Breast Reconstruction – Missoula, Montana

DR. STEPHEN HARDY: Breast reconstruction is really meant to restore the body back to its pre-surgical condition. Normally with a mastectomy, the patient really just ends up having just a flat space with a transverse suture line. Some patients elect to have the reconstruction done at the time or begun at the time of the mastectomy. Some patients will elect to wait. Sometimes the dynamics of the tumor or the clinical situation will dictate that, and we'll have to make it a delayed reconstruction because perhaps the tumor is too deep or we're worried about the patient needing radiation. But the general idea, what we want to accomplish, is to recreate as close as we can to the patient's natural breast, a new artificial breast, whether it be with tissue from their tummy or from an implant. The procedures themselves, the tissue procedures where you take, say, tissue from the belly or the back, wherever, those are much longer and more complicated operations, require longer hospital stays. For example, the belly flap procedure can be anywhere from four to six hours. The recovery in the hospital will be anywhere from two to five days in the hospital as opposed to the implant reconstruction. It is a two-staged operation. The first operation is where we put a tissue stretcher, called a tissue expander, in place under the muscle, and it slowly stretches everything out, so then we can secondarily place an implant. That operation is much shorter. It only takes about a half hour to 45 minutes to complete that operation. Then there are about three months worth of slowly stretching that tissue out, adding with little injections through the skin into that expander, adding saline solution to stretch it out. Then the secondary operation is about half an hour, maybe. Overall, in the long run, this is one of those operations that is very, very rewarding because the patients feel so much better about themselves. Initially they'll see the defect, so to speak. They'll look when they get out of the shower. They'll look in the mirror, and they really don't feel very good about it. Now, there are plenty of patients who are perfectly okay with it, and I don't want to say that everybody should have a reconstruction because there are plenty who just feel, that's fine. I'm okay with it. But there are also plenty of patients who feel really a changed person. They want to restore themselves to the way they were before they had their tumor. So what's nice about the reconstruction is it allows them to feel like themselves again. Then they feel very comfortable in clothing and just walking around town doing things. They don't have to worry about an external prosthesis, and they don't have to worry about the way they look when they see themselves in the mirror, when they get out of the shower and that kind of thing. So it's very, very rewarding to reconstruct them and to allow them to feel better about themselves.