The goal of a breast reconstruction is to recreate the volume and shape of a breast. This is most commonly performed after a mastectomy for cancer treatment or as a prophylactic measure, but may also be required following trauma or to correct a developmental problem.
Breast reconstruction can be performed at the time of mastectomy (immediate reconstruction) or at a time after healing and completion of cancer treatment (delayed reconstruction). Many women may choose to undergo a reconstruction several years after their cancer treatment.
For many women, reconstructive surgery is an important step in the psychological recovery from breast cancer and a mastectomy. Whether or not to proceed with a reconstruction is a personal decision. Your breast cancer treatment team and reconstructive surgeon can help you by providing information relating to your individual situation. Support groups can also be of great benefit.
In order to achieve a more balanced feel and symmetrical appearance, a breast reconstruction may involve simply replacing the fullness lost in one breast, or altering the size of the other. Sometimes additional procedures such as a breast lift, breast augmentation, or breast reduction may be performed to achieve the desired results.
Dr Avery has over a decade of experience in plastic surgery and is highly skilled in the various techniques used in breast reconstruction.
During your initial consultation, Dr Avery will assess your relevant medical history and before going any further, ensure that a breast reconstruction and any additional procedures requested are safe and appropriate choices for you.
Whether you are seriously considering a breast reconstruction or simply looking for more information, book a consultation with Dr Avery so together you can discuss your options and if necessary, develop a personalised treatment plan.
Each breast reconstruction procedure is unique and can involve several different surgical techniques. The techniques used may depend on:
- If the reconstruction is being performed with the mastectomy or at a later date
- The amount of skin and breast tissue remaining in both breasts
- If the operation involves both breasts
- Skin quality and elasticity
- The amount of excess abdominal fat
- If breast implants are an option
- If radiotherapy has been used in your cancer treatment
Lost breast volume can be replaced using a flap of skin and tissue (known as an autologous flap) which is usually taken from the lower abdomen during a tummy tuck, but may be taken from the back, buttocks, or other areas. A breast implant is also an option and can be used in combination with a tissue flap reconstruction.
In addition to a flatter stomach, reconstructing the breast using a tummy tuck or other form of tissue transplant allows the reconstructed breast to fluctuate in weight naturally, yet this procedure may involve more scarring and longer recovery times than that of a breast implant.
The procedure for inserting a breast implant will depend on the amount of skin left on the breast post-mastectomy. If the skin across the breast is left flat and tight, a temporary tissue expander may need to be inserted to stretch the area over several weeks before the implant is put in place.
A new nipple-areola complex may need to be reconstructed using existing tissue, as it is often removed during a mastectomy. After the reconstructed nipple has healed, areola pigmentation can be achieved by tattooing the area for a more symmetrical look.
The length of a breast reconstruction surgery can last anywhere from 2–8 hours depending on the techniques being used, whether one or both breasts are being reconstructed, and whether other procedures such as a breast reduction, breast lift, nipple reshaping, or breast augmentation are being performed.
The recovery period for a breast reconstruction will depend on the different techniques used during surgery. Some procedures may be a simple overnight stay following surgery, while others may require several nights’ recovery in hospital.
As with any operation, you will need to organise somebody to drive you home and it is recommended that you have another adult stay with you during the first night after surgery.
The full recovery period for a breast reconstruction can vary from a few weeks to a few months. Some bruising, pain and swelling can be expected and physical activity should be limited within the first 6 weeks, as follows:
The first 2 weeks after the procedure:
It is recommended that you don’t put any unnecessary strain on your body. This includes exercise, picking up children or even driving, as any pain or discomfort experienced while driving could be dangerous.
Between 2 and 4 weeks after the procedure:
You can begin to do some light exercises such as picking up children and driving, as long as you aren’t straining your body too much.
Between 4 and 6 weeks after the procedure:
You can begin returning to normal activities with care, such as mild exercise. After 6 weeks’ recovery you should be able to resume a normal level of physical activity.
Patients recovering from a breast reconstruction may be required to wear a compression garment for up to 6 weeks to provide support and reduce post-operative pain or swelling.
A customised pain relief program will be created for each patient and issued before leaving the hospital. If circumstances change at any stage during the recovery period, then the pain medication can certainly be adjusted accordingly.
The shape and size of scars from a breast reconstruction will depend on the techniques used during surgery and any additional procedures performed. While they will not disappear, most scars will generally fade to become minimally visible in a matter of months, depending on how well your skin copes with scarring.
Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner. Dr Avery is a member of the two leading professional associations for plastic surgeons in Australia, ASAPS and ASPS. Their websites provide additional information regarding plastic surgery in Australia that you might find useful, please visit ASAPS and ASPS.