Breast Reconstruction Complications

Though uncommon, breast reconstruction complications can and do occur. Any woman who is considering post-mastectomy breast reconstruction should be fully informed of possible complications before proceeding with surgery.

Complications After Breast Reconstruction

Several new advances have minimized the impact and severity of breast reconstruction complications both during breast reconstruction surgery and after breast reconstruction surgery. However, because complications are possible, patients should still be aware of what they are before undergoing surgery.

Poor Reaction to Anesthesia

Poor reaction to anesthesia is one of a few breast reconstruction complications that can occur with any surgical procedure. Common complications and side effects of anesthesia are nausea and vomiting after surgery, dizziness and blurred vision, headache, and itching. Less common problems include urinary difficulties and chest infection, particularly in smokers. People who have pre-existing medical conditions such as heart, circulation, or nervous system problems are at increased risk for anesthesia complications, so patients should provide a complete medical history and be fully forthcoming to the physician before breast reconstruction surgery is performed.

Infection

Infection is another of the breast reconstruction complications that are possible with any type of surgery. In most cases, antibiotics can be used to effectively treat infections. A persistent infection under a breast implant may require removal of the implant so the infection can be completely eradicated. Patients who undergo breast reconstruction surgery should contact their physician immediately if, following their procedure, they experience:

• A color change or increased redness around the breast or incision area.
• Any discharge of fluid or pus from the surgical site.
• A fever that exceeds 100 degrees Fahrenheit.

Bleeding

Patients who experience excessive bleeding at the surgical site should also contact their physician immediately. Patients on blood thinners or other medications that can affect clotting may be told to stop taking the medicine a week or two prior to surgery to minimize bleeding risks.

Implant Problems

Women who choose to have breast reconstruction with breast implants face the same breast augmentation complications as women who choose implants to enlarge their breasts.

The most common of all breast reconstruction complications related to implants is capsular contracture, a condition in which the capsule or scar surrounding the implant tightens. If capsular contracture does occur after breast reconstruction surgery, the surgeon will either remove and replace the breast implant or remove the scar tissue.

Rupture and deflation of an implant can be caused by capsular contracture, damage from surgical instruments, overfilling of a saline breast implant, or other factors. When a saline breast implant ruptures, deflation is usually rapid and noticeable. However, when a silicone breast implant ruptures, deflation can be slow and occur over a long period of time. Saline solution mimics the body's natural fluids and is readily absorbed by the body. Though silicone is thought to be safe, there is no definitive scientific conclusion on the effects free-floating silicone can have on the human body. All implants will eventually rupture, so physicians recommend having an MRI two years after having an implant or implants, and every year subsequently.

Other breast reconstruction complications linked to breast implants include pain of varying duration and intensity following surgery, infection, and delayed wound healing. These are problems common to most surgical procedures, and they can usually be addressed with medications. If a patient smokes, the breast reconstruction surgeon will likely ask the patient to stop smoking two weeks prior to the procedure to help ensure the healing process is not impeded.

A patient can help minimize the likelihood of breast implant problems by carefully following the surgeon’s pre- and post-surgery instructions. If you are considering breast reconstruction with implants, discuss possible complications with your surgeon before going ahead with a procedure. Be sure to provide your cosmetic surgeon with a full medical history and description of all the medications you are currently taking or have taken recently.

Flap Problems

Flap breast reconstruction may also result in complications. Weakened muscles may develop in the donor areas from which the flap was originally taken. Because small blood vessels are involved in the surgery, there is a risk of clotting that can lead to vascular complications. There is also the risk that blood flow in the reconstructed breast may become constricted, causing the flap tissue to die.

TRAM flap breast reconstruction involves removing skin, fat, and muscle tissue from the abdomen to create a new breast. In DIEP flap surgery, only skin and fat are taken from the abdomen. Both are preferred methods because they result in a natural and consistent looking reconstructed breast. Abdominal strength is reduced after surgery, but this is usually a temporary condition. Prolonged discomfort in the abdomen is possible after either of the procedures, and women who desire or intend to have children are typically steered to another type of procedure. Both the TRAM and DIEP flap procedures result in a large abdominal scar and scarring around the reconstructed breast.

Latissimus dorsi flap breast reconstruction surgery involves moving tissue from the upper back to reconstruct the breast. Because this method often requires a breast implant, the patient faces the possible complications associated with implants. The procedure can weaken the arm, shoulder, or back. A large scar on the back will remain after surgery.

In a gluteal flap breast cancer reconstruction procedure, tissue from the lower buttock is used for breast reconstruction. Complications can occur if blood supply to the relocated tissue is insufficient because of vessel blockage or other factors. The procedure leaves a large scar on the buttock in the area from which the flap was removed.

Will Breast Reconstruction Interfere with Other Treatments?

Breast reconstruction will not affect radiotherapy or chemotherapy treatments. However, when implants are used for breast reconstruction, they can result in complications related to mammography. A breast implant can obscure suspicious tissues and cause difficulty in interpreting the mammography results. Also, because the breast is squeezed during a mammogram, it is possible that an implant will rupture. For these reasons, a patient should always inform the technician that she has an implant or implants prior to receiving a mammogram so steps can be taken to ensure optimal results.

Connect with a Breast Reconstruction Surgeon near You

Breast reconstruction entails major surgery and should not be taken lightly. If you are considering a procedure, be sure to choose a breast reconstruction surgeon with whom you feel comfortable, and thoroughly discuss all possible breast reconstruction complications with your surgeon before deciding to go ahead with surgery. DocShop's extensive listings can help you find a cosmetic surgeon in your area with whom you can arrange a consultation to discuss your concerns and the specific complications you may face.