What is breast implant reconstruction?

Breast implants recreate the shape of a breast after part or all of the breast is removed (mastectomy) because of cancer. Several types of implants are available.

Sometimes an implant is placed during the same surgery as mastectomy. But often you will have two surgeries. The doctor will first place a tissue expander beneath the skin. Saline (or air) is gradually added to the expander to help stretch the skin. This may take several months. When the right size is reached, the expander is taken out and an implant is put in. The nipple and the darker area around it (areola) are created at a later time.

After surgery, you will probably go home the same day or the next day. Many people can go back to work or their normal routine in 3 to 6 weeks.

Your new breast will likely not have any feeling. It will also look different.

Breast implant surgery can be done to restore the appearance of a breast after mastectomy. It may also be done for women who have problems with breast development.

Breast reconstruction may help a woman feel better about her appearance. Some women say it helps them feel better about their bodies, more alive, feminine, and sexual—and happier about life.

Breast implants work best for women who have small breasts (A or B cup) or for women who have both breasts removed (bilateral mastectomy).

Compared to tissue flap surgery for breast reconstruction, breast implant requires a shorter surgery and has a quicker recovery time.

A breast implant will likely need to be replaced at some point. Some implants have lasted 20 to 30 years, but that is not common. This means that someday you will probably need to have surgery to replace the implant.

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

• Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
• Understand exactly what surgery is planned, along with the risks, benefits, and other options.
• If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your surgery. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
• Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
• Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.

Activity

• Rest when you feel tired. Getting enough sleep will help you recover.
• For about 6 weeks after surgery, avoid lifting anything that would make you strain. This may include a child, heavy grocery bags, milk containers, a heavy briefcase or backpack, cat litter or dog food bags, a vacuum cleaner, or anything that weighs more than 10 to 15 pounds. Do not lift anything over your head for 3 to 6 weeks.
• You may have pain for a few weeks after surgery. Support the area with your hands or a firm pillow when you bend, cough, or move.
• Ask your doctor when you can drive again.
• Ask your doctor when it is okay for you to have sex.
• You can take your first shower the day after the drain near your incision is removed. This is usually in about 1 week. Do not take a bath or soak in a hot tub for about 4 weeks.
• You will probably be able to go back to work or your normal routine in 3 to 6 weeks. This depends on the type of work you do and any further treatment.

Diet

• You can eat your normal diet. If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.
• Drink plenty of fluids (unless your doctor tells you not to).
• You may notice that your bowel movements are not regular right after your surgery. This is common. Try to avoid constipation and straining with bowel movements. You may want to take a fiber supplement. If you have not had a bowel movement after a couple of days, ask your doctor about taking a mild laxative.

Medicines

• Your doctor will tell you if and when you can restart your medicines. He or she will also give you instructions about taking any new medicines.
• If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
• Take pain medicines exactly as directed.
  • If the doctor gave you a prescription medicine for pain, take it as prescribed.
  • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
• If you think your pain medicine is making you sick to your stomach:
  • Take your medicine after meals (unless your doctor has told you not to).
  • Ask your doctor for a different pain medicine.
  If you were given medicine for nausea, take it as directed.
• If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.

Incision care

• If your doctor gave you specific instructions on how to care for your incision, follow those instructions.
• You may be wearing a special bra that holds your bandages in place after the surgery. Your doctor will tell you when you can stop wearing the bra. Your doctor may want you to wear the bra at night as well as during the day for several weeks. Do not wear an underwire bra for 1 month.
• If you have strips of tape on the incision, leave the tape on for a week or until it falls off.
• Wash the area daily with warm, soapy water, and pat it dry. Don't use hydrogen peroxide or alcohol, which can slow healing.
• You may cover the area with a gauze bandage if it weeps or rubs against clothing. Change the bandage 1 to 2 times every day. Consider having someone help you with this.
• Keep the area clean and dry.

Drain care

• You may have one or more drains near your incision. Your doctor will tell you how to take care of them.

Exercise

• Try to walk each day. Start by walking a little more than you did the day before. Bit by bit, increase the amount you walk. Walking boosts blood flow and helps prevent pneumonia, constipation, and blood clots in your legs.
• Avoid strenuous activities, such as bicycle riding, jogging, weight lifting, or aerobic exercise, until your doctor says it is okay. This includes housework, especially if you have to use the arm on the side of your surgery.
• Your doctor will tell you when to begin stretching exercises and normal activities.

Elevation

• Prop up the arm on the side of your surgery on a pillow when you sit or lie down. Try to keep your arm above the level of your heart. This will help reduce swelling.