Question 1: how many methods of breast reconstruction I can choose?
a. prosthesis implant
b. flap reconstruction-by using of tissue from other parts of the patient's body
c. combination of autologous tissue implant and prosthesis implant
Question 2: which method is most suitable for me?
It depends on your individual condition, such as your whole body physical condition, your breast cancer stage, your breast nature shape, your economic condition(for example, autologous tissue flap implants will cost more), your desired appearance after breast reconstruction, etc. You need to discuss with your doctor personally.
Question 3: is there any risk since surgery and anesthesia lasting for such a long time?
The risk is comparatively low as the surgical site is not penetrated deeply into thoracic and abdominal cavity. The general risks may be bleeding, infection, trauma, etc. The time for flap breast reconstruction is a little long, so preanesthetics visit to assess individual risk of anesthesia is required to avoid risk. During surgery, the anesthesia care team is accompanying you all the time as to monitor patient’s vital signs, lowering the risk.
Question 4: is there any complication after surgery?
Yes, the complications of surgery include: partial fat necrosis for 3-13% (small range), about 1-2% patients have partial flap necrosis and 2-3% patients will have wound infection. Intensive nursing and appropriate dressing can lower down the risk.
Question 5: is it normal that pain or numb around the operated breast or under armpit after modified radical mastectomy?
While remove the breast lesion, the peripheral nerves of skin is removed during surgery, therefore some symptoms (throbbing ache, needlestick sense, numbness or pain) may occur around the wound, armpit and hand on the surgical side. They are normal phenomenon after surgery. Those feeling will last for about six month or one year and become serious during cold weather. You can hit those areas lightly with hand to stimulate.
Question 6: can I touch the reconstructed site?
You can touch it after flap reconstruction, but you cannot oppress it within the beginning three weeks, or it will lead to flap blood disorders.
Question 7: can breast reconstruction affect other breast cancer treatment?
Modified radical mastectomy with immediate breast reconstruction generally will not affect other cancer treatment. But your oncologist will wait for your wound recovery and begin further treatment afterward, thus to avoid incomplete wound healing or infection. If you are undergoing chemotherapy, your surgeon will wait for at least one month and then apply radical mastectomy with immediate breast reconstruction. In addition, based on your condition, doctor may suggest you to undergo immunotherapy to improve your immunity after surgery.
Question 8: can breast reconstruction increase the risk of recurrence? Can it interfere with the diagnosis of cancer?
Currently there is no evidence show that breast reconstruction can increase the risk of recurrence or interfere with the diagnosis of cancer. Most of the local recurrences occur on the original breast beneath the epidermis of skin, so the recurrence can be detected by hand touch. Moreover, patients still need to have follow-up in breast surgical department and oncology outpatient department.
Question 9: can I have shampoo and bath after surgery, when I can resume normal life and wear bra?
When you are transferred to general ward after surgery, you can take a sponge bath by family member’s assist. You can begin to have bath after drainage tube remove and stitches take out. Three weeks after surgery, you can have shampoo and restore normal daily living. 6-8 days after surgery, you can decide whether wear bra or not according to your physician’s advice. Generally, you should first wear no wire bra to avoid flap bleeding.
Question 10: when I can return to work or to travel?
It depends on your personal recovery condition. Generally about 4 weeks after surgery, you can return to work, go to travel and retake daily leisure activities. But you’d better to have more rest.
Question 11: after surgery can we have sexual contact of breast? When I can regain normal sexual life?
4 weeks after surgery, you can have sexual life. You can have a conversation with your partner to understand your worry and be patient both sides.
Question 12: how to take care of the scare after surgery?
The key factors of deciding if the scar has a good look include: suture technique of physician, stitching quality, patient’s physique, self scar care, etc. The scar may need six months to one year to be stable and mature. The suggestions for care scar as follows:
1. Massage scar, daily massage for the scar for about 15~20 minutes every morning and evening, avoid over rub and damage incision tissue.
2. The use of scar beauty tape. If you have allergy to tape, you can use the “baby use” breathable paper tape.
3. Use silicone scar sheet. It has better effect than beauty tape as it can smooth, soften and enlighten scars.
Question 13: can I regulate the breast shape after breast reconstruction if the shape is not good or asymmetric with another side?
3~6 months after the reconstructed breast recover, you can have other reconstruction to adapt the breast, involving in breast augmentation , breast lift, breast reduction and other plastic surgery.
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