Breast Reconstruction.
About the procedure
What is Breast Reconstruction?
There are many options for those seeking reconstruction. They can be broadly split into two groups: implants and autologous. Autologous reconstruction involves taking your own tissue and using that to re-create the breast. The most popular way to do this is to take tissue from the lower tummy and re-attach it to the breast area. This is known as a DIEP flap. A DIEP flap can be used to reconstruct one or both breasts. This form of reconstruction can give you a soft, warm, natural breast that will last forever. It is the most robust option for patients who may require radiotherapy or who have had radiotherapy in the past. Whilst this surgery results in a scar along the lower abdomen, patients get the added benefit of getting a flatter tummy.
Implant based reconstruction can be performed in a variety of different ways: in combination with your own tissue – such as a latissimus dorsi flap, on its own, or in with a support cover called an acellular dermal matrix or dermal sling.
The decision about the type of breast reconstruction is a personal choice and there is often more than one option BAPRAS have an excellent resource that can be found here.
Who is Breast Reconstruction for?
Procedure Overview.
PROCEDURE TIME
2-6 hours.
HOSPITAL TIME
1-2 days.
WORK OFF TIME
4 weeks.
NO gym FOR
2-4 weeks.
NO DRIVING
2 weeks.
GARMENT
6 weeks.
FOLLOW UP
Weekly.
The Consultation.
We will sit and talk through your oncological treatment and your wishes and expectations. Some patients have a good idea what they want, others have no idea. We take this bit slowly so we have plenty of time to talk about what options are available to you and what the pros and cons of each option. You will see a presentation with pictures of all the types of reconstructions – some good, some bad, and some photos showing the journey that patients go on to get their final desired result – from liposuction to nipple reconstruction.
Your consultation letter will be very comprehensive and will be supplemented with an information pack containing leaflets, links to charity support groups and, if an NHS patient, contact details of our wonderful Macmillan specialist reconstruction nurse who will offer a one-to-one service for your entire reconstructive journey.
The Planning.
Once we have decided a type of reconstruction, we will discuss the surgery in more detail and provide an outline of your reconstructive journey. If we are planning to use an implant or expander then we will take some measurements to determine what size and shape we need.
This is a good opportunity for a friend to come for support. We advise no holiday abroad within two months of surgery.
The Procedure.
The procedure is performed under general anaesthetic. Most patients can go home the following day once up and about and comfortable. You may need to go home with drains but your dressings with be showerproof.
The Aftercare.
You will be seen weekly by the nursing team, or sooner if you have drains.
Patient reviews
Patient Reviews
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Patient Reviews
My Holmes was great from start to finish. He explained, in full, what the procedure entails and what to expect after the operation. Everything went great with the operation and the support from him and his staff was fantastic prior, during and after. I’m amazed how good my reconstructed breast looks and he even created me a nipple on a separate operation after just for it to look as “normal” as possible. With all his help and work I feel like a new woman and would highly recommend him to anyone.
My approach
Procedure risks.
Immediate Risks.
- DVT/PE/MI – these are rare and are mitigated with blood thinning injections, specialised stockings, calf pumps. And early mobilisation.
Early Risks.
- Seroma – This is a build up of fluid in the breast or wound sites that causes swelling and tenderness. It may require drainage with a syringe in a clinic room
- Delayed wound healing – Treatment is with topical dressings.
- Dog ears – this refers to bulging at the ends of the scar and may require a small surgical procedure to remove at a later date if a nuisance.
- Lymphoedema – this risk is related to the cancer surgery in the armpit
- Fat necrosis – sometime lumps or oil cysts develop in the reconstructed breast following surgery. These often settle with time but if persist may need corrective surgery or drainage.
- Implant loss – this is approximately 9% at 3 months. The risk is higher if you are overweight, smoke or have radiotherapy.
Late Risks.
- Unsightly scars – these can be tidied-up with a small operation
- Asymmetry is common. Some patients request further surgery to improve size/projection of their reconstructed or other breast to achieve better symmetry
- Chronic pain – rare
Interested in a consultation?
If you are interested to learn more, and would like to come for a face-to-face or virtual chat, please send me and my team a message, and we can get in touch to arrange your consultation.
