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Breast Reconstruction

Breast Reconstruction

What is Breast Reconstruction?

 

The aim of breast reconstruction is to restore one or both breasts to near-normal shape, appearance, symmetry and size after a mastectomy, lumpectomy or congenital deformity.

Breast reconstruction usually falls into two categories: implant-based reconstruction or flap reconstruction. In implant-based reconstruction, breast implants are used to help form a new breast lump. In flap (or autologous) reconstruction, the patient's own tissue from another part of the body is used to form a new breast.

 

When to have Breast Reconstruction?

 

Breast reconstruction can be done:

 

at the same time as the cancer surgery (immediate reconstruction)

after your cancer surgery (delayed reconstruction)

When discussing reconstruction options with you, doctors will consider:

 

the type and stage of your cancer

other treatments that you might need

your feelings and preferences

 

Who can have Breast Reconstruction?

 

Breast reconstruction may be possible for you even if you have:

 

Radical mastectomy (removal of the breast and the muscle behind it)

radiation therapy

large breasts

If you are healthy enough, breast reconstruction can be done at any age.

 

What types of Breast Reconstruction exist?

 

The main ways of creating new breasts include:

 

implants to replace all or some of your breast tissue

Using tissue from another part of your body (autologous or "flap" reconstruction)

Using your own tissue and an implant.

Your surgeon will tell you about the different types of reconstruction. Not all of them may be suitable for you. They aim to fit your second breast as closely as possible.  

 

After reconstruction surgery you may need additional surgery to:

 

Create a new nipple (nipple reconstruction)

Reshape the other breast to match it

 

What is Immediate Breast Reconstruction?

 

Immediate reconstruction allows you to get a new breast straight away. Surgeons try to make the reconstructed breast match your other breast, but it will not be exactly the same.

The new breast will feel and look different from the removed breast. However, some women find that immediate reconstruction helps them cope more easily with the worry of losing their breasts.

 

What are the benefits of Breast Reconstruction?

 

You will have new reconstructed breasts when you wake up after a mastectomy or breast conserving surgery.

Fewer surgeries are usually performed, so less anaesthesia is required.

Your finished breasts may look better because the surgeon usually uses the existing breast skin.

Will there be scarring after breast reconstruction surgery?

 You will have less scarring on the reconstructed breast itself - there may be a small area of skin with a scar around the nipple. But sometimes the surgeon may not need to remove the nipple.

 

What disadvantages can there be after Breast Reconstruction surgery?

 

If you undergo radiotherapy after surgery, this may change the appearance of the reconstruction.

Your doctor may advise you against reconstruction with implants if you are undergoing radiotherapy after surgery. But you can place a temporary implant during radiotherapy and have a second reconstruction operation after radiotherapy.

 

What are the risks after Breast Reconstruction surgery?

 

Breasts that do not match each other in size or appearance (asymmetry)

Breast pain

Rupture or deflation of the implant

Poor healing of incisions

Increased risk of future breast implant replacement or removal surgery

Changes in breast sensitivity

Infection

Bleeding

Formation of scar tissue that compresses the implant and breast tissue into a firm, unnatural shape (capsular contracture).

Risks related to anaesthesia

A very low but increased risk of a rare immune system cancer called anaplastic large cell lymphoma (ALCL), which is associated with textured breast implants, although more research is needed to understand the link between ALCL and breast implants.

Additional surgery may be needed to correct any of these complications.

 

How do you prepare for Breast Reconstruction?

 

Your plastic surgeon will describe your surgical options, discuss the advantages and disadvantages of implant-based reconstruction, and can show you photos of women who have undergone different types of breast reconstruction. Your body type, health status and cancer treatment will affect which type of reconstruction will provide the best result. The plastic surgeon will provide information about anaesthesia, the location of the operation and what follow-up procedures may be required.

 

How many hours does Breast Reconstruction surgery take?

 

On average, breast reduction surgery takes between two and four hours. Your surgeon can tell you how long your particular operation will take.

 

What type of anaesthesia is used for Breast Reconstruction surgery?

 

General anaesthesia

This is the most common form of anaesthesia used for breast surgery. With this choice, you are completely asleep during the operation. General anaesthesia is often combined with local anaesthesia to reduce pain at the incision site.

 

How long does it take to recover from Breast Reconstruction surgery?

 

You may feel tired and sore for a few weeks after surgery. Your doctor will prescribe medication to help you manage the pain.

It may take six weeks or more to return to normal activity. Take it easy during this period.

Your doctor will tell you about restrictions in your activities, such as avoiding lifting weights or strenuous exercise.

 

What is nipple reconstruction?

 

If you wish, breast reconstruction can also include nipple reconstruction, including a tattoo to define the dark area of skin around the nipple (areola).