Road Map to Recovery
- Mastectomy
- 6 weeks of tissue healing
- Rehab to normalize shoulder mobility and core strength –> Return to function
- Reconstructive breast surgery
- Rehab to continue shoulder strengthening and activity specific –> Return to activity/sport/work
Types of Common Reconstruction
- 1 – Expanders and Breast Implants
- Expanders or pouches are placed inside your chest and inflated slowly over time with saline to expand the breast region. Once the pouch has enlarged to the size you wish your implant to be, a breast implant would replace the expander.
- 2 – Liposuction injections or Fat Graft
- Taking fat from your abdomen, glutes, or thighs to transfer to the breast and fill in any shape abnormalities. This is usually common after a lumpectomy where not a lot of breast tissue is removed.
- 3 – TRAM Flap (tummy)
- Use of tissues and muscles from your lower belly, resulting in a tummy tuck.
- This is a large incision across your abdomen and may decrease the strength of your abdominal region.
- Some women who do not have enough fat or belly tissue will not be able to do this procedure.
- This procedure can be done with or without implants following.
- 4 – Lat Flap
- Use of tissue and muscle from the lattisimus muscle to replace the breast tissue that was removed.
- Commonly used when the pec muscle is damaged from Chemo or radiation.
- This procedure is usually done with breast implants following.
Breast Implant Illness?
Breast Implant Illness (BII) is an illness doctors refer to large range of unusual symptoms following breast reconstruction that involves breast implants (of any type of implant material). Some patients feel symptoms immediately after surgery and some develop it months to years later.
Symptoms can include:
- Joint and Muscle Pain
- Chronic fatigue
- Memory and concentration problems
- Breathing problems
- Sleep disturbance
- Rashes and skin problems
- Dry mouth and dry eyes
- Anxiety
- Depression
- Headaches
- Hair loss
- Gastrointestinal problems
Who is more susceptible to BII?
- Autoimmune and connective tissue disorders (Lupus, rheumatoid arthritis) fatigue
- Family history of autoimmune and connective tissue disorders
- Severe allergies to many things
- Irritable bowel syndrome
- Migraines
- Chronic fatigue
- Fibromyalgia
Causes? Symptoms from BII derive from a constant high inflammatory response to the new breast implants. Researchers still don’t know why some women develop BII, but materials and exposure to things that may cause inflammation in the body may induce BII symptoms.
Treatment? Usually removing the implant shows improvement in symptoms for most women within a few months, but not all. Some say a healthy diet, exercise, and decreased stress can help reduce the amount of inflammation in the body and also reduce symptoms of BII.
References
- American Society for Aesthetic Plastic Surgery. Breast Implant Illness – Frequently Asked Questions/Talking Points. August 2019. Available at: https://www.surgery.org/sites/default/files/BreastImplantIllness_8-21-2019_FINAL.pdf
- Maijers MC et al. Women with silicone breast implants and unexplained systemic symptoms: a descriptive cohort study. Neth J Med. Dec. 2013: 71(10). Available at: http://www.njmonline.nl/getpdf.php?id=1392
Nipple Reconstruction and Tattoos?
After your breast reconstruction fully heals, you may elect to also reconstruct your nipples. The coloration would be different because the surgeon will use a different tissue to graft so most people will choose to tattoo and define the dark area of the areola.
A patient of mine went to this tattoo artist, Vinnie Myers, who is famous for creating 3D nipple tattoos for breast cancer survivors. Check out his website: www.vinniemyersteam.com
If you have more questions, please book an appointment with Dr. Ann DeGrey, PT, DPT, SCS or Dr. Lei Lee, PT, DPT for more information and to develop a plan!