Mastectomy without reconstruction
Mastectomy without Reconstruction
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The Operation Complications After Care
This operation involved removal of the entire breast including the nipple.
It is not a particularly large physical operation as such. In many respects it is a larger psychological operation.
The operation involves the use of an elliptical incision over the breast to excise some of the skin overlying the breast, the nipple and the areola as well as the underlying breast tissue. This leaves a flat chest on that side with a straight scar that curves up in towards the armpit.
The operation takes in the region of 1½ hours and requires approximately 3 days in hospital. The surgeon places 1-2 surgical drains into the wound to reduce the chance of a fluid collection developing after the operation and the drains may stay in for number of days following the operation.
Normally it is relatively uncomplicated surgery and somewhat surprisingly doesn't usually incur too much post-operative discomfort.
A small number of patients will develop problems and complications after surgery. This could include wound infection, delayed wound healing, bleeding into the wound after the surgery has been finished (perhaps needing further surgery) and the possible need for a blood transfusion.
Most patients experience quite a bit of bruising on the chest wall afterwards and many patients develop a fluid collection in the wound that forms a number of days after the operation. This is called a seroma. It is very common, almost always harmless and can easily be drained (with a needle) later in the outpatient clinic. Most people get back to normal physical activity without undue pain or tiredness within two to three months following surgery.
Following discharge from the hospital a further appointment is made to come back to the breast unit to check the wounds and to discuss what has been found down the microscope and what further treatments are necessary to reduce the chances of the tumour coming back in the future.
Most patients after a mastectomy would NOT require a course of radiotherapy afterwards but a small number may benefit from its use.
Clearly, having a mastectomy alters one's body image. The breast care nurses are expert at fitting bras and can issue prostheses to fit in a bra, such that when clothed it would not be obvious that the patient had undergone a mastectomy. Despite this, for most women there is a period of grieving and emotional distress following a mastectomy.
Most patients are able to come to terms with their altered body image and altered self-esteem over the period of a year following the operation. Only a relatively small percentage of patients will submit themselves to the operation of a delayed breast reconstruction and many patients are able to adapt psychologically to their altered body image.