Breast Reconstruction

Breast Reconstruction

After a mastectomy the majority of women choose breast reconstruction in order to restore body shape, symmetry & their sense of femininity. 

1. How long is the recovery?
This surgery is technically demanding which neccessitates six to eight hours in surgery. You should be able to go home the following day. You should be able to return to your normal activities after four to six weeks. Depending on your type of work, you should be able to return after four weeks. A limited amount of activity, such as lifting young children, shouldn’t be a problem after about four to six weeks. Regular exercise may help you to return to normal activities. Please do ask the health care team or your GP for advice before you start exercising.

2. I’m worried about pain.
Pain and discomfort are common symptoms after breast reconstruction surgery. You are likely to feel firm and swollen for a week or two. Recovery may take four to six  weeks and you should have minimal need for pain medication. It may take up to eight weeks for the bruising and swelling to reduce.

3. Will I look natural?
Your surgeon will create an appropriate breast shape and size for you. Every effort will be made to give you a natural end result.

4. Can I avoid general anaesthetic?
This procedures is performed under anasthetic.

5. What is the cost?
If you would like a tailored quote, please book an initial consultation to discuss your condition and treatment options with your chosen consultant. Once the initial consultation is complete, you will receive your a tailored quote for your treatment.  Please call us on 01709 464200 or email enquiries@kinvarahospital.co.uk if you wish to receive a guide price for any specific treatments.

About

The vast majority of women who undergo mastectomy are candidates for breast reconstruction. However, not every woman wants to immediately undergo more surgery and so prefers to delay the decision. For those women who have suffered invasive breast cancer, delayed reconstruction is the safest option. The majority of women do choose breast reconstruction in order to restore body shape, symmetry and their sense of femininity.

Mastectomy and Immediate Reconstruction

Women who are due to undergo a skin-sparing mastectomy and do not need radiation therapy, may consider immediate one-stage reconstruction. After removal of the breast tissue, an implant or the patient’s own tissue is used to restore breast volume. If an implant is used, the surgeon may elect to use a special type of material, known as acellular dermal matrix (ADM), to provide an additional layer of coverage over the implant.
 
For patients wishing to use their own tissue, the lower abdomen, inner thigh or buttock are potential donor sites. Nipple reconstruction, if desired, is usually performed three months later. Immediate reconstruction does offer a number of potential advantages including a better aesthetic result and psychological benefits. The goal of breast reconstruction is to create a breast that looks and feels as natural as possible.
 
Whatever the situation, we encourage discussing the various options. Patients can then feel reassured, having all the necessary information to make a fully informed decision.

Correcting Previous Breast Reconstruction

Breast reconstruction techniques have evolved over the years with patients benefitting from shorter recovery times and improved results. Some patients who underwent a breast reconstruction using older techniques, may now seek to improve their reconstruction or correct an issue.
Some of the issues our Consultants treat include;
– Implant related problems e.g. incorrectly positioned implants, implants placed too wide, capsular contracture, incorrectly sized implants, implant rippling,
– Asymmetry,
– Failed breast reconstruction,
– Conversion of implant-based reconstruction to autologous reconstruction,
– Correction of divots / contour defects.

Procedure

Lumpectomy Reconstruction With Fat Grafting
For patients who have undergone lumpectomy and radiotherapy, our Surgeons can reconstruct the defect with fat grafting.

Fat grafting involves harvesting fat from the abdomen or hips, and then injecting that fat into the site of the breast lumpectomy defect. The injected fat eventually becomes part of the native breast tissue.

Mastectomy and Immediate Implant-Based Reconstruction

Immediately after a skin-sparing mastectomy, an implant is inserted into the empty breast envelope. The upper half of the implant is placed under the pectoralis major muscle whereas the lower half is covered by a specially prepared material called acellular dermal matrix (ADM). The ADM is sutured to the inframammary fold, thereby creating a pocket in which the implant comfortably sits.
The ADM is derived from pig skin and has had all the cells removed leaving a collagen structure. Over time it becomes incorporated into the native tissue and and provides an additional soft-tissue layer covering the implant.
 
Implant-based reconstruction can also be undertaken for delayed breast reconstruction. In this situation, as there is no breast pocket, a flap of skin and muscle is taken from the back and transferred to the chest whilst still attached to its blood supply. The flap of skin and muscle is used to recreate the breast pocket, into which the implant is placed.
 
An alternative method of creating a breast pocket is to use a tissue-expander to expand the chest skin. The tissue-expander is inflated at regular intervals over a period of months and once the correct size has been achieved, it is replaced with an implant. An expander cannot be used if the chest skin has received radiotherapy. The technique using a flap of skin and muscle from the back will be required, or another option may be considered.
 

Autologous Breast Reconstruction

This refers to breast reconstruction in which the new breast is made from the patient’s own tissue. Women typically choose this type of breast reconstruction if they are not candidates for implant reconstruction, have excess tissue in an area which can be used, or want to avoid a silicone implant. Autologous breast reconstruction is preferable for women with larger breasts as the reconstructed breast appears more natural.
The main advantage of autologous breast reconstruction is that the breast looks and feels very much like a natural breast. The surgery itself is more technically demanding and therefore longer (about six to eight hours) and recovery will take longer as well (typically four to six weeks).
 
Autologous breast reconstruction should be considered a two stage-procedure. The first stage involves creation of the breast mound, whereas the second stage involves aesthetic refinement e.g. shaping the other breast to match, creation of the nipple and possible contour adjustment with fat grafting.

Autologous breast reconstruction procedures are categorised according to the blood vessels supplying the donor tissue or the site from where the donor tissue is harvested from;
– Deep Inferior Epigastric Perforator (DIEP) flap
This is the most common autologous breast reconstruction method, in which skin and fat from the lower half of the abdomen is used to reconstruct the breast mound. Microsurgery is used to connect the blood vessels in the donor tissue to blood vessels at the chest or armpit. The soft consistency of the abdominal skin and fat, is ideal for recreating a breast. The skin and fat removed from the abdomen is the same tissue that would be removed with a tummy-tuck, and many women find the idea of a simultaneous breast reconstruction and tummy tuck attractive.
 
– Transverse upper gracilis (TUG) flap
The skin, fat and muscle from the inner part of the upper thigh are used to reconstruct the breast mound. Microsurgery is then performed to connect the blood vessels in the donor tissue to blood vessels in the chest or armpit. This method of breast reconstruction may be preferable in those patients with insufficient abdominal tissue for a DIEP flap or require a small breast mound.
 
To help you make an informed decision, we will discuss all your available options. Empowered with this information, you can feel confident about the choices you make.

Speak to a member of our team for further information or to arrange a consultation

Our phone lines are open Monday – Friday, 10am – 5pm. Alternatively you can send us a message via our contact form below.

  • 01709 464200

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Possible Risks

The risks of breast reconstruction depends on the type of reconstruction undertaken but some risks include;

Scars / poor scarring – in some patients the scars may be red and raised and take a number of months to settle.

Infection – may require treatment with antibiotics and/or further surgery.

Haematoma – bleeding within the breast pocket causing the the breast to become swollen and tender. A return to the operating theatre may be required to evacuate the blood and the breast may take longer to settle.

Implant malposition – with an implant-based reconstruction the implant may become incorrectly positioned.

Capsular contracture – with an implant-based reconstruction the scar tissue that normally forms around the breast implant thickens and contracts, causing deformity and pain in the breast.

Limited lifespan of breast implants – breast implants are not designed to last forever. Therefore all women should expect replacement of their implants during their lifetime.

Breast implant rupture or leakage

Need for revision surgery

Risks of general anaesthesia, such as feeling sick and vomiting, deep vein thrombosis, shivering and sore throat.

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Pricing & Finance

When you’re considering a cosmetic procedure, there’s a lot to think about – the choice of treatments available, the results you want to achieve, the recovery time, any potential risks and, of course, the cost.

Kinvara Private Hospital is registered with the Care Quality Commission. Cosmetic surgery results and benefits can vary and are different for each individual. As such, we cannot guarantee specific results.

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