A Breast Reconstruction Can Help You Maintain Your Self-Confidence After Breast Cancer Treatment

Undergoing a mastectomy can be a traumatic event in the life of any woman. Fortunately, there are treatment options available to restore your breast or breasts to their pre-treatment look and feel. Board-certified plastic surgeon Dr. Roger J. Oldham can work alongside your breast surgeon to perform breast reconstruction at his plastic surgery practice in Bethesda, MD, to restore the breast’s size, shape, and appearance after mastectomy. He can perform the procedure using breast implants, tissue flaps from the patient’s body, or a combination of these techniques. Breast reconstruction is a highly customizable procedure, and patient preference will help determine which technique is used. During your consultation, Dr. Oldham can explain all of your options and give you his recommendation.

Do I Need a Reconstruction?

No person needs a breast reconstruction after cancer treatment. You should never feel pressured to undergo such a procedure.

However, the treatment can have psychological benefits for a patient. Many women feel that their femininity and identity as a woman is tied closely to their breasts. Reconstruction allows you to wear the clothes you always enjoyed without external breast prosthetics or pads to minimize the change in your silhouette. You can also enjoy added improvements such as similar symmetry and a boosted sense of self-confidence. 

Candidates for Breast Reconstruction

Whether to have the breast reconstructed after mastectomy is completely up to the patient. While some women choose not to undergo reconstruction, others feel that restoring their breast appearance is a crucial aspect of restoring their sense of normalcy after breast cancer treatment and recovery. In general, candidates for breast reconstruction:

  • Have had (or will have) one or both breasts removed
  • Should be cancer-free
  • Are non-smokers
  • Should be in general good health
  • Are willing to commit to the potential of multiple surgeries and associated recovery periods

Although the reconstruction process can be lengthy and emotionally taxing, Dr. Oldham and his staff are available to guide patients through this treatment from start to finish. 

Planning Your Surgery 

During your initial consultation, you will sit down with Dr. Oldham and your breast surgeon to review your options for surgery. When designing your procedure, the doctors will take into account your medical history, health, age, body composition, and desired outcomes to give you the shape, size, and placement that will best help you achieve your goals. 

The decision to undergo breast reconstruction is a daunting one, but you can feel at ease under the care of a board-certified plastic surgeon.

Overview of Treatment

The options available for breast reconstruction include treatment with breast implants or treatment using tissue flaps from the patient’s own body. There are different options available for reconstruction using tissue flaps. The tissue used can come from the abdomen, back, thighs, or buttocks. Tissue flaps require more surgery and have a longer recovery time, but when they heal, they look and feel more natural than implants. In some cases, the best results can be achieved by combining implant treatment with flap treatment. If only one breast is affected, Dr. Oldham may recommend a breast lift, breast augmentation, or breast reduction on the unaffected breast to achieve symmetry.

Procedures are performed under general anesthesia, and recovery will depend on what technique is used. Typically, patients will require three to four weeks of recovery after reconstruction surgery before they can resume their regular activities.

Breast Reconstruction with Implants

Implant treatment may either be performed at same time as the mastectomy (immediate reconstruction) or after a tissue expander has been placed.

Immediate Reconstruction

If you are still planning your mastectomy procedure, you may want to consider immediate (also known as direct to implant) breast reconstruction. When combined with a nipple-sparing or a total skin-sparing mastectomy, in which neither the nipple nor any skin at all is removed, this technique can produce very good results. However, the direct to implant technique can interfere with circulation if the skin is pulled too tight.

Delayed Reconstruction

Delayed reconstruction is also called two-stage reconstruction. If the surgeon performing the mastectomy feels that the skin flaps will not support an implant immediately, then a sac resembling a balloon can be placed in the chest to stretch the skin. Over a period of two to three months, the patient will make regular visits to the doctor to have the sac, or tissue expander, injected with a salt water solution. When the skin has expanded enough, the expander is removed and the implant is placed. In some cases, the expander may be used as the final implant, eliminating the need for another surgery. Patients requiring radiation treatment following their mastectomy will need to complete treatment before the expander can be placed.

Breast Reconstruction with Tissue Flaps

Though reconstruction with implants is more common, Dr. Oldham will sometimes use a flap technique, especially for patients who have received radiation treatment. There are a number of different flap techniques that are defined by the area from which the tissue is taken. Most often, Dr. Oldham uses the latissimus dorsi flap, which allows him to take skin and muscle from the patient's back and bring it to the chest area to provide healthier tissue. He can also use a TRAM (transverse rectus abdominis myocutaneous) flap, which involves using underlying abdominal muscle and tissue to reshape the breast.

What to Expect After Surgery 

After your surgery, you can generally expect some discomfort, which can be managed with pain medication. Discomfort usually subsides within two weeks after the procedure, and most patients are able to return to their normal activities within four to six months of their reconstruction. Although the timeline of your reconstruction will vary from patient to patient, some reconstructions can take six months to a year from start to finish. This does not include the time needed for any additional cancer treatment. 

Why Choose Dr. Oldham

The decision to undergo breast reconstruction is a daunting one, but you can feel at ease under the care of a board-certified plastic surgeon. Dr. Oldham has been recognized as a "Top Doctor" in publications including Washingtonian Magazine, is a Fellow of the American College of Surgeons, and a member of the American Society of Plastic Surgeons and other organizations. He combines his affiliations and artistry with an extensive background in surgery, having been in practice since 1977. 

To provide all patients with access to this state-of-the-art, transformative treatment, Dr. Oldham accepts financing through CareCredit® and MedicalFinancing™

Schedule a Consultation

Dr. Oldham spends a great deal of time during consultations to highlight the different options women have for breast reconstruction. He has helped many women attain close-to-natural-looking reconstructed breasts, and can show you photos of his results to help you make your decision. Contact us online today or call our office at (301) 530-6100 to schedule your appointment.

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