Preparing yourself

There are a number of things to think about when preparing for breast reconstruction.

THE LEAD-UP TO SURGERY

You’re likely to have a number of appointments before the breast reconstruction surgery, including meeting with your oncologist, anesthesiologist and plastic surgeon.

Your surgeon will describe you surgical options and may show you photos of women who’ve had different types of breast reconstruction, and will also give you information on anesthesia, where the operation will be performed and what kind of follow-up procedures may be necessary. He or she may also recommend surgery on your opposite breast, even if it’s healthy, so that it more closely matches the shape and size of your reconstructed breast.

Questions your surgeon may ask you:

Do you have allergies or bad reaction to antibiotics, anesthetic drugs or any other medicine?

Do you have prolonged bleeding or excessive bruising when injured?

Do you have a connective-tissue disorder such as rheumatoid arthritis, scleroderma, lupus erythematosis, or any other arthritis-like disorder?

Do you have any long-term or recent illnesses?

Have you previously had surgery for breast cancer, or radiotherapy to the breast?

Have you had any psychological or psychiatric illnesses?

You may also be asked to:

Get lab tests or a medical evaluation, including blood tests, a chest X-ray or scans to check your blood vessels, or an ECG to assess your heart

Take certain medications or adjust your current medications

Stop smoking well in advance of surgery

Avoid taking aspirin, anti-inflammatory drugs and herbal supplements, as they can increase bleeding

BEFORE SURGERY

You will probably be told to not eat for 4 to 6 hours and not drink for 2 hours before the operation to reduce the risk of complications during surgery.

On the day of surgery, your plastic surgeon will probably draw on your body to mark where the surgery cuts will be. This will be done when you are awake so that you can sit or stand up to help your surgeon achieve the best possible outcome.

AFTER SURGERY

Having a breast reconstruction will mean having to take time off from work, and is likely to affect other activities such as child care. It’s useful to plan ahead, particularly if not working will affect your finances.

You may want to prepare a “recovery area” in your home. This could include pillows, ice packs, a thermometer and a telephone within easy reach. Also make sure you arrange for a relative or friend to drive you to and from the hospital or clinic. Someone should also stay with you for at least 24 hours after you return home.

Breast reconstruction will not resolve a psychological problem the woman had before mastectomy, nor make an unstable relationship strong. Any expectation of physical perfection is also unrealistic. A woman should have a complete understanding of the benefits and limitations of this surgery for a satisfactory result.

HELPING YOURSELF BEFORE RECONSTRUCTION

Stop smoking

If you smoke you’re more likely to get a chest infection after your anesthesia. Smoking also affects blood supply and delays healing, and if you’re having reconstruction with your own body tissue there is a higher risk of complications, as body tissue reconstruction can fail due to poor blood supply. Smokers also have a higher risk of hernia after abdominal flap reconstructions. Consequently, your surgeon is likely to ask you to stop smoking 3 months before your surgery.

Loose weight

If you’re overweight, you are more likely to have complications with living tissue surgery and complications from anesthesia. Ask to see a dietician to help you lose weight before the surgery. You will feel better and it will help you to recover from your operation more quickly.

Get in shape

Being in shape is a good idea before any operation. With abdominal flap reconstructions, surgeons recommend doing sit ups. Strengthening the abdominal muscles lowers the risk of hernia later and gives better muscle function after the operation. You should aim to build up to 30 sit ups a day, but don’t overdo it too quickly. If you’re very out of shape, it might be best to get some advice from a fitness trainer before you start. You could ask at your local gym, but make sure you tell them about your medical history.