Breast Reconstruction

What is breast reconstruction surgery?

Breast reconstruction is a surgical procedure that involves rebuilding a new breast or breasts, according to the desired shape, size, and feel, or to match your existing breast. It is generally intended for women who have been required to get a mastectomy due to breast cancer or other medical conditions. Breast reconstruction can be performed in several ways, such as using breast implants or autologous tissue, meaning tissue from elsewhere on the patient’s body, and can be performed simultaneously with a mastectomy or at a time of the patient’s choosing. Patients should be aware that they may need to undergo multiple reconstruction procedures.

Having already been through a potentially traumatic experience, women may be adversely affected emotionally and physically after a mastectomy. Therefore, it may be necessary that patients take their time deciding whether to receive a breast reconstruction, as it is an intensely personal decision based on an individual’s needs and wishes. It is not uncommon for women to have breast reconstruction later, long after a mastectomy. However, this depends on the individual in discussion with a qualified surgeon.

What can breast reconstruction achieve for you?

Breast reconstruction surgery can achieve:

• Personalised results through various surgical techniques
• Restore volume and symmetry to the breasts
• Can improve physical balance, which may help address back and posture problems

Please remember that due to the highly personal nature of this procedure, results will be different for each patient. You should weigh the potential benefits with the risks and thoroughly discuss your options with your surgeon.

Am I a suitable candidate?

Many women can be suitable candidates for some type of breast reconstruction, but various factors can influence your suitability, including:

• If you are in poor health, you may not be eligible for the surgery until you have recovered, as risks such as bleeding and infection are much higher
• If you are undergoing chemotherapy or radiation treatments, you may need to schedule your reconstructive surgery until your course of treatments has finished
• If you have scarring from previous operations, this can limit the reconstruction technique used
• Ensure you have realistic expectations for your breast reconstruction, as reconstructed breasts will not look or feel the same as natural breasts. The surgery aims to reconstruct one or both breasts to suit your needs, and having achievable goals is important prior to surgery

Consultation with Dr Matt Starr

During your initial consultation with Plastic Surgeon Dr Matt Starr, you will have an in-depth discussion about why you want breast reconstruction surgery, your expectations, and what you hope to achieve with such a procedure. You will need to discuss your medical history, including your previous or current ongoing treatment if the reconstruction is occurring after mastectomy. If you are planning for pregnancy in the future, ensure you disclose this information, as it can influence the techniques used during your reconstruction. Dr Starr has a passion for breast reconstruction surgeries, having gained experience and medical training, and uses his experience to craft a tailored procedure and aftercare plan based on your health, lifestyle, concerns, and desired outcomes.

Photos will need to be taken of your breasts and chest area but are kept strictly confidential amongst your medical team. Dr Starr endeavours to ensure all patients feel safe and comfortable during their consultation, understanding that it can be an intensely personal topic.

The procedure

There are two different techniques used in breast reconstruction surgery, and the choice of which will depend on the extent of reconstruction needed, your health, and your desired outcomes. The type of reconstruction you may undergo will also vary based on your current or previous cancer treatment, health and lifestyle, current breast size and shape, and your preferences for your breasts’ size, shape, and feel. However, there are general steps and goals that each technique shares:

1. To rebuild the breast mound tissue
2. To sculpt and lift the shape and size of the breast to achieve symmetry
3. To reconstruct the nipple and areola if required

Types of breast reconstruction

• Implant reconstruction
  As the name suggests, this technique involves using a breast implant. During a patient’s mastectomy, patients can choose to have a tissue expander inserted. The balloon-like device will gradually inflate and stretch the skin to provide a tissue pocket where the implants can be inserted. Dr Starr will discuss the suitability of this option with you, weighing up the potential risks and complications associated with breast implants and considering your personal preferences on breast appearance and feel.
• Tissue flap reconstruction
  This type of reconstruction utilises your skin, fat, and muscle to rebuild the breast. The tissue flap technique will be different for each patient, varying based on where tissue is transplanted from, which can include your back, abdomen, buttocks, or hips. However, the recovery time is significantly greater than implant reconstruction. Patients should be aware that the reconstructed breasts will age and change normally as the body ages and you experience weight fluctuations.

Recovery & aftercare

Immediately after the procedure, you may experience pain, swelling, bruising, and fatigue, which are typical post-operative symptoms that can last for several weeks. Before the surgery ends, drains may be inserted in the surgical sites to collect any excess fluid or blood and will be removed after a few days. You will also be fitted with bandages and a compression garment, which you will need to wear for at least six weeks to help minimise swelling, bruising, and discomfort. Pain medication can also be prescribed to help with the pain. You may need to remain in the hospital for a few days to monitor and support your healing. Other general aftercare can include:

• Take sufficient time off from work – at least two weeks
• Avoid vigorous activities and exercise for at least six weeks, including heavy lifting
• Wear your compression garment for a minimum of six weeks
• Avoid wearing underwire bras for several months post-operation
• Take all prescribed medications and creams
• Drink plenty of water and maintain a healthy diet
• Keep in mind that it can take up to one year for the final results of your reconstruction surgery to be seen

What risks or complications are associated with breast reconstruction surgery?

Whether medical, cosmetic, or reconstructive, any surgery you may undergo will always have associated risks and complications that patients must be aware of. Associated risks and complications with a breast reconstruction include:

• Infection
• Poor wound healing
• Excessive bleeding
• Fluid accumulation
• Temporary loss of sensation
• Capsular contracture and implant rupture
• Anaesthetic complications
• Tissue death
• Blood clotting
• Visibly poor scarring