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Breast Reconstruction Orange County Breast Reconstruction

Breast reconstruction is achieved through several plastic surgical techniques that attempt to restore a breast to near normal shape, appearance and size following mastectomy, injury or birth defect. The following information has been prepared to familiarize you with facts about the surgical procedures known as breast reconstruction. You are requested to read this information thoroughly and to discuss any questions which might arise with your surgeon before proceeding with any type of breast reconstruction procedure. You are also requested to keep this form as a reference in the post-operative period.

Breast reconstruction offers women the opportunity to feel whole again after mastectomy, injury (e.g. due to burn scars) or a birth defect. Most techniques involve several procedures which can begin as early as the time of mastectomy. The reconstruction begins with an attempt to restore shape, size, and appearance of the breast. There are several techniques by which this can be accomplished. 

You may visit your surgeon as many times as you wish to have all of your questions answered. At your final preoperative visit, your final questions will be answered and you will confirm that you have understood the procedure to be performed, that this material has been explained to you, that you have read and understand these information sheets, and that you accept the risks by signing the informed consent forms. You will be given prescriptions for surgical soap that is used before surgery, as well as pain pills, antibiotics and instructions for their use.

Certain laboratory tests will also be required about two weeks prior to surgery. If you are over the age of 50 or have had any cardiac problems, you will have to obtain a cardiogram at your doctor’s office or any licensed laboratory. You may have blood drawn by our office nurse during your final preoperative visit, or, if you prefer, at your family doctor’s office or laboratory (e.g. Kaiser Hospital, etc.) All patients will be asked to stop smoking at least a month prior to surgery in an effort to maximize your body’s ability to heal the incisions following the operation. 

Breast reconstruction procedures can be performed in an inpatient or outpatient setting. In most cases, a general anesthetic or deep sedative, along with local anesthetics, are employed to insure your comfort and safety. 

The initial procedures for breast reconstruction may be performed at the same time as your mastectomy or in a delayed fashion. Immediate reconstruction offers the psychological and aesthetic advantage of waking from the mastectomy procedure with less of a deformity. Major disadvantages include the longer surgery and recovery times, and the possibility of unexpected radiation therapy becoming necessary and compromising the reconstructed tissue. Depending on the risk factors known pre-operatively or determined intraoperatively, your procedure for breast reconstruction may be delayed. 

Depending on which operation you are undergoing, you may be admitted to the hospital to start recovering after surgery. Otherwise, after you have recovered to the point where you are awake and comfortable, you will be discharged home with a responsible adult. You are to leave the dressing dry and intact until your first post-operative visit to the office, which will generally be two to five days following the procedure. 

Drainage tubes may be needed during your procedure, in which case you should empty them before they get full and record how much comes out of each tube every day. This will help you surgeon decide when the tubes can be removed. During these initial days, you will be requested to take an antibiotic tablet once daily and to limit your physical activity to avoid lifting or straining. 

Every activity in life, whether driving automobiles or having surgery is associated with risk. The following inherent risks must be understood and assumed by the patient if we are to proceed with this operation. Although most patients have a very satisfactory result, complications may occur following any surgical procedure. The patient must understand that asymmetry (differences in appearance from one side to the other) is perfectly natural and that some will persist following even the most successful procedure. Likewise, visible and occasionally unsightly scars are an expected outcome of such an operation. 

Possible complications include infections, bleeding, fluid collections, capsular contracture, implant rupture, vascular compromise of the flap, skin or tissue loss, which may delay healing, necessitate skin grafts or other subsequent surgical procedures. When autologous flaps are used for breast reconstruction, the donor site will be scarred and can incur complications. Aside from the healing complications listed above, these can include muscle weakness and hernia or bulge of the abdominal wall.

All fees will be discussed freely in advance by the office staff. Co-pays, deductibles, and other patient responsibilities vary with each insurance carrier and plan. Patients will be asked to pay their expected responsibility for surgical fees in advance. Any overpayment or underpayment will be refunded or billed after final adjustments are made by the insurance carrier. Financing may be arranged if desired. Your insurance company may cover a part of the fee but almost never the entire fee. Payment of all fees, however, is the patient's responsibility; all fees are due prior to surgery and the proceeds of the insurance check will go to you when the check arrives (minus a 6% billing fee if you chose to use our billing service). If requested, the office staff will assist you with forms, but recovery of any insurance benefits is between you and your insurance company.

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