Breast Cancer and Breast Reconstruction

What is Breast Reconstruction?

Breast reconstruction is the process of recreating a breast mound aiming to match the remaining natural breast after having mastectomy. It has been shown to improve psychological and emotional well-being, energy level and satisfaction with breast appearance after mastectomy.

Images reproduced with permission from LifeCell Corporation

Reconstruction is performed by a reconstructive plastic surgeon and an oncoplastic surgeon. The main procedure is the creation of the breast shape and volume. Following mastectomy to improve breast shape after lumpectomy (removal of part of the breast)

The majority of patients who have a mastectomy choose to have breast reconstruction, either at the time of their initial surgery at a later stage.

The intention of breast reconstruction is to match the remaining natural breast as closely as possible.

There are two main types of breast reconstruction operation – one type can be done by using an implant, which is put under the skin and muscle that covers your chest, or by using skin, fat and sometimes muscle from another part of your body such as the back or lower abdomen or inner thighs to create a breast shape. A combination of these techniques can be used for some women.

Everybody is different, has specific medical needs and has individual preferences. It is therefore important to carefully discuss which type of reconstruction operation is most suitable for you and to be aware of the advantages and disadvantages of each.

Nipple reconstruction is also an option, this tends to be a separate operation once the reconstruction has happened and the new breast has settled into its final shape. However, it is also possible for this to be done at the same time as the breast reconstruction; this can be discussed with your consultant.

Who can have breast reconstruction?

Breast reconstruction is possible for the majority of women who have had a mastectomy including if you….

  • Have had a radical mastectomy (when the breast, underlying chest muscle and lymph nodes of the armpit are removed)
  • Have had radiotherapy
  • Have large breasts

Depending on your state of health you may have a breast reconstruction at any age.

Timing of breast reconstruction

One of the first choices you will have is whether to undergo immediate or delayed reconstruction. Immediate reconstruction is performed during the same operation as the mastectomy. Usually the mastectomy can be performed in a “skin sparing” fashion, i.e., the skin of the breast is preserved and only the underlying breast tissue needs to be removed with the cancer.

The nipple may also usually removed because the ducts, where the cancer cells originate, exit at the nipple. In this type of breast reconstruction the volume of the breast as well as a small skin patch needs to be restored.

In cases where the decision for reconstruction could not be made or it was not offered at the time of mastectomy, then a delayed reconstruction can be performed. In this type of breast reconstruction, entire breast skin, as well as the breast volume needs to be restored.

Delayed reconstruction involves only performing the mastectomy at the first operation. After you have fully recovered and any additional necessary treatment has been completed, a second operation is performed to reconstruct the breast. These are normally a few months apart.

Below are some advantages and disadvantages of either having immediate reconstruction or delayed:

Immediate Breast Reconstruction:

Advantages: Disadvantages:
Better cosmetic results Possible distortion of reconstructed breast if radiotherapy is required
One anaesthetic and recovery period Increased risk of infection
One hospital stay
Smaller breast scars

Please click here to view/hide images of before and after immediate breast reconstruction results

Immediate TMG post operative
Immediate TMG post operative

Delayed Breast Reconstruction:

Advantages: Disadvantages:
Not so much to deal with at once Longer breast scars
Staggered surgery resulting in easier and shorter recovery after each procedure More time away from work due to multiple operations
Time to consider if reconstruction is right for you without delaying cancer treatment Multiple hospitalisations

Please click here to view/hide images of before and after delayed breast reconstruction results

Delayed DIEP post operative Image
Delayed DIEP post operative

Types of Breast Reconstruction >>

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