SURGICAL PROCEDURES

Breast reconstruction (Available Upon Request)

Overview

The after effects of breast cancer surgery can leave women’s chests disfigured. Breast reconstructive surgery is a way of remoulding the chest to achieve perfectly aligned and full breasts. Surgery is done using tissue flaps, expansion, implant reconstruction and fat grafting techniques.

Procedures

Reconstructive breast surgery includes the following:

  • Reconstructive surgery using breast implants is done by means of a tissue expander (balloon filled with water) that helps inflate the area of the skin. The area is slowly inflated in the doctor’s rooms till you are happy with the size of the breasts. The plastic surgeon removes the water-filled balloons during the second procedure and replaces them with breast implants. Afterwards, further reconstructive techniques may be perused, which involve reconstructing the nipple and areola of the affected breast.
  • Reconstruction using breast implants can be done without a tissue expander. Silicone implants mimic natural breast tissue, which is why they are favoured among women. Saline implants are full of sterile salt water, so plain salt reabsorbs into the body when they rupture. However, when saline or silicone breast implants rupture, they can be replaced through revision surgery.
  • Flap/autologous reconstruction transfers fat from the abdomen, thighs or buttocks to refill and remould the existing breast tissue.

Breast reconstructive surgery can occur immediately after treating breast cancer or after several months. 

Recovery

A drain is surgically placed to pump out excess fluid and blood from the site. The tubes are removed once all the blood has been drained. The time it takes to heal largely depends on the type of breast reconstructive procedure undergone, including overall physical health. Until you recover fully, you are not allowed to lift anything heavy or engage in any form of strenuous exercise.

There is still a probability of cancer returning following reconstructive surgery of the breasts. Regular check-ups, including mammograms, help reduce the risk of this.

FAQ

1Is breast reconstruction right for me?
You can discuss many different reconstructive techniques with your plastic surgeon. However, it remains a personal choice when deciding to rebuild your breast. Of course, there are options of using breast prosthetics to make up for the lack of breast tissue. When reconstruction costs are too high, patients usually consider breast prostheses that replicate the natural breasts or at least parts of them.
Breast prostheses include:
  • An external soft silicone breast prosthetic that appears heavy but life-like.
  • Fiberfill prosthetic is a light, non-silicone option that can be worn when out for a swim.
  • Camisole breast prosthetics are light, durable, and worn directly after surgery.
  • A self-adhesive breast prosthetic can be attached to the chest wall.
  • Shell/shaper breast prosthetic is made of silicone or fiberfill and fits over the breast to outline and fill the breast.
2Will the feeling in my affected breast return after breast reconstructive surgery?
Some types of reconstructive procedures do not help return sensation to your breasts. However, given time, the feeling may return.
3What types of flaps exist?
  • A DIEP flap makes use of fat, skin and blood vessels in the lower stomach to remodel the remaining breast tissue.
  • A TRAM flap utilises fat, skin, muscle and blood vessels from the lower abdomen to remodel breast tissue.
  • A Lattissimus Dorsi flap takes the back’s muscle and tissue to reshape the breast.
  • An IGAP flap only retrieves the buttock tissue instead of the muscle and transfers the tissue to the breast.
  • Like IGAP, an SGAP flap uses the buttock tissue, not the muscle, to rebuild the breast. The difference between these two procedures is an SGAP involves taking different blood vessels to reconstruct the breast.
  • A PAP flap transfers tissue from the inner and outer thigh to the breast. A PAP flap does not involve the transfer of the thigh muscle.
  • A TUG flap takes the thigh’s muscle and tissue to use for the breast.
  • A SIEP/SIEA flap uses types of blood vessels to remould the breast. Not all patients qualify for a SIEP flap because they do not have the type of blood vessels required for the transplant.

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