Breast Reconstruction
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Please note that a referral letter is required before an appointment can be confirmed.
Useful Information
About our services
Breast reconstruction is an option for women who require a mastectomy, where all of the breast tissue is removed from the breast as a result of cancer, or cancer risk reduction. Reconstruction restores the breast shape and volume to allow patients to look and feel more like themselves again.
Reconstruction can be done during the mastectomy surgery (immediate) or at a later date (delayed) after your mastectomy incisions have healed and your breast cancer therapy has been completed. Delayed reconstruction can happen months or even years after the mastectomy. The timing decision may be medically led, but usually is the patient’s choice.
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Women who choose to have their breasts reconstructed have two main options for how it can be done.
Autologous (Flap) Reconstruction
With Autologous (where patient’s own tissues are used) reconstruction, a surgeon takes tissue (a flap) from another area of your body to shape the new breast. The flap is usually taken from the stomach area (abdomen), and this type of procedure is called a DIEP flap procedure. The flap can also be taken from your thigh, and this procedure is called a PAP flap procedure. Both of these procedures have fewer long-term complications than implant reconstruction with higher rates of short-term and long-term success.
Implant Reconstruction
Breasts can be rebuilt using implants which can be either saline or silicone. Saline implants are most commonly used due to their superiority in terms of shape, texture and longevity. Implant reconstruction usually has a faster recovery time than flap reconstruction but it also tends to require follow up surgery at a later time.
When deciding on the most appropriate technique your consultant will take into account your medical details, any need for ongoing breast cancer treatment particularly radiotherapy, and any relevant personal issues. Your surgeon will discuss the pros and cons of each option with you to determine the best choice for you and your lifestyle.
Nipple reconstruction is usually carried out as a day case at a later date.
Breast symmetry
While no breast reconstruction will ever be perfect, the aim is to achieve a reasonable match to the opposite breast. However, it can sometimes be difficult to closely match the opposite breast. In these circumstances, your surgeon may discuss the option of surgery to the opposite breast to best achieve symmetry.
The procedure
Implants are most often placed as an immediate reconstruction, in a single staged procedure. Implants can be placed directly under the preserved breast skin using a biological mesh to support the implant weight, or placed underneath the chest muscle should additional tissue coverage be required.
Following the procedure
Your medical team will monitor you closely for complications. You may benefit from physical therapy to improve or maintain shoulder range of motion or to help recover from weakness in the area from which the donor tissue was taken.
What factors influence the type of reconstructive surgery I can have?
Several factors can influence the type of reconstructive surgery chosen. These include the size and shape of the breast that is being rebuilt, your age and health, your history of past surgeries, surgical risk factors (for example, smoking history and obesity), the availability of autologous tissue, and the location of the tumour in your breast.
Does breast reconstruction affect the ability to check for breast cancer recurrence?
Studies have shown that breast reconstruction does not increase the chances of breast cancer coming back or make it harder to check for recurrence with a mammogram. Women with breast implants should inform the radiologist that they have implants before their mammogram so that the procedure can be adjusted to ensure accurate results and protect the implant from damage.
Your team
Breast reconstruction is carried out by a plastic or breast surgeon, as part of the multidisciplinary team which includes the oncologist, radiotherapist, and specialist nurses.
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