgical goals
- Medical conditions, drug allergies and medical treatments
- Current medications, vitamins, herbal supplements, alcohol, tobacco and drug use
- Previous surgeries
Dr. Laliberte will also:
- Evaluate your general health status and any pre-existing health conditions or risk factors
- Examine your breasts and take measurements of their size and shape, skin quality and placement of nipples and areolae
- Take photographs
- Discuss your options and recommend a course of treatment
- Discuss likely outcomes of breast reconstruction and any risks or potential complications
Delayed Breast Reconstruction – The Procedure
A breast reconstruction procedure includes the following steps:
Step 1 – Anesthesia
Medications are administered for your comfort during the surgical procedure. The choices include intravenous sedation and general anesthesia. Your doctor will recommend the best choice for you.
Step 2 – Flap techniques reposition a woman’s own tissue to create or cover the breast mound
Sometimes a mastectomy or radiation therapy will leave insufficient tissue on the chest wall to cover and support a breast implant. In these cases, breast reconstruction usually requires either a flap technique or tissue expansion.
A TRAM flap uses donor muscle, fat and skin from a woman’s lower abdomen to reconstruct the breast. The flap may either remain attached to the original blood supply and be tunneled up through the chest wall, or be completely detached, and formed into a breast mound.
Alternatively, Dr. Laliberte may choose the DIEP flap or SIEA flap techniques, which do not use abdominal muscle but transfer only skin and fat to the chest from the abdomen. If there is insufficient tissue on the lower abdomen, other donor sites such as the buttocks or thighs may be selected (SGAP flap, TUG flap, PAP flap).
A latissimus dorsi flap uses muscle, fat and skin from the back tunneled to the mastectomy site and remains attached to its donor site, leaving blood supply intact.
Occasionally, the flap can reconstruct a complete breast mound, but often the latissimus flap provides the muscle and tissue necessary to cover and support a breast implant.
Step 3 – Tissue expansion stretches healthy skin to provide coverage for a breast implant
For women who do not require breast radiation and would like to avoid a separate donor site, implant-based reconstruction is an option. Reconstruction with tissue expansion allows an easier recovery than flap procedures, but it can be more lengthy reconstruction process.
It usually requires several office visits over 1-2 months after placement of the expander to gradually fill the device with saline through an internal valve to expand the skin. Newer air-filled devices may allow patient-controlled expansion at home using a remote dosage controller.
A second surgical procedure will be needed to replace the expander if it is not designed to serve as a permanent implant.
Step 4 – Surgical placement of a breast implant creates a breast mound
A breast implant can be an addition or alternative to flap techniques. Dr. Laliberte may also use an implant as a temporary placeholder during other breast cancer treatments until you are ready for more involved flap reconstruction techniques. Saline and silicone implants are available for reconstruction.
Dr. Laliberte will help you decide what is best for you. Reconstruction with an implant alone usually requires tissue expansion. Direct-to-implant breast reconstruction may be an option for some women undergoing mastectomy with certain tumor characteristics and breast shapes.
Step 5 – Reconstructing a nipple and areola, breast revision techniques
For women who are not candidates for nipple-sparing mastectomy, breast reconstruction is completed through a variety of techniques that reconstruct the nipple and areola. Techniques usually involve folding skin to create the shape of a nipple followed by tattooing. Three-dimensional nipple-areolar tattooing may be used alone to create the appearance of a realistic nipple with the illusion of projection.
Breast reconstruction outcomes can often be enhanced with staged revision procedures that improve symmetry, use liposuction with fat grafting and improve the appearance of the donor site.
Delayed Breast Reconstruction Recovery & Results
Following your breast reconstruction surgery for flap techniques and/or the insertion of a breast implant, gauze or bandages may be applied to your incisions.
An elastic bandage or support bra will minimize swelling and support the reconstructed breast. A small, thin tube may be temporarily placed under the skin to drain any excess blood or fluid.
You will be given specific instructions that may include:
- How to care for your surgical site(s) following surgery
- medications to apply or take orally to aid healing and reduce the risk of infection
- specific concerns to look for at the surgical site or in your general health
- when to follow up with Dr. Laliberte.
The final results of breast reconstruction following mastectomy can help lessen the physical and emotional impact of mastectomy. Over time, some breast skin sensation may return, and scar lines will improve, although they will never disappear completely.
There are trade-offs, but most women feel these are small compared to the large improvement in their quality of life and the ability to look and feel whole. Careful monitoring of breast health through self-exam and other diagnostic techniques is essential to your long-term health.
Following your Dr. Laliberte and our healthcare team’s guidance is key to the success of your surgery. It is important that the surgical incisions are not subjected to excessive force, abrasion or motion during the time of healing. Dr. Laliberte will give you specific instructions on how to care for yourself.
Delayed Breast Reconstruction Frequently Asked Questions
It is never medically necessary to have breast reconstruction. This is considered an elective procedure, meaning you can choose to have it done or not. Some women choose to have a mastectomy (removal of breast tissue) without reconstruction.
Some patients prefer to have reconstruction done (or at least the process started) at the same time as their mastectomy. Breast reconstruction performed at the same time as your mastectomy is called immediate reconstruction. Delayed reconstruction is a term used if you choose to have the mastectomy done and then wait to have the reconstruction at a later date.
The vast majority of women are candidates for reconstruction. There are a variety of reconstructive options and you may not be a candidate for all types. You and your Dr. Laliberte will discuss which type of breast reconstruction is best for you.
For implant reconstruction, most women take four weeks off following the mastectomy and placement of the tissue expanders and one week off of work after the second surgery (removal of the tissue expanders and placement of the permanent implant). Many women are able to return to work during the tissue expansion process.
For tissue flap reconstruction, women generally take four to six weeks off of work.
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Meet Dr. Michael C. Laliberte
MD, FRCSC
Canadian Board Certified Plastic Surgeon
Dr. Laliberte, Radiance Plastic Surgery’s Royal College-certified plastic surgeon has quickly established himself among the finest Cosmetic and Reconstructive Plastic Surgery specialists throughout western Canada.
With extensive training and years of specialized experience, Dr. Laliberte has built an outstanding team of healthcare professionals and clinical staff to ensure an exceptional in-patient experience and seamless delivery of service and post-operative care.
Having operated alongside word-class surgeons throughout North and South America, Dr. Laliberte brings to the Canadian Rockies a practice that encompasses the breadth of Aesthetic and Reconstructive Plastic Surgery.
Dr. Michael Laliberte has extensively trained in Plastic, Aesthetic, and Reconstructive surgery. After completing undergraduate and medical school at the University of Saskatchewan, Dr. Laliberte specialized in Plastic Surgery at the University of Manitoba.
Dr. Laliberte and the team at Radiance Plastic Surgery are best known in Alberta, and throughout Canada for exceptional surgical outcomes and compassionate care. Our goal is simple: to support you in achieving your cosmetic goals and restoring your confidence.
A Cosmetic Experience Designed To Help You Rejuvenate Your Confidence
The secret is out. We’ve built a state-of-the-art clinic and private surgical centre servicing patients from Calgary, Canmore, Banff, Edmonton, Red Deer, Airdrie, Lethbridge, Medicine Hat and across Canada.
You’ll find us in the Canmore Crossing Complex. We are excited to welcome you to our new clinic and private surgical centre.
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Our Canadian Rockies plastic surgery practice has quickly established a strong reputation as one of the leading cosmetic and reconstructive surgery centres throughout Alberta, and Canada.
We encourage women and men considering plastic surgery to view our gallery of before-and-after photos and read patient-written reviews, so they can rest assured they will be in good hands at our practice.
