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Choosing whether to have breast reconstruction surgery—and whether to get implants or autologous reconstruction—is one of many decisions patients with breast cancer face.
Though the majority of patients choose implants, more women are choosing autologous reconstruction, which uses tissues transplanted from the abdomen to shape breasts that look and feel more natural.
Five to 10 years ago, patients who chose autologous reconstruction spent several days in the hospital and were prescribed narcotic medication for post-surgical pain, which could last up to a month.
Now, our patients who receive autologous reconstruction leave the hospital two or three days after surgery—and sometimes even drive themselves home. Many of them are going back to work or on long walks around the neighborhood just a week later because of:
- Muscle-sparing surgical techniques
- Precise pain targeting
- Collaborative decision-making between patients and care providers
By consistently listening to patients’ concerns about breast surgery, we have developed protocols to reduce patients’ pain and discomfort during recovery and help them feel more like themselves again faster.
Minimally invasive technique spares muscles.
MedStar Washington Hospital Center is one of only a few treatment centers that specializes in deep inferior epigastric perforator (DIEP) flap breast reconstruction. In these microsurgery procedures, a specialized plastic surgeon transfers abdominal fat, skin, and blood vessels to a patient’s chest, reattaches these tissues, and artfully shapes a new, natural breast.
In nearly every DIEP flap, nerves from the abdomen are also reconnected to the chest to enhance sensation in the new breast.
The surgeon does not remove a patient’s muscle during a DIEP flap procedure. This technique not only prevents the pain associated with removing muscle but also helps patients retain their core strength to resume physical activity faster. For some patients, this means getting back into triathlon training. For others, it means being able to lift their grandchildren again.
Timing of the surgery.
Plastic surgeons partner closely with breast surgery colleagues to determine the best time to perform the reconstruction, based on each patient’s cancer treatment plan. For example, radiation can increase the risk of surgical complications such as infection or wound healing issues. If a patient doesn’t need radiation therapy after mastectomy, we often recommend immediate DIEP flap reconstruction, which is performed at the same time as the breast cancer surgery.
For patients who need radiation therapy after their mastectomy, we’ll perform a delayed reconstruction. During the mastectomy, we place a temporary tissue expander in the chest to maintain the shape of the breast. After radiation is complete, we remove the expander and perform the surgery.
A DIEP flap procedure can take 6-10 hours, compared to a few hours for implant reconstruction. However, the results will last the rest of your life.