Breast reconstruction after double mastectomy

Breast Reconstruction Options after Double Mastectomy​

Breast reconstruction surgery can be performed through various methods, more particularly after a double mastectomy through the following: Here are the main options:

Implant-Based Reconstruction

• In this case, the method focuses on augmentation of the breasts using silicone or saline implants.
• Direct-to-Implant Reconstruction – Implants are put at the time of mastectomy.
• Two-Stage Reconstruction – A tissue expander is placed in the first stage and then replaced by the implant in subsequent surgery.

Autologous (Flap) Reconstruction

• Transplants the tissue from one part of the patient and molds it into the breasts.
• DIEP flap (Deep Inferior Epigastric Perforator) – It involves the tissue from the lower abdomen but does not take muscle.
• TRAM Flap (Transverse Rectus Abdominis Muscle) – similar to DIEP flap but there is a use of some of the abdominal muscle.
• Latissimus Dorsi Flap – In this case tissue from the back can be used in addition to an implant.
• A flap that is derived from the buttock is referred to as the SGAP/IGAP Flap.
• TUG/PAP Flap – Inner thigh tissue is employed.

Hybrid Reconstruction

• A technique of uniting the implants with the autologous tissue for giving natural appearance.

No Reconstruction ("Flat Closure")

• There are some patients who opt for no reconstruction at all after mastectomy.

Double Mastectomy Reconstruction Surgery​

Breast reconstruction following a double mastectomy is the process by which the shape and contour and size of the breasts are restored, using implantation of prostheses, using tissue from other parts of the body or both implantation of prostheses and use of the patient’s tissue.

Types of Reconstruction Surgery

Implant-Based Reconstruction

• Uses silicone or saline implants.
• It can be also being performed at the time of surgery (immediate Reconstruction mastectomy) or after sometime, either after healing or any other treatment.

Autologous (Flap) Reconstruction

• It entails the use of the patient’s own tissue from another part of the body.
• May be carried out at the time of mastectomy or at a later stage.

Hybrid (Combination) Reconstruction

• Both implants and the natural tissues are used in an effort to achieve better shape and softness.

Recovery Time for Breast Reconstruction after Mastectomy

Recovery time of breast reconstruction depends again on the kind of reconstruction done, general health status and whether other therapies such as chemotherapy or radiation are required.

General Recovery Timeline

Hospital Stay

• Implant-Based Reconstruction: 1–2 days
• Flap (Autologous) Reconstruction: 3–5 days

First Few Weeks (Initial Recovery)

• Pain & Swelling: Common for 2–4 weeks. Managed with pain medications.
• Drains: May be necessary to be left in place for about 1 – 2 weeks to aid in the elimination of fluid buildup.
• Restricted Arm Use: Do not engage in lifting objects and lifting the arms above the head level for 2– 4 weeks.
• A surgical bra may be needed to provide any support and also for compression purposes.

Returning to Daily Activities

• Light Activities: 2–4 weeks after surgery.
• Driving: 2–3 weeks (once off pain medication).

Returning to Work:

• Desk job: 4–6 weeks
• Physically demanding job: 6–8 weeks
• Self-Employment: After 6-8 weeks (on a doctor’s advice).

Long-Term Healing (3–6 Months)

• Scars: They should begin to subside but the whole process of disappearance might take 1-2 years.
• Returning of breast sensation: It may take months or even years for the feeling in the breast to come back. Some numbness may be permanent.
• Breast shape is reached within 3-6 months.

Implant vs. Flap Reconstruction after Double Mastectomy​

Breast reconstruction after a mastectomy, especially a double mastectomy, can be done using implants or flap (autologous) method. All the options have their advantages and drawbacks depending on the woman’s medical history, gives preference to slender bodies with all-year diets, or any other individual nuance.

Implant-Based Reconstruction

Pros:

• Shorter surgery (1–2 hours per breast).
• Faster recovery (4–6 weeks).
• In this method no tissue is taken from another part of the body hence no scar is left on the body.
• It is suitable for people with low body fat or those who do not wish to have excess scars after the procedure.

Cons:

• May need replacement in future (indication stands around 10-15 years).
• Less natural feel compared to flap reconstruction.
• The drawbacks involve enhanced chances of complications like implant rupture, infection or even capsular contracture which is a hardening of scar tissues.
• Not suitable for radiation therapy patients (higher risk of implant failure).

Flap (Autologous) Reconstruction

Pros:

• Less operative invasiveness when compared to implants.
• Long-lasting results (no need for implant replacement).
• From the foregoing discussion, it can be deduced that it is better for radiation patients in that tissue heals better compared to implants.

Cons:

• Longer surgery (4–8 hours).
• Longer recovery (6–8 weeks).
• Additional scars from the tissue donor site.
• Risk of tissue flap failure (rare but possible).

Factors Affecting Cost of Breast Reconstruction after Mastectomy​

The cost of breast reconstruction depends on various factors such as; type of surgical procedure to be used, hospital bills, and any other extra treatment to be applied. There are several factors that should be considered on the general cost as follows:

• Type of Reconstruction
• Timing of Surgery
• Hospital & Surgeon Fees
• Anaesthesia & Operating Room Costs
• Post-Surgical Care & Follow-ups
• Additional Procedures

Nipple Reconstruction after Double Mastectomy​

Following a double mastectomy, some patients opt to have nipple reconstruction so that they regain a natural appearance of the breasts. Nipple reconstruction can be achieved through surgical methods or through non-surgical means such as 3D tattooing.

Surgical Nipple Reconstruction

• A minor outpatient procedure in which the surgeon recreates a raised nipple by shaping skin on the breast.

Procedure

• Performed 3–6 months following breast reconstruction (so that the shape of the breast settles).
• Creates a raised nipple using local skin flaps.
• Can be performed under local anaesthesia (little downtime).
• Heals in 2–3 weeks.

Nipple Tattooing (3D Areola Tattoo)

• A non-surgical treatment that employs natural coloring and shading to achieve the look of a nipple.

Procedure

• Performed 6–8 weeks following breast reconstruction.
• Utilizes specialized tattoo ink to replicate the natural skin tone.
• May be performed in one or two visits.

Combination (Surgical Nipple + Tattooing)

• Surgical nipple may be supplemented with tattoo shading for a more realistic appearance.

Autologous Breast Reconstruction after Mastectomy​

Autologous breast reconstruction, or flap reconstruction, employs your own body tissue (rather than implants) to reconstruct the breasts following a mastectomy. It gives a natural appearance and feel, is durable, and tends to be an option of choice for women receiving radiation therapy.

Types of Autologous (Flap) Reconstruction

• Abdominal Flaps (Most Common)
• Back Flap
• Buttocks & Thigh Flaps

Risks of Breast Reconstruction Surgery​

Breast reconstruction is usually safe but, as with any surgery, carries possible risks and complications. The risks will depend on whether the reconstruction includes implants or autologous (flap) reconstruction.

• Infection
• Bleeding or Hematoma
• Poor Wound Healing
• Scarring
• Numbness or Loss of Sensation
• Asymmetry
• Capsular Contracture
• Implant Rupture or Leakage
• Rippling or Wrinkling
• Implant Rejection or Extrusion
• Interference with Mammograms
• Tissue Death
• Blood Clots
• Hernia or Weakness
• Longer Recovery & More Scarring

Best Hospitals for Breast Reconstruction​

• Medanta-The Medicity, Gurgaon
• Fortis Memorial Research Institute, Gurgaon
• Artemis Hospital, Gurgaon

Breast Reconstruction Success Rates​

Breast reconstruction has very high success rates, but the outcome is influenced by aspects like the type of reconstruction, patient health, and surgical skills.

Overall Success Rates

• Implant-Based Reconstruction – 95%–98% success rate
• Flap (Autologous) Reconstruction – 90%–97% success rate

Preparing for Breast Reconstruction Surgery​

Proper preparation can improve healing, minimize complications, and ensure a smooth recovery. Here’s a step-by-step guide:

• Choose the Right surgeon & Hospital
• Understand the Procedure & Recovery
• Medical Preparation
• Plan for Recovery
• Nutrition & Hydration
• Mental & emotional Readiness

Why Choose GetWellGo for Breast Reconstruction after Double Mastectomy?

GetWellGo is regarded as a leading supplier of healthcare services. We help our foreign clients choose the best treatment locations that suit their needs both financially and medically.

We offer:

• Complete transparency
• Fair costs.
• 24 hour availability.
• Medical E-visas
• Online consultation from recognized Indian experts.
• Assistance in selecting India's top hospitals for breast reconstruction.
• Expert surgeon with a strong track record of success
• Assistance during and after the course of treatment.
• Language Support
• Travel and Accommodation Services
• Case manager assigned to every patient to provide seamless support in and out of the hospital like appointment booking
• Local SIM Cards
• Currency Exchange
• Arranging Patient’s local food