The topic of breast reconstruction can be a very sensitive one for most women because they are also dealing with illness. When considering reconstruction, be sure to talk with friends about the procedure to discuss your feelings associated with having reconstructive surgery. There will be an extensive recovery period in which you will have pain, bruising, and swelling.

The procedure can be done at the same time as your mastectomy, or it can be delayed until you have fully recovered and are no longer receiving any medical treatment. Either way, reconstructive surgery, although not what you want to do, is a big step toward feeling whole again.

Before your surgery, you will meet with Dr. Saltz to discuss how your surgery will proceed. If you are having a mastectomy at the same time, it may require meeting with both surgeons at once to fully plan everything out. During this consultation, you will discuss your goals for the surgery as well as any worries you may have.

The procedure is done in one of the following ways:

• Flap Technique — This technique uses your own muscle, skin, and fat to create or cover the breast mound.
• Tram Flap — Sometimes mastectomy leaves little tissue to be used for reconstruction. In this case, muscle, fat, and skin from the abdomen is used. Once placed, the blood supply is reattached to the muscle and skin.
• Latissimus Dorsi Flap — This technique uses muscle, tissue, and fat from the upper back tunneled to the mastectomy site. This leaves the tissue attached to the blood supply, requiring no surgical attachment.

All these steps are used to cover a breast implant. Sometimes there is sufficient flap tissue to create a full breast, but usually an implant is needed. The breast implant will be either saline or silicone gel.

• Saline Implants — Breast implants filled with a sterile salt water solution. The fill size of these implants can be adjusted depending on the increase, firmness, and shape you would like. The benefit of saline implants is that if they should they ever leak, the salt water solution will be naturally absorbed by the body.
• Silicone Gel Implants — Breast implants comprised of silicone gel. The benefit of silicone is that it looks and acts more akin to natural tissue than saline. Since detecting a leak in a silicone implant is not easy, yearly mammograms to check for leakage are required with silicone implants.

Finally, the areola and nipple are reconstructed using various grafting techniques which you will discuss with Dr. Saltz.

After your surgery, you will have bandages and elastic supports to allow the newly reconstructed breast to properly heal. A small thin tube will be used to drain any excess fluids, and you may be given a pain pump to reduce the need for narcotics. Dr. Saltz will talk you through your individual recovery timeline because this will be heavily dependent on your individual needs and the progress of your recovery from illness, as well.