Breast Reconstruction
There are many breast reconstruction techniques and they depend upon patient choice, previous surgery and available tissues. The appropriateness, implications and possible complications of each will be discussed in multiple preoperative outpatient visits
Techniques undertaken by Robert Morris include:
Expansion/Implant
Implant and Artificial Dermal Matrix,
Latissimus Dorsi +/- Implant
Free abdominal tissue transfer, usually Free DIEP but also Free TRAM
These can be performed immediately, in conjunction with a breast surgeon, or in a delayed setting. This surgery is complex and it is important that all the implications and risks of each technique are fully explored. Some may require multiple procedures which may be combined with contra-lateral reduction. Nipple areola reconstruction is also performed.
Anaesthetic
General. Stay is dependant upon technique
Back to work
Dependant on operation
Scars
Depend on technique
Reopening and closing original scar
Around new breast and either back or abdomen
Feeling
Varies depending on technique
Examples;
Immediate DIEP
DIEP Lumpectomy Reconstruction
Delayed Latissimus Dorsi and Contralateral Breast Reduction
Further information
British AssociationReconstructive & Aesthetic Plastic Surgeons
Nipple Areola Complex Reconstruction
Most patients undergoing breast reconstruction consider nipple reconstruction, (nipple areola complex / NAC), although this is by no means essential and can be planned at any stage once the reconstruction has settled.
Methods include:
Prosthesis
3 D tattoo
Skin flaps and subsequent tattoo / graft under local anaesthetic as a day case.
Scar Revision / Opposite Breast Reduction
Many patients are content with an external prosthesis or decide to wait a while until they contemplate a formal reconstruction. Some wish to consider a contralateral reduction to reduce the weight of a prosthesis and increase its manageability.
On occasions the scar resulting from a mastectomy is uneven making it difficult to retain an external prosthesis comfortably or without it slipping. In these circumstances a scar revision may afford improvement
Surgery
Scar revisions can be performed under local anaesthetic, (if a small area is being revised), or general anaesthetic. The original scar is excised and the surrounding tissue adjusted before being re-sutured.
Reducing the contralateral breast uses the same technique as a bilateral breast reduction. (See here)
