Why do people choose flap reconstruction after breast cancer surgery?

Last Modified: May 8, 2009

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Question

Dear OncoLink "Ask The Experts,"

Why do people choose flap reconstruction after breast cancer surgery? Doesn’t it take longer to recover from than breast implant surgery?

Answer

Rachel McKenna, MSN, CRNP, Nurse Practitioner in the Division of Plastic Surgery at the University of Pennsylvania Hospital, responds:

It is true that breast reconstruction using a free flap is more work up front; you are in the hospital for longer (usually 4 days) and has a longer recovery, 6 weeks. However there are many advantages to this type of breast reconstruction. Below is a brief summary of advantages and disadvantages. However, you will need to speak to your surgeon to decide the best type of reconstruction for you.

Advantages of a free flap breast reconstruction:

  1. You have your own tissue being used to reconstruct your breast.
  2. The flap reconstruction does not deflate which may occur with a breast implant.
  3. The flap reconstruction does not need to be replaced which may occur with a breast implant if the implant is too old.
  4. You do not have to wear a breast prosthesis.
  5. Since there is no breast implant, infection from the implant is avoided.
  6. The bottom half of your abdomen will be less distended, this is similar to a “tummy tuck.”

Disadvantages of a free flap reconstruction:

  1. The surgery time during the operation is long. For unilateral (one breast) surgery is approximately 4 to 5 hours, and for bilateral (both breasts) surgery may take 7 to 9 hours, which includes mastectomy time.
  2. The breast free flap may not survive and the flap signal may be lost. This is a major complication but the probability is low. If the flap does not survive within the first 48 hours after surgery, you may be brought back to the operating room for re-evaluation of the flap.
  3. There will be scars on your abdomen and breast. There is a risk of hernia.



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