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Breast Reconstruction Center

A diagnosis of breast cancer can overshadow a woman’s entire world, producing a flood of questions and emotions. At the UVA Breast Reconstruction Center in Charlottesville, VA, our world-class plastic surgeons are just one part of a team of experts, all focused on the physical and emotional well-being of our breast cancer patients from Richmond, Roanoke, and surrounding areas. Wherever women are in the process, our experts offer state-of-the-art solutions and compassionate support as women transition from diagnosis to treatment and beyond.

Our Approach to Breast Cancer Treatment

Because conquering breast cancer often requires more than one type of treatment—such as cancer surgery, reconstructive surgery, drug therapy (chemotherapy, hormone therapy, bone-directed therapy), and radiation—the UVA Breast Care Program involves a multidisciplinary team of experts, which may include:

• General surgeons perform diagnostic workups and evaluations, followed by cancer surgery.
• Plastic surgeons perform breast reconstruction, which may require coordination with general surgeons.
• Medical oncologists specialize in chemotherapy treatments for breast cancer.
• Radiation oncologists specialize in breast cancer radiation treatments.
• Radiologists perform breast imaging using mammograms, ultrasound, and MRI.
• Pathologists review tissue specimens to aid breast cancer diagnosis and treatment.
• Registered nurse coordinators provide direct support and care to patients and their families.

All subspecialty care is coordinated by the breast cancer team, which meets together weekly to review all breast cancer cases and discuss each patient’s unique complexities and treatment plan.

Breast Reconstruction Considerations

Breast reconstruction may be an option for women who have had, or intend to have, a mastectomy due to a cancer diagnosis or as a preventive measure (prophylactic mastectomy) because of a strong family history or genetic mutation (BRCA gene). Breast reconstruction may involve one or more of the following decisions: whether to have reconstruction at all, when to have it, and which type to select.

Making the Choice

After a breast cancer diagnosis, the first and most basic decision is whether to undergo breast reconstruction. While most women choose reconstruction, some do not.

Timing of Breast Reconstruction

Women who choose breast reconstruction and have not yet had surgery for their cancer have the following options for the timing of their reconstruction procedure:

• Immediate reconstruction: Breast cancer surgery or prophylactic mastectomy is combined with breast reconstruction in one surgical procedure allowing for one recovery process.
• Delayed reconstruction: Breast reconstruction is performed separately from breast cancer surgery. Breast reconstruction may be delayed because the patient needs time to decide whether she wants to undergo reconstruction or because adjuvant treatment, such as radiation or chemotherapy, is needed to more completely control the cancer.

Types of Breast Reconstruction

Our plastic surgeons are experienced in all forms of reconstruction, including:

• Implant-based reconstruction involves silicone or saline breast implants like the ones used for breast augmentation. The implants are placed under the remaining chest skin. Unless a mastectomy is performed with a skin-sparing technique, a tissue expander is first placed to gradually stretch the skin enough to cover the implant. Our surgeons can refine implant reconstruction results using fat grafting.
• Autologous tissue reconstruction creates the new breast with skin and tissue (often called a flap) from another area of the patient’s body, such as the back.
• Free-tissue reconstruction uses the patient’s skin and tissue as above; however, the blood supply to the newly formed breast is re-established using a highly intricate microsurgical technique. This option is usually reserved for more complicated cases.

For details about breast reconstruction options, visit the UVA Cancer Center website.

How long does it take to recover from reconstructive breast surgery?

While experiences vary, recovery after breast reconstruction with an implant generally takes 3 to 4 weeks, and recovery from autologous tissue reconstruction takes approximately 4 to 6 weeks. The actual length of recovery varies with the type of reconstruction, the specifics of the surgery, and individual healing rates. However, most patients can expect the following during their healing journey:

Pain Management

• The initial days following surgery may involve moderate discomfort and mobility restrictions.
• Pain medication may be prescribed to the patient, though many patients can manage their pain with over-the-counter pain relievers.

Bruising and Swelling

• Bruising and swelling peak during the first week after surgery.
• The swelling should be less noticeable after a few weeks, though it can take months for it to fully dissipate.
• A compression garment or surgical bra should be worn as much as possible during your first month of recovery to promote healing and minimize swelling.

Incision Care

• Stitches or staples are usually removed within 1 to 2 weeks, depending on your surgeon’s recommendations.
• Surgical drains may be used for the first 10 to 14 days to prevent fluid from building up around the incision sites.
• Your surgeon will provide you with detailed instructions about proper incision care and hygiene.

Implant “Drop and Fluff”

• If implants are used, they may initially appear high on the chest due to swelling and muscle tightness.
• The implants gradually “drop” to a more natural position and “fluff” as the implant settles into the lower portion of the breast.
• This “drop and fluff” process can take up to 3 months.

Return To Normal Activities

• Light activities, such as walking, can be resumed shortly after surgery, but avoid strenuous activities for the first 2 to 4 weeks.
• After a month, you should be able to reintroduce most strenuous movements and activities.
• High-impact exercises and heavy lifting can strain healing breast tissue, so postpone these activities until your surgeon clears you.

Smoking Cessation

• Smoking can impair healing and increase the risk of complications.
• You will need to refrain from smoking for at least a month before your surgery and for the duration of your recovery period.

Scar Fading

• Scars from breast reconstruction may take several months to a year to mature and become less noticeable.
• Applying silicone-based scar gels or sheets, as recommended by your surgeon, can minimize scar appearance.

Breast Reconstruction FAQ

What type of breast reconstruction is best?

There is no single “best” type of breast reconstruction. Available options depend on the patient’s case and preferences. Your surgeon will review all available options during your consultation to help you choose the method that is best for you.

What’s the most common type of breast reconstruction surgery?

Implant-based reconstruction is the most common version of this procedure, with around 80% of women pursuing this approach.

Is the surgery safe?

Although all surgeries carry some degree of risk, trusting your breast reconstruction to a board-certified plastic surgeon goes a long way toward ensuring a safe, smooth procedure in a hygienic, highly accredited facility.

Can you keep your nipples after a mastectomy?

Certain patients may be candidates for a nipple-sparing mastectomy, which removes the breast tissue and leaves the outside skin and nipple intact. If you are not a candidate for this procedure, the nipple and areola may be replaced through minor surgery, medical tattooing, or both after the reconstructed breast has healed. Some patients choose not to have the nipple reconstructed at all.

Is breast reconstruction painful?

Patients do experience temporary soreness or pain after breast reconstruction. In most cases, prescription or over-the-counter medication effectively relieves the discomfort. The degree of pain patients experience varies with the type of reconstruction performed and individual factors. Autologous tissue reconstruction typically involves more pain initially because there are multiple surgical sites: the reconstructed breast and the donor site.

How does a reconstructed breast feel?

Breasts reconstructed with natural tissue typically feel more like natural breasts because they are warm, living tissue. Breasts reconstructed with silicone implants tend to feel more natural than saline. Reconstructed breasts may regain sensation partially, but this takes time.

What is the current research on breast cancer?

As a National Cancer Institute (NCI)-designated cancer center, UVA regularly conducts its own research studies and participates in groundbreaking, national clinical trials. This involvement gives our breast cancer patients treatment options not available anywhere else in the region. Visit our Clinical Trials page to learn more.

Are you ready to find out more?

To meet with one of the world-class plastic surgeons at the UVA Breast Reconstruction Center in Charlottesville, request a consultation using our online form or call (434) 924-1234 for an appointment.