Breast reconstruction is a surgical procedure intended for women who have had a mastectomy or breast conserving surgery due to breast cancer or other conditions. A new breast or breasts that resemble your natural shape and size are recreated using breast implants or your own tissue, or a combination of both. Breast reconstruction is an integral component of a woman’s breast cancer journey and can improve well being and body image after breast cancer.
Breast reconstruction may be performed immediately after a mastectomy during the same surgery, depending on the specific circumstances and patient choice. Breast cancer treatment is physically and emotionally demanding, and competing life priorities often make it necessary for patients to take their time deciding whether breast reconstruction is right for them. It is not unusual for patients to have breast reconstruction later in life. However, most patients often find it a rewarding experience in restoring their self-esteem and confidence as a woman.
During your consultation with Sydney Plastic Surgeon Dr Alaina Taylor, she will discuss your general health, current cancer treatment, and your journey towards recovery. Dr Taylor spends as much time as required with each patient to explain their reconstructive options in detail. She will help you to understand the advantages and disadvantages of the various approaches so that you can make an informed choice and any questions you have will be answered. She will work with you to make sure you feel comfortable during your consultation, understanding your concerns and anticipated goals for breast reconstruction. Photographs will need to be taken of your chest area, but all images remain strictly confidential on your medical record. Dr Taylor works with renowned Breast Surgeons throughout Sydney, and together they will develop a procedure plan tailored to your specific circumstances. Every reconstructive surgery is personalised to the patient, as various factors must be considered to ensure a safe, optimal result.
There are different types of breast reconstruction surgery including implant reconstruction, autologous reconstruction (meaning using your own tissue) which is transferred as a “flap,” or a combination of the two. Fat transfer is another method but is rarely sufficient as a standalone technique. The choice of which method to use will vary depending on your specific circumstances, your body and general health and your preference. Breast reconstruction is performed in stages. You may need to undergo multiple procedures to achieve your preferred results. The first stage of the procedure is to reconstruct the breast(s).
Additional stages may be required for;
- Achieving symmetry with the other breast by way of a breast reduction or lift, breast augmentation or fat grafting to the unaffected breast
- Any additional sculpting, lifting or size adjustments to the reconstructed breast(s)
- Nipple areola reconstruction
Dr Taylor is focused on ensuring the best possible aesthetic outcome and recovery from your first surgery so that her patient’s feel confident to focus on moving forward with their lives without a sense of urgency to undergo any additional stages.
Types of breast reconstruction surgery
- Implant reconstruction
This type of reconstruction involves inserting a breast implant into the breast pocket, which would have been created during your mastectomy, to recreate the shape and size of the breasts. You will need to discuss with Dr Taylor if this type of reconstruction is suitable, considering the potential risks and complications associated with breast implants as well as your personal preferences on appearance and feel.
- Tissue flap reconstruction
This type of reconstruction uses your skin, fat, and/or muscle to rebuild the breast. The commonest procedure performed in this category, and the gold standard procedure for breast reconstruction is the abdominally based DIEP flap ( Deep Inferior Epigastric Artery Perforator Flap) or TRAM (Transverse Rectus Abdominis Muscle Flap) which is raised from the abdomen and transferred to the chest as a free tissue transplant using microsurgical techniques, and shaped into a new breast. Other sites that can be utilised for breast reconstruction include the back, buttocks or hips. Autologous flap reconstruction creates a more natural look and feel, and will also age naturally as the body ages and change with weight loss or gain.
The specific reconstruction surgery you may undergo will vary based on your current or previous cancer treatment, health and medical history, current breast size and shape, and your personal preferences for breast appearance.
Your length of surgery, hospital stay, overall recovery time and return to normal activities will depend on the extent and complexity of your surgery.
Risks and complications
Risks and complications are present with any procedure you may undergo, and it is essential to be aware of them before deciding on surgery. Potential risks and complications associated with breast reconstruction surgery include:
- Excessive bleeding
- Wound healing issues
- Poor scarring
- Changes to sensation
- Asymmetry and contour irregularities
- Implant complications like infection, capsular contracture and implant rupture
- Anaesthetic complications
- Deep vein thrombosis and pulmonary embolism
- Chest infection
Following Dr Taylor’s post-procedure instructions will be vital in helping to reduce the potential for complications and minimise scarring.