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What Is Breast Reconstruction Surgery?
Breast reconstruction is performed following a mastectomy due to breast cancer or other medical condition. The procedure is considered to be reconstructive surgery and not cosmetic, and health insurers should cover it after mastectomy surgery according to the Women’s Health and Cancer Rights Act. A mastectomy removes part or all of the breast, including the nipple and areola, depending on the location and size of the cancerous cells.
The loss of one or two breasts can have a negative effect on a woman’s self-esteem and psychology, as well as the quality of life, and Toronto breast reconstruction can help improve them. Breast reconstructions replaces the breast tissue, skin and, if necessary, nipple to recreate the normal appearance, shape and size of the original breast. While a reconstructed breast will look close to natural, it may not feel or have the same sensation as the one that was removed. This is just one of the issues that Dr. Colin Hong, a noted Toronto plastic surgeon, covers during his detailed consultations with his patients.
Breast reconstruction is not just a physical procedure, but it can affect a woman mentally and emotionally as well. Patients need to thoroughly understand all implications and be fully aware of the nature of the procedure, the recovery issues and the expected results.
Toronto Breast Reconstruction
Toronto breast reconstruction may be performed either at the time of the mastectomy or later after the recovery from the initial surgery and chemo treatments. The surgical procedure may use either breast implants to create the shape and size of the new breast or flaps of tissue from other parts of the body such as the buttocks, abdomen, thighs or back. The surgeon will decide which option is the most suitable based on the specifics of each case. All surgery is performed under general anesthesia, and depending on the nature of the procedure, it can take from one to six hours.
Dr. Colin Hong is a Board certified Toronto Plastic Surgeon serving cosmetic surgery patients from across the GTA including Toronto, North York, Richmond Hill, Scarborough and Mississauga.
Frequently Asked Questions
If you suffer from breast cancer and had to remove your breast(s) to stop the spreading of the tumor
This surgery aims to reconstruct the breast (including the nipple) that was lost due to a mastectomy with the use of breast implants or flaps of tissue from other parts of the body (buttocks, abdomen, thighs or back).
Wound infection, fluid under the wound, flap failure, fat necrosis and asymmetry are possible risk/complications.
Patients can artifically wear a breast prosthesis on their chest.
The reconstructioning can be done right after your mastectomy in the same operation and also it can be delayed after the patient has completed cancer treatment
You should discuss this with your doctor and if you are comfortable/strong enough to do so, you may since the breast reconstructioning will not interfere with chemotherapy/radiation treatment or mammographs.
If you are comfortable with your body, you do not need to proceed with the procedure.
Reconstruction can be done later on down the road and it is dependent on whether the patient is ready to proceed with the procedure or not.
Somewhat but it will not be 100% identical to your old breast.
You can either have an implant inserted for reconstruction or tissue transfered from other parts of your body, such as abdomen, buttocks, back and thighs
Refer to my website for before & after pictures or request them during consultation.
This will be determine at consultation.
Yes, if you choose not to have implants for your reconstruction.
The entire reconstruction process can take anywhere from 2-6 hours.
It should last for a life time if there are no complications or infections.
An incision is made at where the mastectomy scar was and at the location of the donor site. The incision will be fairly large at the donor site.
Yes, but scarring will fade over time but still be visible.
You will experience discomfort, soreness, bruising and soreness for a couple of weeks and will need assistance to move in/out of bed the first day but all this will subside as you move forward with your recovery process.
Swelling can last around 2-3 weeks.
Short term wise, you will feel pain, numbness and tightness around the breast area and have visible scarring. The pain, tightness and scarring will go down as time goes by, however numbness may still remain.
No, it should not.
Pain will be moderate but medication is given to relieve any you will experience.
Patients may take extra strength Tylenol, Tylenol 3, Percocet to help with the pain.
I almost always use drain after breast reconstructioning
Patients are recommended to wear loose clothing that will not compress or irritate the chest area.
Most breast reconstruction surgery are outpatient procedures for tissue expander surgery and flap surgery are usually done inpatient
Patients can return to their normal routine in a few days.
Patients can return to their normal routine in 6 weeks after surgery
Patients can return to their normal routine in 6 weeks after surgery but if your work is high demanding and physical, it may take several weeks.
The choice of anesthesia will be discussed and chosen for you before surgery by an anesthesiologist that will review your medical history.
You will meet with the anesthesiologist prior to the surgery in the preoperative area. You may arrange to speak to an anesthesiologist by telephone prior to your surgery date.
Yes, both and the anesthesiologist during your pre-operative visit will review your medication before your surgery.
You may need to stop blood thinners and any herbal medication prior to surgery. We will review that during your pre-operative visit.
History and physical, EKG, CBC, and metabolic panel for patients over 55 years of age. Thyroid panel for patients with thyroid disorders.
Stop eating and drinking at least 6 hours before the start of your surgery or by midnight the night before surgery.
Arrive one and an half hour before your scheduled surgery.
You can get the information on our website or call my office for direction.
Yes. You will need an adult to drive you home and stay with you 24 hours after surgery.
- Arrange for personal items you might need during your hospital stay
- Arrange for someone to take care of responsibilities at home and work
Yes, arrange for help driving, heavy lifting, and caring for pets for the first few days. - Arrange for someone to take you home from the hospital
You will need an adult to drive you home and stay with you 24 hours after surgery.
- Arrange for someone to stay with you the first night after surgery
You will need an adult to drive you home and stay with you 24 hours after surgery. - Call your doctor if you think of other questions
You can call my office if you have any other questions. - Notify your doctor if you get sick within 10 days of your surgery (even minor illnesses like a cold)
- Stop eating and/or drinking as advised by your doctor
Do not drink alcohol 24 hours prior to surgery. Do not smoke at least 6 weeks prior to surgery. - Do not drink alcohol 24 hours prior to surgery. Do not smoke at least 6 weeks prior to surgery.
- Make sure you have the doctor’s contact information
- Make sure you have directions to the hospital/office for visitors
This can be found on my website or by calling the office. - Wear a button-front shirt and loose clothing to the clinic/hospital
Yes, wear easy to dress clothing such as loose pants with an elastic waistband and a comfortable shirt with a zip up front.
- The surgery can take 2-6 hours.
- Patients usually wake up 10 minutes after surgery is finished.
- Usually in the recovery room, within an hour of your surgery ending.
- You will receive IV antibiotic immediately prior to surgery start and additional doses if needed in the recovery room. The antibiotic dosing follows the national surgical site infection protocol.
- Make sure your identity has been confirmed with name and date of birth
Yes. Your driver’s license or identity such as OHIP number will need to be verified at your appointment and at the surgery center. - Make sure your procedure has been confirmed
Yes, review the surgery specifics at your preoperative appointment and again the day of surgery. - Make sure the correct site of your surgery has been marked
Yes, you will be marked while you are awake in the preoperative area. Communicate with your surgeon. - Make sure the correct side of your surgery has been marked
Yes, you will be marked while you are awake in the preoperative area. Communicate with your surgeon. - Confirm any allergies and side-effects you might have
- Make sure you understand and have signed the informed consent forms
Yes. Please also ask any questions if you need them to be clarifying.
- I usually talk to you in the recovery room as well as with one to two days after surgery in your postoperative visit to explain how your surgery went.
- The antibiotics are stopped within 48 hours of surgery.
- Discuss with your surgeon.
- For the majority of breast reconstruction patients, drains are removed when the drainage stops
You may eat and drink after surgery as soon as you feel well and not nauseated. Start with a soft, bland diet.
You may be released once you have met all the discharge criterias.
You need to have instructions reviewed with a responsible adult and meet all discharge criteria.
You will receive narcotic pain pill prescription to fill prior to surgery. You may receive IV pain medication if you need.
Tell the doctor or nurse which pharmacy you prefer. Non-narcotic medications such as Compazine may be sent electronically but narcotic pain medications must be printed and hand delivered to the pharmacy.
Yes, you will receive a list of medications to avoid prior to surgery and initially after surgery. Do not take NSAIDS, ibuprofen, or aspirin until your doctor approves.
Yes, the postoperative instructions will be reviewed at your preoperative appointment. After the initial bandage is removed, apply polysporin or vitamin E to your incisions twice daily.
There should not be any pressures on the reconstructed breast and should avoid strenous exercises and avoid situatiosn that can raise blood pressure
If you begin to struggle physically with the exercises, stop right away and contact a doctor.
Patients are seen 1-2 days after their surgery as a follow up appointment.
The bandages are removed the next day.
Most of the sutures used in this procedure are dissovable but the ends may need to be cut
It is recommended that patients remain braless during the recovery process and if the patient wishes to wear a bra, they must make sure that the breast does not feel too tight.
Patients are to be in bed rest and slowly transition into a high activity level. Any physically demanding exercises for the first 7 weeks should be avoided.
A couple of weeks after surgery, as long as the patient feels comfortable and doesn’t experience any tightness/soreness. It should be noted that the patient does not raise her arm above her head during any sexual activity.
You may go back to work in a couple of weeks but may take longer if your work requires any heavy lifting or is physically demanding.
You may drive once you stop taking narcotic pain medication and feel able to drive or lift your arms without any discomfort
- Make sure your care providers wash their hands before and after your care
- Do not wait until your pain is severe before you ask for pain medication
- Make sure the call button is within reach before medical staff leave the room
- Sit on the edge of the bed for a few minutes before you stand up to prevent getting dizzy
Yes. If you cannot reach the doctor immediately, call 911. - Do not get out of bed without help if you feel weak or dizzy
- You have a fever higher than 100.4 degrees Fahrenheit
- You have shortness of breath or chest pain
- You notice increased redness, swelling, warmth, or pain around your surgical incision
- You notice that your incision is separating or you have infected discharge from your incision
- Your bandages are repeatedly soaked with blood
- You have pain that your existing pain medications cannot control
- Take pain and other medications as prescribed
- Do not drive when you are on prescription pain medications
- Do not soak in a bath or go swimming for ten days after your surgery
- Follow your doctor’s instructions on caring for any drains you may go home with
- Keep your incisions clean and dry
- Follow your doctor’s instructions on massaging your breasts to prevent hardening of breast tissue around the implants
- Wear a special supportive bra as long as advised by your doctor
- Avoid strenuous exercise and heavy lifting as long as your doctor advises
- Follow your doctor’s instructions on resuming normal daily activities
- Follow your doctor’s instructions on resuming sexual activity
- Inform your care providers before having any testing (X-rays, MRI, CT scans)
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Amazing experience, Doctor Hong is very confident and good at what he does. Every time I go to him I always get good results that I love and feel safe. Very friendly and helpful staff!