02 4002 4150

Dr Avery is the most genuine health professional I have had the pleasure in meeting. I am now living life to the fullest & being the Mum that my children deserve.

- Jessie

Breast reconstruction recreates the volume and shape of the breast and is commonly performed after a mastectomy for cancer treatment or as a prophylactic measure. In some instances, this procedure may be required following trauma or to correct a developmental issue.

A breast reconstruction can be carried out at the time of mastectomy (immediate reconstruction) or at a time after the completion of cancer treatment (delayed reconstruction). Many women may choose to undergo a reconstruction several years after their cancer treatment.

The aim of breast reconstruction is to match the remaining breast in dimension, position, and contour in order to achieve a more balanced feel and symmetrical appearance. A combination of living tissue, and or breast implants with cohesive silicone gel are used to match the remaining breast. Temporary implants, known as tissue expanders, may also be used to help ensure there is enough skin to cover a breast implant.

Additional procedures such as breast lift, breast augmentation or breast reduction may be performed on the opposite breast if only one side requires reconstruction. These additional procedures may be considered to achieve as symmetrical a result as possible.

At Avery, we welcome the opportunity to have an open conversation with you to understand the changes you are looking for with surgery. Our patients’ stories matter a great deal to us. You can discover some of our wonderful patients’ journeys here.

Wherever you are on your personal journey, we would like to assist you. Dr Avery will listen to your concerns and what you want to achieve with surgery. Dr Avery will assess your health and medical history to ensure any surgical procedure you are considering is a safe and appropriate choice for you.

Procedure

Each breast reconstruction procedure is unique and can involve several different surgical techniques depending on the following factors:

  • If the reconstruction is being performed with the mastectomy or at a later date
  • If the operation involves both breasts
  • If breast implants are an option
  • If radiotherapy has been used in your cancer treatment
  • The amount of skin and breast tissue remaining in both breasts
  • Skin quality and elasticity
  • The amount of excess abdominal fat (see below)
  • Whether the lost breast volume can be replaced using skin and tissue from another part of the body (known as an autologous flap) which is usually taken from the lower abdomen (generally the excess skin and fat removed during an abdominoplasty surgery), or whether breast implants can be used in combination with a tissue flap reconstruction. Skin and tissue may also be taken from the back, buttocks, or other areas.

Reconstructing the breast using lower abdominal tissue or other forms of tissue transplant allows the reconstructed breast to fluctuate in weight naturally, yet these procedures may involve more scarring and longer recovery times compared to using breast implants.

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.

It may be possible to reconstruct a new nipple-areola complex using existing tissue, as it is often removed during a mastectomy. Cosmetic tattooing of a nipple and areola can be considered either on its own or after a reconstructed nipple has healed.

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 on the other breast.

Consultation

There are two main pathways to a consultation with a Specialist Plastic Surgeon. Your GP or another health practitioner can make a referral to Dr Avery. Alternatively, it is possible to refer yourself for a consultation. This decision may be made after talking with family or friends or following your own research into plastic surgery and Dr Avery.

The purpose of your initial consultation with Dr Avery is to discuss both your concerns and your goals. It is an opportunity to openly communicate what you want to change, improve, restore, enhance, or remove. We will discuss any concerns you may have about your potential surgery and its outcome. We will also collect information that is specific and tailored to you, to add to the knowledge you acquired through your research outside of the consultation process.

When you arrive at Avery, you will check in with our front-desk team and complete a medical history form, if not already completed. We encourage you to bring a supportive family member or friend who can remain with you throughout the consultation if you like, and be a sounding board during your decision-making process following the consultation.

The consultation with Dr Avery will include an examination of the area of your body that you are concerned with and considering changing. Our aim will be to determine if plastic surgery can achieve what you hope it will, and if so, what specific plastic surgery procedures will address your concerns and meet your expectations in a realistic way.

Plastic surgery procedures generally impact both physical appearance and your psychological response to the new changes in your body. Besides all the advantages of having plastic surgery, it is important to be fully aware of any potential limitations of the operation and how they apply to your unique situation. This includes possible complications and what can be done if these occur.

We will discuss what the surgery involves, how it relates to you specifically given your uniqueness and current state of health, what the possible risks of the surgery are, and then decide if having the surgery is a safe and appropriate choice for you as an individual.

After your consultation, our support team will be there to talk through any further questions you have, including the cost of the surgery.

At Avery, our goal is to ensure you are equipped with the knowledge needed for you to feel empowered throughout the decision-making process, surgery and post-surgery.

Recovery

The recovery period for breast reconstruction surgery will depend on the different techniques used during surgery. Some procedures may require an overnight stay following surgery, while others may require several nights in hospital. As with any surgery, 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 leaving the hospital.

The full recovery period for a breast reconstruction can vary from a few weeks to a few months and some bruising, pain and swelling can be expected. Physical activity should be limited within the first 6 weeks.

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 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, some becoming minimally visible in a matter of months, depending on how well your skin copes with scarring. As with most scars from surgery, the final result may be seen at 12-18 months.

Price Guide

The financial aspects of your surgery are as important as the medical elements when planning for surgery. At Avery, the surgeries we offer fall into three different financial categories: Self-funded – aesthetic surgery; self-funded – plastic and reconstructive surgery; and health insured – plastic and reconstructive surgery.

To make sense of these three financial categories, we have created a detailed price guide to help you understand what may or may not be covered by your health insurer/Medicare and your out of pocket expenses.

To download this guide, please click here.

For more information or to book a consultation, please contact our team on 02 4002 4150.

Breast Reconstruction FAQs

How long does breast reconstruction surgery take?

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 on the other breast.

Which method may be best for me?

The best method for you depends on many factors, including your body shape, past surgeries, current health, treatment needs and personal preferences.

During your consultation with Dr Avery your reconstructive options will be discussed, including the risks, benefits and choices for each procedure.

Does reconstruction change the risk of my cancer returning?

The risk of breast cancer recurrence depends on the stage and nature of the cancer and any additional breast cancer treatments. Any risk of breast cancer recurrence is best discussed with the doctors treating your breast cancer. Reconstructive surgery has not shown to increase the risk of the cancer returning or make it harder to detect if cancer does return.

What if I need chemotherapy?

Your medical oncologist will help determine if and when chemotherapy may be a beneficial treatment option for your breast cancer. If chemotherapy is required after surgery you may need to wait until your surgical wounds from your mastectomy and reconstruction have healed and recovered before starting chemotherapy. If you have complications such as wound healing problems or infection, chemotherapy may be delayed.

What if I need radiation?

You may want to delay breast reconstruction until you are finished with radiation therapy as radiation may influence the final result of your reconstruction. Radiotherapy may impact any wound healing and the final appearance of any reconstruction. If you require radiation or have had radiation, it is frequently recommended to use your own tissue or a combination of your tissue with an implant.

Implant-only reconstruction may not be recommended as radiation often results in an increased risk of implant complications such as infections, fluid build-up and severe capsular contracture (scar tissue around the implant causing hardening of the breast).

What if I am considering a lumpectomy or breast conservation instead of mastectomy?

Breast conservation surgery usually involves removing a portion of breast tissue where the cancer is located, followed by radiation therapy. The removal of breast tissue can often leave an indentation or dimple on the breast. This dimple may not be seen until after radiation treatment. Reconstructive options can help improve the contour and appearance of the breast.

What is capsulectomy?

When a breast implant is placed inside the body, the body forms a layer of scar tissue around the implant, this layer is known as the implant capsule. How thick an implant capsule develops varies between people and varies over time. It can also be influenced by the properties of the implant and where the implant is placed (under or over the pectorals muscle in the chest). With time the capsule may cause symptoms such as pain or a change in appearance in the breast. These changes can occur with or without a problem with the implant itself such as an implant rupture. A capsulectomy refers to the surgical removal of this scar tissue layer. This can be performed during implant replacement or during implant removal. When the entire capsule is removed this is referred to as a total or complete capsulectomy. When it is removed all in one piece with the breast implant included, this is known as en bloc removal and is generally the goal when removing implants in women with symptoms suggestive of breast implant illness. At times, it may not be possible to remove the entire capsule due to factors such as its thickness or its attachment to other important structures.

Capsulectomy is generally performed with implant removal or implant replacement, the total operation taking between 1-3 hours. An overnight stay is over required.

Will I experience much pain and movement restriction post-op?

Pain following surgery will vary depending on the extent of surgery. Pain immediately after surgery may be reduced by the use of local anaesthetic at the surgical site given during the surgery. The pain will also be managed with tablets or injections as required. Physical measures such as the dressings and supportive garments as well as limited movement and possibly ice packs will all help minimise any pain. Pain is usually well tolerated within a few days after surgery with all these measures. If your pain is increasing following surgery this is usually a sign that you may need a review to ensure your recovery is proceeding as expected.

Dressings and supportive garments will offer support to the wounds and the areas of your body that are still recovering. You will be also be advised to restrict excessive movement of the surgical area in the first two weeks after surgery. A good general rule throughout your recovery is if an increase in movement or activity does not increase any discomfort or swelling, then it is probably safe and this gradual progression back to ‘normal’ will be encouraged.

How long is a cosmetic consultation?

Please allow an hour for your time with Avery. This will include meeting with Dr Avery and the Avery care team.

Will I have a general or local anaesthetic?

Body contouring surgery is performed under a general anaesthetic given by a specialist anaesthetist in an accredited private hospital.

Where does Dr Avery operate?

Dr Avery operates at the accredited Lingard Private Hospital. This is to ensure your operation takes place in an environment governed by the guiding principle of safety to ensure your surgical experience is the best it can be.

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.