Updated August 6, 2019
Ft. Worth Reconstruction with Dr. Emily J. Kirby
Breast reconstruction is performed to restore breast shape and volume after removal of a tumor or cancer from the breast. Patients who test positive for the BRCA gene who choose to remove their breasts before any cancer has begun (a prophylactic mastectomy) may also choose to undergo breast reconstruction. Breast reconstruction can either be performed during the same surgery in which your breast tissue is removed (immediate) or months to years later (delayed).
It is never too late to reconstruct a breast!
There are many techniques to restore breast shape and volume including the use of breast implants, muscle, and soft tissue. If only one breast is reconstructed, it may be recommended that the other breast undergo a lift, augmentation, or reduction in order to attain symmetry.
What will my procedure be like?
If implant reconstruction is chosen, tissue expanders are placed at the time of the initial surgery. This may be immediately after your lumpectomy or mastectomy, or it may be several months to years after your initial lumpectomy or mastectomy. Expanders are slowly filled in the office after surgery in order to stretch the skin and soft tissue to make room for your breast implants. Silicone or saline implants are placed during a separate procedure for final reconstruction. If you are undergoing a nipple-sparing mastectomy, you may be a candidate for immediate implant reconstruction, without needing expanders first. Ask Dr. Kirby and your surgical oncologist if you are a candidate for this procedure.
Flap reconstruction of the breast uses tissues from your own abdomen or back muscles to reconstruct your new breast. Occasionally, flap reconstruction will be used in combination with implant reconstruction.
Depending on your personal breast history, you may be a candidate for one or more of these procedures.
What kind of anesthesia will I have?
Breast reconstruction surgery is typically performed under general anesthesia for optimal comfort. This means that you will be asleep for the entire surgery.
How long will my surgery last?
Breast reconstruction surgery, if performed alone, typically takes 1-2 hours for implant placement. Muscle and soft tissue surgeries usually take longer. Combination surgery (for example, immediately following tumor removal or mastectomy) will also take longer.
What are the risks?
Your decision to undergo breast reconstruction is a personal decision and should be made with a full understanding of the benefits and potential complications of the procedure. The possible risks of breast reconstruction include, but are not limited to, bleeding, infection, poor healing of incisions, and anesthesia risks. You should also know that your own breast skin may have difficulty healing following lumpectomy or mastectomy surgery. Muscle and soft tissue flap reconstruction surgery can lead to partial or complete loss of the flap and a loss of sensation at the location where the flap was taken and at the new breast site.
The use of breast implants carries the risk of capsular contracture and implant rupture. These situations may require additional surgery for repair. Breast implants do not impair breast health. Careful review of scientific research conducted by independent groups, such as the Institute of Medicine, has found no proven link between breast implants and autoimmune or other systemic diseases.
How do I prepare for surgery?
Prior to any procedure, it is necessary to review medications you are taking that may affect your surgery. You may be asked to stop or to adjust some medications you are on. As always, it is important to include supplements on your list of medications. Aspirin and aspirin products (Alka-Seltzer, Carisoprodol, Excedrin, Goody’s, Midol), anti-inflammatory medications (except acetaminophen, or Tylenol), and herbal supplements must be avoided for 10 days prior to your surgery. For more details about which medications and supplements to avoid, click here. Dr. Kirby will discuss your medications with you.
Depending on your medical condition, you may be asked to get lab testing or a medical checkup prior to your surgery. You may also be asked to have an updated mammogram prior to your surgery if you have not had one recently.
Tobacco products impair your body’s ability to heal. You will be asked to stop smoking for 6 weeks prior to any surgery. Tobacco step-down products such as chewing gum and Nicoderm continue to provide your body with tobacco and must be stopped as well. Please ask Dr. Kirby if you will need assistance with quitting.
Be sure to arrange for a responsible adult to drive you to and from your surgery. You will need someone to stay with you the night following your surgery as well.
You will receive specific instructions for your surgery day from Dr. Kirby’s office.
What will recovery from surgery be like?
Following your breast reconstruction surgery, you will notice that you have swelling, soreness, and possibly some changes in sensation as well. Some breast sensation may return over time. You may be asked to wear a supportive or surgical bra following surgery as your breasts heal from the procedure. Dr. Kirby will discuss with you when your dressings will be removed and when to return for a post-operative visit. If tissue expanders are placed, you will return to the office for the expanders to be filled on a regular basis until they are full.
Your specific surgery may require that you stay in the hospital overnight or for several days following surgery. Depending on your job, you can expect to return to work in 1-2 weeks. More strenuous activity, however, cannot be resumed until 4-6 weeks after surgery. You will be directed on scar massage techniques by Dr. Kirby when the timing is appropriate. Your reconstructed breasts will continue to improve in the months following surgery.
Which insurance do you accept?
Please visit our office page for the list of in-network insurance we accept.