There are multiple techniques of breast reconstruction which vary widely in application and complexity of surgery.
This is a very wide and complex topic and we will provide overview information here. Dr Kippen will carefully discuss all options at the time of consultation.
There are two main groups of reconstruction. In the first group, an implant is used to supply breast volume. In some cases, an implant only will be used or in other cases, an implant covered with some additional tissue from the back.
In the second group, tissue from the abdomen or tummy is used to reconstruct a breast.
Reconstruction may be performed at the time of mastectomy (an immediate reconstruction) or delayed to a time after the initial mastectomy. Important considerations include body build, weight, height, breast cancer characteristics, breast size, tumour size, radiotherapy, lifestyle issues such as exercise, smoking, opposite breast characteristics and whether one or both breasts are to be removed.
At the time of mastectomy, the nipple, areola and some skin is usually removed. If an implant is to be used, an expander is often inserted at this time to stretch the remaining tissue to accommodate the implant. An expander is a silicone balloon that is sequentially injected with salt solution to increase its size and thus stretch the skin. At a second stage, surgery is performed to replace the expander with the breast implant.
If you have undergone radiotherapy, the remaining tissue does not stretch well. In these cases, it is necessary to use some tissue from the back, which is normally muscle and overlying skin. The tissue is placed over the breast implant to obtain the required volume. The result of taking the back muscle is hardly noticeable as a part of daily living. This reconstruction process is done as single stage surgery.
In other cases, the abdominal skin, fat and muscle can be used to reconstruct a breast. This can be done by either leaving the muscle attached, taking some muscle and joining the tissue blood supply with microsurgery, or by taking only skin and fatty tissue and joining the blood supply with microsurgery.
The complexity of surgery increases with each of the methods described, with the most complex and therefore longest recovery time being the abdominal tissue procedure.
At the time of consultation, Dr Kippen will give a far more comprehensive explanation of the different procedures and likely recovery. He will give you an information pack and brochures to read as well as showing you a computer presentation of these types of reconstruction. Two consultations are usually needed to cover such a wide and complex range of information.
You should read the information presented here in conjunction with the information contained on the Frequently Asked Questions page of the website.
View our before and after images regarding this procedure.