What to Know About Breast Reconstruction Surgery

As a way to treat or prevent breast cancer, a woman may be advised to undergo a mastectomy, or surgery to remove the breast. Afterwards and after she has recovered from treatment, she might consider breast reconstruction surgery. Rachel Anolik, MD, a Washington University plastic and reconstructive surgeon, explains more about breast reconstruction surgery and what a woman can expect.

Who is a candidate?
While there are many women who choose to go flat, anyone who underwent a mastectomy and is interested in breast reconstruction surgery can have it done. Because it is an elective procedure, the surgical team will ensure a woman is as healthy as possible before undergoing another surgery. This includes making sure she is both physically and emotionally prepared. Even if a woman had a mastectomy in the past and is now at a point where she’d like to think about reconstruction, she can still have reconstruction at any time.

What does the procedure involve?
In Dr. Anolik’s practice, breast reconstruction is done in stages. At the time of the mastectomy, the plastic surgeon is there to insert a tissue expander under the skin where the breast surgeon has done the mastectomy. The tissue expander stays in place until the final reconstruction. At this point, the team is waiting on pathology to make sure that the cancer has been completely removed. 

The patient will then return in a few weeks for her reconstruction, which can either be an implant-based reconstruction or flap surgery, where the woman’s own tissue is used. If a woman has had chemotherapy or radiation as part of her cancer treatment, this surgery will happen much later to give the body time to heal.

How long is recovery?
For implant-based reconstruction, recovery is slightly quicker than flap surgery at just a couple of weeks. Implant reconstruction does often require revision surgeries three to six months later to touch up scars or address any asymmetries. Over time, the implant also needs to be exchanged every 10 years or so. However, each of those surgeries is outpatient with a relatively quick recovery, all of a week or two. 

Flap surgery where the woman’s own tissue is used takes a little bit longer to recover, usually two to four weeks. While it is a bit more of a commitment upfront in terms of recovery time, it is a more natural and durable reconstruction that lasts the woman’s entire life. 

Regardless of which option a woman chooses, breast reconstruction is a journey. She will have several check ins with her surgeon and may undergo multiple surgeries, so it’s important to choose a care provider she can trust and develop a relationship with.

Rachel Anolik, MD, is a Washington University plastic and reconstructive surgeon with an office at Barnes-Jewish St. Peters Hospital. For more information or to schedule an appointment, visit BJCStCharlesCounty.org or call 636.928.WELL.