|
PROSTHESIS |
IMPLANT
(NO TISSUE EXPANSION) |
TISSUE
EXPANDER FOLLOWED BY IMPLANT |
NATURAL
TISSUE: TRAM (Abdominal Flap) |
NATURAL
TISSUE: LATISSIMUS DORSI
(Back
Flap)
|
| Who
is a Candidate? |
All
women. |
Very
small-breasted women. |
Most
women. |
Most
women. |
Most
women. |
|
Timing
|
A
lightweight style is best for the initial recovery period. After
mastectomy scar heals, you can switch to a more lifelike silicone
model. |
May
be immediate or delayed. |
May
be immediate or delayed. |
May
be immediate or delayed. |
May
be immediate or delayed. |
|
Length of Recovery
|
None. |
3-4
weeks may be required before it is possible to return to work
or perform strenuous activities. |
3-4
weeks may be required before it is possible to return to work
or perform strenuous activities. |
Most
women can resume normal activities after six to eight weeks.
During this period, lifting objects heavier than five pounds
is not permitted. |
Most
women can return to work and resume other normal activities
after 4-6 weeks. |
|
Scarring
|
Scars
from mastectomy only. |
None
or very little additional scarring, since mastectomy incision
is usually reopened to insert implant. |
None
or very little additional scarring, since mastectomy incision
is usually reopened to insert implant. |
Scarring
at the donor site, on the abdomen. For TRAM, this is a scar
running from hip to hip. Mastectomy site scar on chest. |
Scarring
at donor site, on the back. Mastectomy site scar on chest. |
|
Drains
|
Drains
from mastectomy only. |
Wear
drains for 3 days to 2 weeks. One week is about average. |
Wear
drains for 3 days to 2 weeks. One week is about average. |
Wear
drains for three days to as long as three weeks. One week is
about average. |
Wear
drains for three days to as long as three weeks. One week is
about average. |
|
Hospital
Stay
|
Hospital
stay for mastectomy only (outpatient to 2 days). |
1-2
days if immediate; none (outpatient) to 1 day if delayed. |
1-2
days if immediate; none (outpatient) to 1 day if delayed. |
3-5
days. |
2-4
days. |
|
Follow-Up
Surgeries
|
None. |
Additional
surgeries may be necessary to remove or repair the implant if
it leaks, hardens, or becomes infected. |
An
additional surgery will be necessary to remove the tissue expander
and insert an implant. Further additional surgeries may be necessary
to remove or repair the implant if it leaks, hardens, or becomes
infected. Surgeries on the opposite breast may be required to
achieve symmetry. |
Additional
surgeries may be required for additional contouring or in case
of complications, such as hernia. Surgeries on the opposite
breast may be required to achieve symmetry. |
If
an implant is used with the back flap, additional surgeries
may be necessary to remove or repair the implant (see "Implant"
columns). |
|
Possible
Complications and Concerns
|
Adapting
swimsuits and lingerie to hold the prosthesis. Feeling self-conscious
in revealing clothes. Sweating underneath the prosthesis. Not
being able to scratch an itch. |
Implant
can leak, harden, or become infected. This will lead to more
surgery to remove or replace the implant. If a silicone implant
was used, more lengthy and complicated surgery may be needed
to remove any silicone. |
Tissue
expander can leak or become infected, which may lead to more
surgery to remove or replace the tissue expander. Implant can
leak, harden, or become infected. This will lead to more surgery
to remove or replace the implant. If a silicone implant was
used, more lengthy and complicated surgery may be needed to
remove any silicone that may have spread throughout the body. |
Hernia;
potential loss of abdominal wall strength; changes in overall
body appearance, Potential loss of reconstructed breast. |
Potential
loss of reconstructed breast. Implant complications if an implant
was used (see "Implant" columns). |
