Breast reconstruction is now widely available to patients who undergo surgical treatment for breast cancer, and is known to improve the quality of life for women treated for this disease. It can occur at the same time as treatment for breast cancer (immediate breast reconstruction) or may be undertaken following completion of surgical treatment, sometimes after many years (delayed breast reconstruction). It is most often considered for women who require a full mastectomy. Nationally, about a third of women having a mastectomy choose to have an immediate reconstruction and a further smaller group choose to have a delayed reconstruction.
Partial breast reconstruction or breast reshaping ( using breast reduction techniques) can also be useful in women who are able to preserve some of their own breast tissue but where there will be a noticeable change in volume or shape after the cancer surgery.
Types of Breast Reconstruction after Mastectomy.
There are 2 main types of reconstruction
1. Techniques that depend on a breast implant to recreate the volume of the missing breast
This is the commonest type of reconstruction for patients having an immediate breast reconstruction. Much of the skin of the breast is preserved and a cohesive silicone breast implant is placed inside the space left after the mastectomy.
Sometimes the nipple can also be preserved if the cancer is small and not close to the nipple and there is no extensive DCIS associated with it.
The implant can be placed under the chest wall muscle or on top of it and the choice often depends on the shape and size of the breast and the amount of overlying fatty tissue for implant coverage.
Occasionally a tissue-expander may need to be used, either to change the size of the reconstructed breast or if the patient has medical conditions which might put her at a higher risk of wound healing problems (and therefore implant infection and loss).
It is now common to combine an implant reconstruction with a biological mesh wrapped around the implant for an additional internal support.
2. Techniques that use a ‘flap’ of your own tissues from elsewhere ( “autologous” reconstruction)
In recent years, own tissue or ‘autologous’ reconstructions have become more and more popular with patients because the breast can appear more natural looking. Tissue is usually taken from the tummy or back, but sometimes the buttocks or thighs, and unlike an implant based procedure, once surgery is complete a flap will not need to be replaced in the future.
This type of surgery will necessitate scars on other parts of your body where the tissue-flap is taken from and will often entail a longer initial recovery period.
Reconstruction after Breast Conservation
- Therapeutic mammoplasty. This technique uses a breast reduction technique to remove a larger breast cancer while leaving a good shape breast
- Fat transfer. This may be used to “fill in” dips in the breast after breast cancer surgery and radiotherapy
The decision to undergo any reconstructive surgery is a very personal one, and there are advantages and disadvantages of this type of surgery and the techniques used are specific to your individual situation and needs. Rachel will be happy to talk to you in more detail about the pros and cons of all these techniques.
The decision to undergo reconstructive surgery is a very personal one, and there are advantages and disadvantages of this type of surgery and the technique used specific to your individual situation and needs.
I am experienced in all aspects of immediate and delayed breast reconstruction and will be happy to discuss the options open to you before you decide if it is the right thing for you or not.
Discussion with Rachel is important to answer any questions that you may have. For information about any additional conditions not featured within the site, please contact us for more information.