Breast Reconstruction Surgery
Plastic, reconstructive and aesthetic practice are all involved when dealing with breast reconstruction surgery and tends to be performed after a patient has gone through a form of cancerous procedure such as a mastectomy or a lumpectomy. It can be difficult to go through a breast cancer diagnosis and to go through as breast reconstruction is often seen as a secondary option.
When Would A Breast Reconstruction Surgery Be Required?
Generally, breast reconstruction surgery tends to be considered after the diagnosis of the following:
- Mastectomy
- Lumpectomy
Case Studies
What Is Breast Reconstruction After A Mastectomy?
There are pros and cons with having breast reconstruction surgery after a mastectomy which can make it a difficult decision to go through for a patient. It’s important that a careful discussion is had to make sure that the decision-making process is as smooth as possible. In order to do this, you may require a number of consultations with the oncological team for your breast reconstruction.
Breast reconstruction surgery can be performed through autologous reconstruction, non-autologous tissue transfer or a combination of both. Implants and tissue expanders are used when going through non-autologous methods whilst autologous reconstruction would involve using your own tissue. The benefit of using autologous tissue is that it ages better and the changes that occur are minimal. Patients who opt for implants after mastectomy are also very happy with their results as they can have a bigger size if that is what you wish.
Autologous Reconstruction
Having breast reconstruction after mastectomy or a lumpectomy with autologous reconstruction, also known as flap surgery can be a time-consuming procedure. It aims to remove fat from one part of the body to form new breasts. Autologue reconstruction may also require more than one procedure pending your needs and the extent of the breast reconstruction surgery. The recovery time of breast reconstruction with autologous can take longer as it requires more work but it can be more beneficial and less risky.
During autologous breast reconstruction surgery, tissue can be used from the abdomen to reshape the breasts without having a diverse effect on the abdomen itself. This is achieved by dissecting the tissue that would normally be exerted from a tummy tuck surgery from its blood supply. This would prevent damage to the abdomen muscles since a flap of tissue is created hence the name flap surgery. Other parts where the blood vessels are dissected is from the armpit or chest. Here, the veins in the chest and tummy tissue are stitched together.
The stomach is then closed as it would be with a traditional tummy tuck and the new tummy tissue is shaped onto the chest wall to create new breasts. There are other areas where tissue can be taken from around the body for breast reconstruction surgery but this choice will be discussed during your breast reconstruction consultation.
Another option is to take the tissue from the back to transfer on to the breast area. The disadvantage of this is there may not be enough tissue to form the breast, in which case an implant may be required.
Non-Autologous Reconstruction
This can be combined with autologous breast reconstruction methods also and would involve using an implant to help with the construction of the breasts. This can be beneficial for patients who are looking for a simple solution after a mastectomy. It’s worth noting that this wouldn’t be recommended if radiotherapy is required in the short or long term.
Shape, size and symmetry are the most important elements for you to consider during breast reconstruction surgery as several aspects of this would need to be considered. It will require 2 surgical procedures. As the breast will be moulded from scratch, the first procedure is required to ensure that there is a base for the breasts. After this, the rest of the breast is then moulded.
There are also other procedures combined together during breast reconstruction surgery to ensure that the appearance and symmetry are maintained. These include the following:
- Fat Transfer
- Liposuction
- Nipple Reconstruction
- Areola Tattooing
- Unilateral reconstruction (via a mastopexy, breast reduction or mastopexy implant)
- If this is required it would be discussed during your consultation.
Breast Reconstruction After Lumpectomy
It is common for asymmetry to occur between the breasts after Lumpectomy. How this can be rectified tends to be through several ways including a mastopexy or autologous fat transfer procedure. In some cases, the breast reconstruction procedure would need to be combined and applied to the unaffected breast in order for the breasts to appear correct and fuller.
Similar to mastectomy, autologous and nonautologous methods can be used to correct asymmetry but in extreme cases, immediate breast reconstruction after mastectomy may be required to obtain results that you are satisfied with.
