Breast Reconstruction

Breast Reconstruction2021-06-29T18:04:39+02:00

What is Breast Reconstruction?

Breast reconstruction surgery rebuilds or reshapes the breast following a mastectomy (removal of the entire breast) or a lumpectomy (the removal of a part of the breast to remove a tumour). There are two main techniques used in breast reconstruction:

  • Implant reconstruction – inserting a silicone or saline implant; and
  • Autologous (skin flap) surgery uses tissue from another part of the body.

Some reconstructions use a combination of both techniques for the best results.

Losing one or both breasts to a mastectomy can be tough. Breast reconstruction surgery can restore not only your shape but your self-confidence too. Anxiety, depression, or loss of self-confidence after a mastectomy are valid reasons for this procedure.

Today, most traditional mastectomies are skin-sparing. Here the surgeon removes all breast tissue and glands but preserves the skin and some of the fat layer. The result is a more natural-looking reconstruction with less scarring.

Breast reconstruction can start during the same procedure as the mastectomy. However, the procedure can also wait until after the mastectomy has healed, and other cancer treatments are finished.

An alternative option to rebuilding your breast shape is Aesthetic Flat Closure.

What is Aesthetic Flat Closure?

Aesthetic flat closure is post-mastectomy chest wall reconstruction. After the breast tissue has been removed during the mastectomy, additional work is required to smooth and contour the chest wall. Excess skin is removed, and the clean symmetric incisions are neatly closed to create a smooth, flat chest.

This reconstruction of the chest wall can be done at the same time as the mastectomy. However, aesthetic flat closure can also be done at a later stage or after an implant removal.

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FAQ

How to plan for breast reconstruction2021-05-28T14:09:48+02:00

When you plan for breast reconstruction first make an appointment with me to come and discuss all the options. I will recommend the best procedure and discuss the techniques for the best outcome. We will also discuss when to have it, and whether we do both breasts in order to achieve symmetry. I favour a team approach where we have combined meetings with the cancer surgeons and occasionally oncologists.

Some other factors to consider are your body type, the type of cancer and the other cancer treatments you may have had, your general health, and how soon you expect to recover.

What is the procedure for breast reconstruction?2021-05-28T14:05:52+02:00

The procedures for breast reconstruction have two main techniques: implant reconstruction and skin flap (autologous) surgery.

In an implant reconstruction, I will insert a tissue expander under the skin or muscle. This expander gradually stretches the remaining tissue. After this has healed, I inject saline or saltwater into the expander over several weeks until the breast is the size you’re happy with. At this stage, I will then replace the expanders with a silicone or saline implant.

In skin flap surgery, I will rebuild the breast by transferring tissue from the abdomen or other parts of the body. One technique is free-flap surgery where I will completely remove the tissue (usually from the lower abdomen) and blood vessels and transfer them to the breast. The other technique is pedicle flap surgery, where the tissue transferred remains attached to the body and is rotated into place.

Fat grafting procedures may be needed to iron out contour deformities, soften the reconstruction and build a new nipple. Fat will be harvested by liposuction from areas that you prefer to lose fat. The areola is tattooed by a professional artist dedicated to this type of reconstruction.

 

How to prepare for breast reconstruction?2021-05-28T13:55:07+02:00

To prepare for breast reconstruction surgery, you may be asked to stop smoking for 2 – 4 weeks prior to the procedure. Nicotine retards the healing process, and quitting for as long as possible before surgery helps improve blood flow.

You might also have to have a blood test before surgery is performed.

During the consultation be sure to disclose what medication, vitamins, and supplements you are taking. I may need to adjust this leading up to surgery. You should avoid certain medications like aspirin and some anti-inflammatory drugs. You may also need to stop taking some vitamins and supplements. Avoid any recreational drugs.

Be sure to arrange for transport to and from the clinic. You will not be able to drive yourself after the procedure.

What to expect after breast reconstruction?2021-05-28T13:51:37+02:00

After breast reconstruction surgery expect to have bandages covering the incisions. An elasticated support garment should be worn to assist healing. You may have a small drainage tube under the skin.

Some pain and discomfort is normal but your prescribed pain medication will help. Apart from pain or discomfort in the breasts, if you have had skin flap surgery, you may experience some abdominal pain too, or pain at the site from which the tissue was removed. Deep breathing will be difficult but a physiotherapist will give advice as to how to treat this.

You will be advised on how to look after yourself while healing, how and when to take medication, and what to look out for.

Recovery time will depend on the type of reconstruction but most patients can resume normal activities within 6 – 8 weeks. Movement, such as lifting your arms above your head, should be restricted until you have recovered. Physiotherapy is highly recommended. Avoid vigorous activity and exercise and try not to put pressure on the incision area. Be slow and gentle in resuming your normal activities.

What are the risks of breast reconstruction?2021-05-28T13:46:14+02:00

The risks of breast reconstruction can include fluid build-up in the breast or at the donor site and slow wound healing. After a skin flap reconstruction, there may be tissue death (necrosis).

With any surgery, there is a (low) risk of post-operative infection, bleeding, and swelling.

Fatigue is often associated with this surgery.

With implants, there is a risk of rupture or leakage. This may result in more surgery to either remove or replace implants.

There can be changes in breast sensation and asymmetry.

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Enhancing your appearance can have wonderful positive effects on your self-esteem, confidence and happiness.
It’s an empowering decision that is yours to make, and we are here to help you reach that dream.

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