Involves restoring the shape, volume and symmetry of your breasts.
Breast reconstruction involves restoring the shape, volume and symmetry of your breasts. It is most commonly performed following treatment for breast cancer. It is also carried out in women with a higher than average breast cancer risk, who opt to undergo risk-reducing surgery. Your breasts can be reconstructed at the same time as your breast cancer or risk-reducing surgery (immediate reconstruction), or during a subsequent operation (delayed reconstruction).
Plastic surgeons are constantly refining breast reconstruction techniques to optimise outcomes, both physically and emotionally. Your breasts can be reconstructed using breast implants or your own tissues (autologous reconstruction). Autologous reconstruction involves moving fat (fat grafting), or a combination of skin, fat and muscle (flap surgery) from your abdomen or back to your chest to recreate your breast mound.
Careful consideration is given to optimising the silhouette and contour of your reconstructed breast. A series of procedures may be necessary to achieve the best possible aesthetic result. Sometimes this may involve an adjustment of your unaffected breast for the purposes of symmetry.
Where possible, Dr Collins will perform your breast reconstruction at the same time as your breast cancer or risk-reducing surgery. The goal is to obtain the desired result in the safest possible manner. In some patients, the best results are achieved when Dr Collins performs your reconstruction in a separate operation to your breast cancer surgery, once you have completed post-operative radiotherapy for example.
An implant-based reconstruction can be performed in one or two stages. The two-stage procedure involves placing a tissue expander under your pectoralis major chest muscle in the first instance. A tissue expander is an empty breast implant that is filled with sterile saline in a gradual manner. Once your desired size is reached, your breast is rested for three months before exchanging the expander for a permanent implant. Using a tissue expander affords you the opportunity to have more control over your final breast volume. Adjustments can be made to your other breast, if indicated, when your expander is replaced with a definitive implant.
Flap surgery involves transferring healthy tissue with its own blood supply from one part of your body to another. This can involve moving fatty tissue that you will not otherwise miss, such as abdominal fat that is discarded in a tummy tuck operation (TRAM or DIEP flap), or an expendable muscle with overlying skin and fat (Latissimus Dorsi flap).
Fat grafting involves harvesting fat from one part of your body via liposuction and transferring it to another. When transferred to the breasts, fat offers an alternative to implants to restore lost volume and achieve a natural-looking result. In the reconstructive setting, fat grafting can be used as an adjunct to correct contour deformities and improve symmetry. It can also be used to reconstruct the entire breast, though this is best suited to patients who desire smaller volume breasts. A series of procedures are required.
There are a number of factors that need to be taken into account, including your age, general health, smoking status and previous or planned radiotherapy. Following a comprehensive consultation and examination, Dr Collins will discuss the most appropriate reconstructive options for you and together formulate your management plan.
Expander and implant-based reconstructions take up to 2 hours per breast. Whether this is performed in an immediate or delayed manner will determine the length of your hospital stay, which can be up to 4 days. Breast reconstruction using your own tissue takes significantly longer; from 5 to 8 hours for one breast and 8 to 12 hours for both. The post-operative stay is usually between 5 and 7 days.
If you undergo an expander or implant-based reconstruction, you can expect to be feeling back to your normal self in 6 weeks. You may be able to return to work sooner than this, depending on your occupation. Patients undergoing flap reconstruction generally require from 6 to 12 weeks off work and it may be 6 months before you return to full function.
Dr Collins uses implants that have a high safety profile, supported by reputable scientific data. In the current era, breast implants can last for decades without causing any issues. It is more likely that changes in your breasts, as a result of weight fluctuations and/or ageing will prompt you to seek revision surgery, rather than your implants becoming problematic.
No. Patients with breast implants can still undergo effective breast cancer detection with mammograms, ultrasounds and/or MRI scans.
There is no association between breast implants and breast cancer. Breast Implant Associated-Anaplastic Large Cell Lymphoma (BIA-ALCL) is a type of Non-Hodgkin’s lymphoma that has been linked to both silicone and saline breast implants. The current estimated lifetime risk in patients with textured implants is between 1:2,207 and 1:86,029. It manifests on average 8 to 10 years after surgery. Common symptoms include breast enlargement, pain, asymmetry, lumps in the breast or armpit or a large fluid collection. Treatment generally involves removing the implant and surrounding capsule. When caught early, BIA-ALCL is curable in most patients.
After your consultation, Dr Collins will provide you with a personal estimate which will include hospital and anaesthetic costs, in addition to her surgical fee. The total cost will be determined by the type of reconstruction you choose.