Surgery

Q: What types of complications are there during surgery?

A: Any type of surgery can be complicated with bleeding, infection and severe scarring. For the most part, these complications are uncommon and can be treated by the patient's surgeon when they occur.

Complications that are specific to breast reconstruction include skin loss of the remaining breast skin. Breast skin loss occurs because the circulation has been impaired by the mastectomy when the breast tissue is removed. This complication is more likely to occur in patients with larger breasts and in patients who are smokers or diabetics. Skin flap loss is due to an impaired circulation of the flap itself. Contributory factors that can lead to flap loss include obesity, smoking and diabetes. The average patient in good health is unlikely to suffer this effect.

Deflation of a saline breast implant is another possible complication. A deflation will require replacement of the implant.

Finally, patients who have been previously treated with radiation therapy are at a significant risk to suffer these complications due to the extensive scarring and marked reduction in the circulation of the tissues.

Q: Should I donate blood to myself before surgery?

A: Patients that are having an implant method of reconstruction do not need to donate their own blood. Patients who have elected a flap method of reconstruction should donate one to two units of blood to account for the more extensive nature of this operation.

Q: How many hours will I be in surgery?

A: The initial mastectomy and breast reconstruction will take between three and five hours to complete. Implant methods of reconstruction take less time to complete but require the subsequent reconstructive procedure. Peg Flap reconstructions are more extensive and require a longer period of time in the operating room. However, many of these patients can have their mastectomy and reconstruction completed in a single stage.

Q: Will my plastic surgeon and general surgeon assist each other throughout my surgery?

A: With the Peg Procedures that use back or abdominal flaps, the general surgeon and the plastic surgeon must closely coordinate their efforts throughout the surgery. In most circumstances, both surgeons should be present through the entire mastectomy and breast reconstruction procedure.

Q: Will I have a drain in my breast after surgery?

A: Yes. Patients require drains to remove the serum (body fluid) that is produced at a surgery site. If a drain is not used with a mastectomy, then a seroma (accumulation of serum fluid) will occur under the breast skin and underarm area which could lead to infection.

Q: Will I be asleep during the operation?

A: Yes. Patients undergoing a mastectomy with breast reconstruction require a general anesthetic. If a subsequent reconstructive stage is needed, this (less extensive) procedure can typically be performed under a local anesthetic on an outpatient basis.