With a few exceptions, regardless of the type of reconstruction selected, two surgical procedures or “stages” will likely be needed to complete your full breast reconstruction. In some cases, however, you may be able to have the reconstructive process completed in a single operation.
Surgery may include nipple reconstruction as well as a procedure on the unaffected breast to produce symmetry. While the majority of women prefer to have nipples reconstructed as this minor procedure greatly enhances the aesthetic results and the natural appearance of their reconstructed breast, not all women choose to do so.
Our practice offers breast reconstruction surgery in Connecticut and New York City. If you live outside of these areas, you can comfortably return home between stages of treatment.
Below, you will find timelines that are typical for each type of breast reconstruction that the surgeons of the Advanced Reconstructive Surgery Group offer. Depending on individual patient circumstances, the time course to complete reconstruction may vary.
STAGE I: Creating a Breast with Natural Tissue
At the first stage of natural-tissue breast reconstruction, transferring borrowed tissue to the mastectomy site restores a breast. The tissue is sculpted to restore the natural shape and form of the breast as closely as possible. Women who undergo this type of surgery generally stay three nights in the hospital for monitoring, but typically have minimal pain.
STAGE II: Refining Your Breast Reconstruction And Nipple Reconstruction
About three months or more after the first stage of reconstruction, a relatively short outpatient procedure can be done to refine the shape of your reconstructed breasts, and to reconstruct nipples, if that is part of the surgical plan. You’ll be able to go home the same day as this procedure and most women can return to work or other non-vigorous activities after only a few days. The shape of your reconstructed breasts will be carefully refined, as will the donor the donor site, to achieve the best possible aesthetic results. If you have had only one breast reconstructed, a breast lift, breast augmentation or breast reduction can be done on the unaffected breast at this time to improve symmetry.
Direct-to-Implant reconstructions, also called “One-Step Reconstructions,” or “One-Stage Reconstructions,” are generally our preferred, and our patients’ preferred approach to breast implant reconstruction. That’s because when it is possible to perform such procedures, at the same surgery, an implant can be placed directly in the space created by the mastectomy, and therefore there is no need to undergo tissue expansion. Furthermore, the potential for chronic problems—including discomfort, reduced strength, and reduced mobility—associated with lifting of the chest wall muscles in the more traditional tissue expander-implant approach, is dramatically reduced. Women who have a one-stage breast implant reconstruction generally go home the day after surgery.
TISSUE EXPANDER/IMPLANT RECONSTRUCTION
STAGE I: Creating Space for a Breast Implant by Tissue Expansion
A tissue expander will be placed under the pectoralis muscle of the chest, typically at the time of a mastectomy. In the weeks following surgery, by injecting sterile fluid or air at a series of office visits, the expander will be gradually enlarged in order to expand the tissue at the mastectomy site to make room for an implant.
STAGE II: Replacing a Tissue Expander with a Breast Implant
Following completion of the expansion process, at a second surgery approximately 4-12 weeks following the initial procedure, the tissue expander is exchanged for a breast implant. A nipple reconstruction can sometimes be done at this stage, but often it is done during a short additional procedure. You’ll be able to go home the same day as this procedure and most women can return to work or other non-vigorous activities after only a few days. If you have had only one breast reconstructed, a breast lift, breast augmentation or breast reduction can be done on the unaffected breast at this time to improve symmetry.
Natural appearing color can be restored to reconstructed nipples and areole (the pigmented area that surrounds the nipples) about three months after nipple reconstruction. Pigment is applied as a 3-D medical tattoo in the comfort and privacy of our office. If necessary, topical numbing medication can be used to assure that the tattooing is painless.