Breast reconstruction is a surgery that is done for aesthetic purposes, after a medically required surgery such as mastectomy (removal of the breast). It can also be done to give the breast its natural shape after it has been operated upon for medical treatment reasons.
Rebuilding of the breast may not retain the sensation and feel as the original breast, but it is reconstructed to achieve the shape and look of the natural breast so that a person need not draw unwarranted attention.
The reconstructed breast will still have lines from the surgery. If skin or tissue is borrowed from other places on the body, those surgical incision lines will also be visible on the skin (at the donor site).
To achieve symmetry between both breasts (if only one breast is affected by medical treatments), breast reconstruction can be done in conjunction with breast augmentation, nipple repositioning, breast lift, or other surgical procedures.
1) Doctor recommends and uses anaesthesia suited to the individual to ensure that no pain is felt during the surgery
2) Flap techniques such as TRAM, DIEP, SGAP are used to recreate the breast using the woman’s own skin, muscle, and fat
Skin, fat, muscle or other tissue from a healthy site in the woman’s body such as abdomen or buttocks is used to cover the breast mound. Blood supply may be routed through the new path, or detached and replaced. In a latissimus dorsi flap technique, healthy tissue from the back is used on the chest, but the blood supply route remains as before. The whole breast mound can also be recreated using tissue from a healthy site, or only a part may be done.
3) In other cases, tissue expansion technique is used – this requires more sittings with the surgeon. This is used when an implant is being used to give the breast its shape. This whole procedure takes 4-6 months, plus recovery time.
This procedure might need to be repeated if the implant used is not a permanent one. Sometimes a ‘tissue expander’ is used to fill the device slowly, thus rebuilding the mound over a period of time.
This procedure is used when radiation or mastectomy has not left enough tissue for the surgeon to work with.
4) Surgical placement of breast mound- this recreates the whole breast mound. Saline or silicone implants are used, and the surgeon can offer recommendations as to which is best for each individual.
5) Nipple or areola reconstruction can also be undertaken.
Sometimes both healthy body tissue and an implant are used in combination to achieve optimum results of shape and symmetry. Reconstruction is done right after the mastectomy or lumpectomy. It is possible that chemotherapy and radiation might result in the reconstructed breast losing volume. In this case, a gap is recommended between surgeries so that the reconstructed breast is not affected in shape, size, colour, and look by heavy medication.
Reconstruction can also be done several years after surgery. In cases of high-risk breast cancer, reconstruction is done soon after the surgery. It can also be done in stages, and in such cases, your plastic surgeon will work hand in hand with your other doctors to achieve optimum results.
A patient’s surgery is planned and done with the patient’s full consent, only when she is fully comfortable with the idea of undergoing the procedure. Only when it is performed under such ideal circumstances is the patient happy with the outcome of the surgery.