Breast surgery is undertaken in two cases:
– Breast augmentation
– Breast reconstruction
乳房專科 for breast augmentation involves making a single incision in or near the breast and inserting the implant either between the breast and the chest muscle (sub-glandular placement) or behind the chest muscle (sub-muscular placement).
A second incision can be made in the natural crease under the breast, called the infra-mammary crease approach.
A third approach is to make the incision at the junction of the coloured part around the nipple(areola), and the natural skin, called the peri-areolar approach.
Each of these approaches has its advantages and disadvantages. Which one is utilized on a patient is totally dependent on her natural anatomy, her preferences and what the doctor advises.
Breast augmentations use saline-filled implants because of their safety and natural look.
Post surgical swelling, pain and discomfort is normal. Most women return to work in about ten – twelve days after surgery.
One of the most valuable surgical procedures used today is breast reconstruction. This is a surgical procedure to bring back the appearance of a breast for women who have had a breast removed (mastectomy) to treat breast cancer. The surgery rebuilds the breast contour and, if desired, the nipple and areola.
Although the reconstructed breast will not have natural sensation, the surgery can give a great result that looks like a breast.
One has the choice of immediate or delayed reconstruction after a surgery.
– Immediate reconstruction or the one stage process involves placing a breast implant directly after mastectomy. Few women are able to go through a one-stage process — having the implant placed at the time of the mastectomy. In autologous tissue reconstruction, the doctor transfers a section of skin, muscle, fat and blood vessels from one part of the body to the chest to create a new breast mound. The skin and tissue need to be augmented with a breast implant to achieve the desired breast size.
– Delayed reconstruction: It involves placement of a tissue expander that is eventually replaced by an implant.
Reconstructive breast surgery does not interfere with future treatments such as radiotherapy, chemotherapy, or detection of recurrent breast cancer. It also does not increase the risk of recurrence of the breast cancer.
Recovery time is usually six to eight weeks. Risks of bleeding or infection are possible. It may take as long as 1 to 2 years for tissues to completely heal and for scars to fade, but the scars never go away entirely.
Lumpectomy is a surgical treatment method for women who have been diagnosed with breast cancer. This is breast-conserving surgery since the surgeon removes only that part of your breast that contains the tumour (the “lump”) and some of the normal marginal tissue that surrounds it. If cancer cells are found in the margins, additional surgery (called re-excision) is required. Most women receive five to seven weeks of radiation therapy after lumpectomy, in order to eliminate any remaining cancer cells.
The combination of lumpectomy and radiation is called breast-conservation therapy.
Lumpectomy is a breakthrough surgical procedure for early stage breast cancer with around 50% of women suitable. The location, size, and type of tumour are of importance when considering breast cancer surgery options. Experts agree that since survival rates are equivalent to masectomy, lumpectomy followed by radiation is the preferable treatment for most women with early-stage cancer. For women who have had lumpectomy with clear margins, followed by radiation, the average risk of non-recurrence is between 85-90 percent.
Post surgery precautions:-
– Do not lift anything heavy. Restrain doing repetitive movements (like ironing or vacuuming) with the affected side for at least 4-6 weeks.
– Do not swim or play sports until your scar has healed – about 4-6 weeks.
– Women should wear a well-fitting support bra both day and night for approximately one week after surgery.
– Protect your hand and arm from infection.
– Keep the fluids moving in your operated arm. Do not wear tight sleeves, bracelets, wristwatches or rings on that arm.
– Do exercises to stop swelling and improve circulation. For instance, try squeezing a rubber ball with your hand for a few minutes a day.
Risks associated with lumpectomy:-
– There is usually a loss of sensation in the breast, depending on the size of the lump removed. Some or most of this ability to feel gradually returns.
– After surgery, both the breasts may mismatch in size and shape.
– Seroma – a collection of fluid under the arm occurring about five days after surgery. It is likely to go way in a few weeks or else needs to be drained by doctor.
Risks associated with breast surgery –
Any surgery involves a certain amount of risk and it is important that the patient understands the underlying risks, before she takes a decision on it.
Complications vary from person to person and every patient experiences her own individual risks, but still the patient should have complete idea about the possible outcomes.
An overview of the possible risks:-
A. Capsular contracture – occurs if the scar or capsule around the implant begins to tighten. This can cause the breast to feel hard. Additional surgery may be required to remove the scar tissue. In some instances, the breast implant may need to be replaced.
C. Difficulty in mammography
D. In many cases, nipples become oversensitive or even numb.
E. Leak or rupture of the implant
F. Hematoma (collection of blood), and seroma (collection of fluid) within the tissue leading to capsular contracture and infection.
G. Wrinkling and rippling of the implant