After a mastectomy, many women want to undergo breast reconstruction with tissue expander/prosthesis. This procedure is a multiple-step process. During the first stage, the tissue expander is placed to stretch out the skin. During the second phase, the tissue expander is replaced with a permanent prosthesis. The information below gives a detailed overview of what you can expect.
First Stage
- The procedure will take about 2-4 hours, including the mastectomy.
- General anesthesia will be used, and you will need to spend about 0-2 days in the hospital.
- Side effects include temporary soreness, swelling, bruising, numbness, and burning. Bruising can last 2-4 weeks while moderate swelling will last about 4 weeks and mild swelling can last up to 3 months.
- Risks include infection, asymmetry, tightening and hardening of scar tissue around the implant, rupture of the implant, and permanent decrease in sensitivity of nipples or breast skin.
- You may resume daily living tasks immediately and go back to non-strenuous work in 2-4 weeks. You should avoid pushing, pulling, or repetitive upper body movements for 4 weeks.
- You can resume 1/3 intensity exercise after 3 weeks; 2/3 intensity at 6 weeks; and full-intensity exercise after 8 weeks.
- You should support the area as needed for 6 weeks and take ibuprofen or narcotics as needed for pain.
- You will visit your doctor between 7-10 times in the first three months, and then yearly after the reconstruction stages are completed.
- The tissue expander will be replaced with a permanent prosthesis in 3-6 months. Implants may require removal or replacement at some time in the future.
Second Stage
During the second stage, the tissue expander is exchanged for permanent prosthesis with fat grafting to reconstruct the breast. Nipple reconstruction will take place 2-3 months later.
- This stage is an outpatient procedure that will take about 1.5-2 hours and uses general anesthesia.
- Side effects include temporary soreness, swelling, and bruising. Bruising can last 2-4 weeks while moderate swelling will last about 4 weeks and mild swelling can last up to 3 months.
- Risks include infection, asymmetry, tightening and hardening of scar tissue around the implant, rupture of the implant, and permanent decrease in sensitivity of nipples or breast skin.
- You may resume daily living tasks immediately and go back to non-strenuous work in 3-5 days. You should avoid pushing, pulling, or repetitive upper body movements for 4 weeks.
- You should support the area as needed for 6 weeks and take ibuprofen or narcotics as needed for pain.
- You can resume 1/3 intensity exercise after 3 weeks; 2/3 intensity at 6 weeks; and full-intensity exercise after 8 weeks.
- You will visit your doctor 3-5 times in the first 3 months after surgery, and then yearly after reconstruction is complete.
Nipple Reconstruction
- Takes place 2-3 months after permanent prosthesis or 6-8 months after mastectomy.
- This procedure takes about 1 hour and can be done in the doctor’s office.
- You will experience bruising for about 2 weeks, swelling for 6 weeks, and redness for about 6-12 months. You will need to visit your doctor after 7 days and then again after 2 weeks.
Nipple Tattoo
Pigment is added to the nipple areola area 2-3 months after nipple reconstruction.
- This procedure takes about 1 hour and can be done in the doctor’s office.
- Fading of the tattoo can occur and will need to be touched up in the future.
- You will need to visit your doctor after 6 weeks, then 3 months, and then yearly thereafter.
Contact Boulder Plastic Surgery
If you are interested in breast reconstruction with tissue expander/prosthesis, contact Boulder Plastic Surgery at 303.578.4193 to schedule a consultation.