Recovery following breast cancer surgery.
Previously, I have tried to give an answer to this question, but it is obviously is a
very big question.
Because quite frankly there are different kinds of breast surgery, there are different
recovery times; there is a different extent of surgery.
But let’s focus right now on recovery following mastectomy with a flap rotation.
Now I have previously shared with you here breast cancer answers, the kinds of flaps
that we can rotate in to a reconstructive mastectomy site.
One of the traditional ones is called a TRAM flap from the belly rotating skin, subcutaneous
fat, and the rectus muscle up into the mastectomy site, particularly if a large amount of skin
has been removed.
That particular type of reconstruction has been around I think for about 25 years, so
that is called a rotational TRAM.
There is now are Free TRAM where we disconnect the vessels down below, reconnect them up
here at the side, big operations.
So you know there are other flaps from the back bringing the muscle and tissue around
from the latissimus dorsi flap.
The deep flap is another type of flap from the abdominal wall up.
So one of the reasons I think flap reconstruction has become less and less overtime has been
because these are really big operations and recovery times can be quite long and depending
what is going on here on the abdominal wall, some of the recoveries down here on abdominal
wall can frankly be tougher, and hard around patients than the recoveries up here.
In my own clinical experience one of the easier flap reconstructions to recover from is a
latissimus dorsi flap been brought around with usually a small implant?
My clinical experience is patients recover quite nicely from that.
The recovery from the deep over the TRAM flaps is really dependent on the size of the area
taken theoretically the deep flap patients recover a little bit better because you have
got less being moved up, but quite frankly this is highly variable.
So one of the questions that is coming recently is from a patient who is some period of time
out in thinking gosh why do not I feel normal?
Why am I still having discomfort?
My advice to any of you is always go back to your original plastic surgeons and breast
surgeons, make sure that technically there is not something wrong down below.
One of the consequences of these flaps from the abdomen can be the development of a hernia
and that hernia could be painful, so may be that is what is going on, and then please
understand that the bigger the operations, potentially the longer the recovery that always
be working with a multidisciplinary team to try and get to the bottom of your particular
set of circumstances.