What is breast reconstruction surgery?
Breast reconstruction surgery aims to rebuild one or both breasts following breast cancer surgery such as mastectomy. It can be performed at the time of mastectomy or at a later time frame once the primary breast cancer treatment is completed. Both reconstructive and cosmetic disciplines are used in order to deliver results that take each patient’s personal preference and unique anatomy into account.
At AR Plastic Surgery we offer a personalised and holistic service. We are here to listen, gently guide you and ensure you make the right decision for you.
Our specialist plastic surgeon, Dr Eddie Cheng, collaborates with a multi-disciplinary team of specialists and allied health including breast surgeons, breast care nurses, physiotherapists, psychiatrists, cancer support staff, geneticists, oncologists, and radiologists, to manage the complexities of each individual situation. This procedure can make a real and positive difference to the lives of women.
Our highly experienced team will provide support every step of the way, in a safe and caring environment.
Why breast reconstruction could be right for you
Breast reconstruction is not for all women, however, all women should have the opportunity to learn about their options and make an informed decision before having mastectomy. Women may choose to have breast reconstruction for a variety of reasons. These include making their chest look balanced, to regain shape and form, and to restore confidence and assist in the psychological and emotional recovery following breast cancer.
In certain instances, breast reconstruction is able to be performed at the same time as the mastectomy, however, in nearly all instances breast reconstruction surgery often requires more than 1 surgery.
A delayed reconstruction is also a viable option for many patients. For example, if there are unexpected complications during the initial mastectomy or the patient is overwhelmed at the prospect of making both medical and aesthetic treatment decisions. Breast reconstruction can be commenced months and sometimes years after a mastectomy has been performed.
Types of breast reconstruction procedures
An implant reconstruction procedure typically entails 2 stages. In the first stage, Dr Cheng places a tissue expansion device to stretch and expand the chest skin and tissue to allow adequate space for the breast implant to be correctly positioned. Over the course of a few months, Dr Cheng and our Nurse will gradually expand the skin by injecting saline into the tissue expander device. This allows the skin to gradually stretch to the right proportions amd size ready for a more permanent breast implant. Several months later the tissue expander is exchanged for a permanent silicone or saline gel implant that is placed behind the chest muscle.
How will my breasts feel and look after breast implant reconstruction?
It is important to understand that breast implant reconstruction will look and feel very different to natural breast. It may feel cold and often feels firmer to touch comparative to natural breast tissue. Achieving perfect symmetry or matching the unaffected breast may also be difficult, particularly for women with larger breasts. Often in these situations, refinement procedures can be performed to enhance the appearance and symmetry.
Sometimes both fat transfer and implants are combined to produce a hybrid reconstruction. For example, in cases where there is insufficient fat a small breast implant is used to augment size and shape. A key advantage of a hybrid approach is the ability to create results that may not be possible using only one surgical technique.
Autologous breast reconstruction
Autologous or Using your own tissue including skin, fat and muscle to reconstruct your breast is also an option for some women, particularly those who have adequate or excess abdominal or tummy tissue.
TRAM or DIEP flap reconstructions involve reconstructing the breast by transferring belly or abdominal tissue containing skin, fat and blood vessels, and shaping this into a breast.
During a free TRAM flap, fat/skin blood vessels and muscle are all taken from the wall of the lower belly and transferred to the chest. The blood vessels are then attached to the blood vessels in the chest via microsurgery.
Muscle Flap with Implants
Also known as Latissimus Dorsi Reconstruction, muscle flap reconstruction involves taking skin and muscle from the back to create a new skin envelope. The transferred skin flap contains a combination of muscle, fat and blood vessels that remain attached to their original blood supply, ensuring the blood continues to circulate. Once the flap is positioned, it is shaped to create a natural looking breast. An implant is also placed within to provide shape and volume for the breast contour.
What to expect after surgery
Each patient is different and full recovery from reconstruction surgery can take several weeks. It also depends on what type of reconstruction procedure the patient has had. For example, TRAM procedures generally have longer recovery periods than direct implants as the body needs to heal from two surgical sites both breast and tummy.
Just like after any operation, you’ll likely experience some pain or discomfort. This can vary considerably though from patient to patient. In addition, you may experience some swelling and bruising as well as some itchiness around the breast area. Proper rest and avoiding strenuous exercise are both important factors in your recovery, while appropriate medications can also be prescribed to manage pain.
How soon you’re able to return to your regular routine will depend on the type of work you do and the type of surgery involved. However, it’s critical to keep in mind that it’s natural for your body to feel more tired than usual for a period of time.
Checking your breasts after reconstruction surgery
If you’ve had a breast completely removed and reconstructed, it is generally unnecessary to conduct future mammogram screenings on the reconstructed breast. Sometimes it is recommended to conduct a baseline mammogram or MRI after reconstruction for comparison in the case anything unusual develops in the future.
To find out more about this procedure and which type of reconstruction is right for you, or to request a consultation with Dr Cheng, please do not hesitate to get in contact.