Breast Reconstruction

Breast reconstruction is a surgical procedure that is performed in order to restore the look and shape of one or both breasts after a lumpectomy or mastectomy of one or both breasts. The procedure is key to restoring a woman’s self-confidence as well as aiding her during their psychological and emotional recovery after breast cancer treatment.

2-6 hrs

General

4-6 weeks

Minimal

of procedure time

type of anesthesia

of initial recovery time and full recovery in 3 months

scarring, Some scarring at incision area which will fade over time

ABOUT BREAST RECONSTRUCTION

Majority breast reconstruction surgery cases are as a result of partial or total mastectomy after the successful treatment of any form of breast cancer. Breast reconstruction options depend on what has been removed during the breast cancer treatment. If a small part of your breast has been removed, for instance during a lumpectomy, then no reconstruction may be required. But when you’ve had a full mastectomy whereby you’ve had skin, breast tissue, and nipple and areola (flat part of the nipple) removed, then a reconstruction is needed.

When it comes to breast reconstruction, there are two options. One uses a part of your body to reconstruct your breasts, and the other simply uses a breast implant to reconstruct your breast; in some instances, a combination of both is applied.

Free Tissue Transfer

Free tissue transfer breast reconstruction is considered the gold standard of breast reconstruction. This is because it has reduced complications, and most patients prefer this option. During the procedure, an tummy tuck or abdominoplasty procedure is used to harvest skin, fat and sometimes a degree of muscle from the abdomen. This harvested tissue is carefully disconnected together with its blood supply, so it has artery and vein. After the mastectomy, and skin and nipple and areola have been removed, a small piece of the rib removed, behind which there is an artery and a vein. A specialised microsurgery procedure is performed, which involves a microscope, and the artery from the harvested tissue is attached to the artery, and the vein to the vein. This procedure is done in order to create a new blood supply to the tissue that was harvested from the abdomen. The actual technical term is TRAM flap, which describes the blood vessel that supplies the tissue harvested from the abdomen. Once tissue has its new blood supply, it can be moulded onto the chest and actually tailored to look very much like any existing breast. It can also be used in situations where both breasts have been removed. In this situation, it’s called a bilateral or both-sided reconstruction. Other alternative techniques include DIEP flap or SIEA flap, whereby only the skin and fat from the abdomen is transferred to reconstruct the breast. Other donor sites for harvesting the tissue include the thighs or the buttocks; in techniques known as TUG flap, SGAP flap, PAP flap.

Silicone Implants

Breast reconstruction with implants is considered the simplest form of breast reconstruction. In majority of the cases, silicone implants are preferred. In cases where the reconstructive surgeon is replacing breast tissue, a silicone implant is usually enough, but more often than not their needs to be other procedures done at the same time. For instance, if there has been a substantial loss of skin during the mastectomy, a paddle of skin and muscle might be harvested from the back and swung to the front where it is used it to give padding over the implant with the blood supply still intact. This technique is known as a latissimus dorsi flap.

Fat Transfer

In addition to breast implants, the patient’s own body fat may be used during a technique known as Autologous Fat Transfer (AFT). This option allows the patient to undergo a liposuction procedure to harvest the fat, then that fat is processed then injected in and around the breast tissue and/or the implant if it’s been used. This is done in order to give more volume to the breast as well as adding symmetry. Once the breast tissue has been conformed in the shape of the breast, the patient is left to heal. In some cases, a second procedure is performed to reconstruct the nipple and areola.

Reconstruction of the Nipple and Areola

The nipple, which is the protruding part of the breast, and the areola, which is the flat pigmented part of the breast, may also need reconstruction in cases where they have also been removed as part of the breast cancer treatment. These two breast structures can be reconstructed using skin which overlays on the breast implant. This can be done by either using the native skin of the breasts or from the skin that has been swung in overlying muscles from the back. In other cases, the areola – the pigmented dark part – can be reconstructed using medical tattooing or hyperpigmentation. The results of this can be quite impressive to the point where one cannot really tell the difference between a natural areola and a tattooed areola.

HOW IS BREAST REVISION PERFORMED?

Breast revision involves the removal (and often replacement) of your breast implants. Breast revision is performed under general anesthesia for your comfort and safety. This procedure usually takes between an hour and an hour and a half to complete. An incision is made along the inframammary fold or around the areola to remove the breast implant and surrounding scar tissue. If your implants are being exchanged, the new implant will be inserted into the breast pocket. If you have decided not to replace your implants, then your breast pocket will be tightened, and the incisions closed.

PRECAUTIONS IN BREAST RECONSTRUCTION SURGERY

Breast reconstruction is usually performed in stages. Once the breast volume and the desired shape has been achieved, the secondary reconstruction is started. This is where elements such as the nipple and areola reconstruction are done.

All the stages of breast reconstruction are dependent on the general health of the patient; what elements are missing and if the patient is eligible to undergo all these surgical procedures. This is because, for instance, the DIEAP flap option takes an average of 6 to 8 hours to complete, and this is before the second stage of reconstructing the areola and the nipple.

In short, general health considerations need to be considered, which makes it very important for you to consider your reconstructive options carefully, when you are diagnosed with breast cancer.

BREAST AUGMENTATION PACKAGE INCLUDES:

Return flights
Private, unshared transfers from the airport to your hotel, and to/from your medical appointment/s at the hospital
Hospital and surgical fees
Hospital and 4* or 5* hotel stay (this duration varies depending on your procedure.
Find out more in ‘Fast Facts’ above)
Daily breakfast at your hotel
Breakfast, lunch and dinner during your hospital stay
Comprehensive aftercare during and after your procedure
Phone access to our registered doctors and nurses on your return home.

Pre and post-surgery

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