The majority of the reconstructive surgeries were due to cancer-induced mastectomies, and more than three-quarters of those women reported that breast reconstruction was an important factor in helping them to recover psychologically from the devastating effects of breast cancer.
Under the Women’s Health and Cancer Rights Act of 1998, if a health insurer provides coverage for a mastectomy, the insurer must also provide coverage for breast implants cost or other reconstructive surgery. This includes procedures to provide symmetry to both breasts. Without insurance, breast implants cost several thousand dollars, depending on the area and the surgeon.
There are several methods used for breast reconstructive surgery but breast implants recovery times are shorter, the surgery is less invasive, and it has the least effect on other parts of the body.
Other types of breast reconstructive surgery are the TRAM flap, which relocates an abdominal muscle to the chest wall; a lat flap, which takes a muscle from the back to provide skin and blood supply for a new breast; or microsurgery, which uses either stomach fat and skin or buttock fat and skin to provide skin and blood supply for a new breast. These types of reconstructive surgery require longer hospital stays and recovery times and leave additional scarring at the donor site. However, since the tissue comes from the patient’s body, there is no concern about rejection of the donor tissue.
There are pros and cons for implants also. Although the recovery is quicker and there are fewer surgeries, implants will probably need to be replaced during a person’s lifetime. Occasionally, the implants may leak or shift, therefore, a correction may need to be made; since implants do not sag with age, symmetry may not be permanent.
However, considering all these factors, breast implant reconstructive surgery remains the most popular procedure and usually involves two surgeries. The first surgical procedure will insert a tissue expander with a port in it so that the physician can periodically add saline (usually once a week) until the implant reaches just slightly larger than the desired size. There will be a surgical drain near the incision to funnel away excess fluid and help the wound heal. The reason for making the expander larger than needed is to enable the skin to stretch larger than is ultimately desired, so that when the implant is slightly reduced in size, the breast will have a natural droop. Sometimes there is pain associated with the expansion, but this generally subsides as the skin and tissue stretches.
When the skin and tissue have reached the desired size, the expander is removed and the implant inserted, which requires another surgery. Not all women require an expander, in which case the surgeon inserts the implant directly and only one surgery is involved. Breast implants recovery time is shorter for cosmetic surgery.
The U.S. Food and Drug Administration published a possible link between both saline and silicone implants and a rare form of lymphoma, anaplastic large-cell lymphoma (ALCL) in the capsule surrounding the implant. Although ALCL is completely curable and the FDA doesn’t consider the link viable, they suggest getting regular checkups, particularly if symptoms appear such as pain, lumps or swelling.
The best candidates for implant reconstructive surgery are women with smaller breasts and smaller builds. Obesity, high blood pressure, smoking and excessive alcohol intake are risk factors that may make a woman a poor candidate for implant reconstruction. A walking/stretching program and a yoga regimen started as far in advance of the surgery as possible appear to reduce recovery time and speed healing.
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