Results

Q: If you transplant some tissue from another part of my body, couldn't it get cancer too?

A: Yes and no. Recurrent cancer is certainly a possibility if flap tissue is used to reconstruct a deformity after lumpectomy with radiation. In this circumstance, the remaining breast tissue will be the source of the recurrent breast cancer that grows into the transferred flap tissue. With the Peg Procedures, the remaining breast tissue is removed with a mastectomy. For this reason, it is predicted that long term local recurrence rates will be lower.

Q: How much scarring should I expect?

A: Every patient will vary in the amount of scarring that may occur for a given procedure. Preexisting conditions such as radiation therapy will significantly increase the amount of scarring that a patient will experience. Regardless of the individual variation, the Peg Procedures will camouflage visible scarring by confining the mastectomy and breast reconstruction incisions within the border of the areola.

Q: Will my breast be numb after surgery?

A: Mastectomy essentially involves the removal of all breast tissue. The surgical removal of the breast tissue temporarily interrupts the sensation to the breast. To a lesser degree, the removal of the axillary lymph nodes will temporarily interrupt sensation to the inner parts of the upper arm. The numbness that patients experience will diminish over a six to 12-month period of time. Most sensation of the breast and upper arm will return in the majority of patients.

Q: Will my breast look and feel natural after surgery?

A: The Peg Procedure combines a skin preservation mastectomy with a Peg Flap that further limits scarring on the breast by confining the incisions to the reconstructed nipple. As a result, the appearance and feel of the breast should be more natural than with other surgical methods.

Q: If I exercise too much after I have the Peg Procedure, will the muscle tissue in my breast make it larger or firmer than the other breast?

A: No. Although the tissues in the breast may initially feel firmer, softening of the breast will occur after the surgical swelling is gone. For patients who have had an implant reconstruction, scarring around the implant may lead to a longer-term firmness. Scarring around the implant with breast firmness is much less frequent with the use of saline implants. An exception is patients previously treated with radiation who may experience severe firmness from radiation.

Q: Will I have a nipple?

A: Although the nipple is removed during a mastectomy, a recently developed procedure called the Bowtie Technique can reconstruct the nipple and areola without any additional scarring. For most patients, the natural contours of the breast and the nipple are recreated with this technique.

Q: Will I have any sensation in my new nipple?

A: Although it will not be at the same level as before, most patients will partially regain sensation to their reconstructed nipple.

Q: Will the new nipple have the same color as my own skin or will it be darker?

A: Initially, the reconstructed nipple and areola will have the same color of your skin because the Bowtie Technique uses the breast skin to make the nipple and areola. Six weeks later the new nipple will be pigmented to a color that is similar to the nipple on the opposite breast.

Q: After my surgery, are there any special instructions for when I have a mammogram?

A: There are no special instructions other than informing the radiologist that you have had a mastectomy and a breast reconstruction. For patients who have had an implant reconstruction with the Peg Procedure, you can inform the radiologist that the implant is behind the pectoral muscle.

Q: Do you have before and after pictures that I can look at?

A: Yes. It is important that patients are fully informed about the benefits and potential complications of any procedure. Photographs depicting the very best and the very worst results may be misleading to patients. Instead, patients should view photographs that depict results that are achieved in the majority of patients.

Q: May I speak with a woman like me, who has undergone the operation?

A: Yes. There are volunteers who have undergone mastectomy with reconstruction that can talk to you, patient to patient.