Breast Reconstruction

The purpose of breast reconstruction surgery is to rebuild one or both breasts following mastectomy, lumpectomy or other trauma.  

Breast reconstruction may involve multiple stages and can be done at the time of the mastectomy (direct to implant or one-step) or delayed until a later time.

Most often breast reconstruction surgery refers to removing a current breast cancer while also creating symmetry with the contralateral breast but it can also be done at a later date to correct misshapen breasts or to achieve symmetry after lumpectomy or mastectomy.

During the consultation, you should be prepared to discuss your comprehensive medical history. Relevant information includes current and previous medical conditions, drug allergies, previous medical treatments and current medications.

Your Plastic Surgical Arts surgeon’s recommendation is based largely on the complete and accurate information you provide during this initial visit.  Your surgical options will be discussed as well as the recommended course of treatment, likely outcome, risk factors and any potential complications.

Your surgeon will examine your breasts and take photographs for your medical record. He will consider such factors as the size and shape of your breasts, the quality of your skin and the placement of your nipples and areolas (the pigmented skin surrounding the nipples).

Some important things to remember in preparing for your breast reconstruction surgery:

You may have a choice between having immediate reconstruction (see video here) at the time of your mastectomy or at a later time (delayed reconstruction).  There may be factors that cause your surgeon to suggest waiting for the reconstruction process and some women are overwhelmed while coping with a new cancer diagnosis and choose to wait for the reconstruction surgery.   Breast forms or prosthetics worn inside the bra are available for women who opt not to have immediate reconstruction and this is typically covered by insurance.

Healing could be affected by previous surgery, chemotherapy, or radiation therapy.  Smoking, diabetes, some medications and other factors may also affect your healing.

A rebuilt breast will not have the same sensation and feeling as your natural breast.  In time, the skin may become more sensitive, but it likely won’t feel the same as before surgery.

Breast skin or flaps occasionally do not survive the reconstruction process resulting in necrosis, or tissue death, and more surgery would be needed to correct this.

Not all reconstructive surgery is a total success and the end result will be much different than your previous, natural breast(s).

For a wealth of information on the reconstruction process and types of surgeries as well as breast cancer diagnosis and treatment in general, we recommend visiting the American Society of Plastic Surgeons website

Your breast reconstruction surgery will be performed at a Lincoln facility such as Lincoln Surgical Hospital, Bryan Medical Center or CHI. Check-in is typically 1 1/2 to 2 hours prior to your surgery time. Just before your procedure, the surgeon will speak with you briefly to discuss the surgery and make any necessary markings. Then a general anesthetic is administered; this type of anesthetic ensures you are asleep throughout the procedure.You will most likely stay in the hospital or surgical facility overnight.

Following the procedure, your incisions will be covered with steri-strips and you will be provided with a surgical bra that you can wear throughout your recovery. The stern-strips are to be left on for up to 10 days, or until your surgeon opts to remove them. It is fine to shower with them in place.  You may also wish to wear a soft dressing or unscented sanitary pad over them to keep them dry as well as absorb any drainage.

Depending on the type of surgery performed, you will most likely be discharged from the hospital in a day or two.  Expect to have drains (small tubes) in place that will aid in the removal of extra fluid from the breasts.  You will be instructed on how to empty them and measure the amount of fluid that is draining in each 24 hours period, which will then determine when your drains can be removed. You will be prescribed medication for pain control.

You’re likely to feel tired and sore for a week or two after surgery, longer if you’ve had reconstruction with flap but the typical recovery period is about 6 to 8 weeks depending on the type of surgery performed.  Your surgeon will instruct you on limits and restrictions which should be followed closely to aid in optimal healing.

Shooting pains, burning, spasms, and numbness are common and temporary sensations most women experience the few weeks following surgery.  Taking minimal pain medicine can help relieve these post-surgical effects.  Sleeping in a reclining position may be most comfortable and will help relieve pressure on your reconstructed breasts.

Some things to keep in mind during the healing process:

It may take up to 8 weeks for bruising and swelling to dissipate.

It’s imperative that you follow your surgeons advice on when to begin massage techniques, stretching exercises and when to resume your normal activities.  As a basic rule, you’ll be instructed to avoid overhead lifting, strenuous sports and sexual activities for 4 to 6 weeks following your reconstruction.

You may experience a period of emotional adjustment after reconstruction while getting used to the loss of a breast and your newly reconstructed breast(s).  Talking with other women who have also had breast reconstruction or a mental health professional may be beneficial while adjusting.

Infections are uncommon, but can occur. If you are experiencing high fevers, excessive drainage from the incisions, redness, or swelling that is not symmetrical with your other breast, you should contact our office at 402-483-2572.   Follow the prompts when calling after hours to reach the surgeon on call.

Fpasms, and numbness are common and temporary sensations most women experience the few weeks following surgery. Taking minimal pain

Initially you will have some swelling and discoloration; this should disappear quickly, although residual swelling may occur for up to a month’s time.

Within two days after your surgery, you should be up and around, although your breasts may feel tight and appear high on your chest, over time, your breasts will drop into position.  

Since the nipple is typically removed during mastectomy you will have a breast mound without a nipple or areola and you’ll have a scar midline across each reconstructed breast.  

Nipple reconstruction is the final stage of the reconstruction process and can be done in our office under a local anesthetic after you’ve healed entirely from the reconstruction surgery.  

Some women elect to have nipple tattooing to create the appearance of an areola. Tattooing is not something we do in our office, and is often done by another qualified professional (MD) or in a tattoo parlor.

Insurance will cover for the tattooing if done by an MD but not if done in a tattoo parlor. We can help point you in the right direction if this is something you are interested in.

Most women can start to get back to normal activities within 4 to6.

Some things to keep in mind:

Sensation often changes after breast reconstruction.

It may take as long as 1 to 2 years for the breasts to heal fully and scars to fade (the scars never go away completely).

Follow your surgeon’s advice on when to begin stretching exercises and normal activities.

As a basic rule, you’ll want to avoid overhead lifting, strenuous sports, and some sexual activities for 4-6 weeks after reconstruction.

Call your doctor right away if you notice any new skin changes, swelling, lumps, pain, or fluid leaking from the breast, armpit, or flap donor site if applicable, or if you have other symptoms that concern you call 402-483-2572.