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Surgery on the Opposite Breast

It is important to consider the opposite breast when planning your reconstruction. While some women choose to leave the healthy breast untouched, many want to achieve symmetry with the newly reconstructed breast, with as little scaring as possible. Depending on the needs of the patient, symmetry may be achieved with a breast reduction, breast lift, or breast enlargement with an implant. The timing of these procedures will vary depending on what other treatments you may need.

Several months after you have healed from the mastectomy and reconstruction, you may have surgery on the opposite breast. If you need chemotherapy, surgery on the opposite breast can be done once your blood counts are normal. This usually takes about one month.

The approach to surgery on the opposite breast may vary depending on the type of reconstruction you have chosen. For patients with flap reconstruction, the opposite breast may be operated on during the second stage of surgery when the flap is revised and the nipple areola reconstructed. For patients with expander implant reconstruction, the opposite breast can be operated on when the expander is exchanged for the final implant, or it may require a separate third surgery. Because implants tend to be round in shape, having an implant placed into the opposite breast may offer better symmetry. The nipple areola will then be reconstructed at a later time, once the final implant and the opposite breast have settled and healed.

All of these are outpatient procedures, and generally do not require drains. The surgical time is relatively short, and although you will require several days to recover, you should be able to resume most normal activities within two weeks. It is important to discuss with your doctor what measures of follow-up care you will need. After altering the opposite breast, it is essential to continue screening for cancer.

Photos and Doctor Commentary
 

After right mastectomy and reconstruction

After left breast reduction

Surgery on the Opposite Breast

Click Image to Enlarge

This patient had a right mastectomy with tissue expander AlloDermĀ® reconstruction. Six months later, she underwent exchange of the tissue expander for a cohesive gel implant. Surgery on the opposite breast was delayed an additional five months to allow the right implant reconstruction time to settle and heal. A symmetrical outcome was provided with a left breast reduction.