Breast Reconstruction (cont.)
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
In this Article
- What is breast reconstruction?
- Who is a candidate for breast reconstruction?
- What are the potential risks associated with breast reconstruction?
- When is breast reconstruction performed?
- What are the different types of breast reconstruction procedures that are available?
- Is breast reconstruction surgery possible after radiation?
- What is the recovery like after breast reconstruction surgery?
- What type of screening for breast cancer should be done after reconstructive surgery?
- Find a local Plastic Surgeon in your town
What are the potential risks associated with breast reconstruction?
Risks associated with any surgical procedure vary and are dependent on patients' existing medical problems. Some patients are at much higher risk for complications, especially patients who have diabetes, obesity, and/or high blood pressure. Patients who actively smoke are setting themselves up for major complications post-surgery. Patients who have had prior lumpectomy and radiation therapy to the chest are also at a high risk for complications. Being at risk for higher rates of complications does not mean that the patient will never have reconstructive surgery, but it may be that the surgical team may elect to “delay” reconstructive surgery. Some lifestyle modifications may also be recommended while preparing for the delayed reconstructive surgery. The goal is to set the patient up for success with this process, as reconstructive surgery is a major undertaking and will require multiple procedures.
As with other surgical treatments, there are always risks from anesthesia. Breast reconstruction complications may include bleeding, infection, and complications in the healing of the incision site. The risks of infection and seroma formation (fluid collection in the breast pocket) are higher with patients undergoing immediate reconstruction compared to those who are “delayed,” but the psychological benefits outweigh the risks for some patients.
In a patient who requires flap surgery, there is a risk of loss of sensation in the flap and the donor site. The use of implants carries the risk of firmness in the breast, known as capsular contracture, and risk of implant rupture. Fortunately, past concerns in the 1990s that silicone implants led to certain systemic diseases have been dismissed. Research conducted by the Institute of Medicine has shown that the use of silicone implants does not pose additional health risks, such as autoimmune or other systemic diseases, or complicate breast health or healing.
No matter which technique is used to rebuild a breast, a woman's chest skin will change over time with age, weight, and hormonal changes. Therefore, the shape of the breast will also change over the years and revision procedures may be needed if the patient desires them.
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