Breast Reconstruction for Breast Cancer
BREAST RECONSTRUCTION
FOR BREAST CANCER
Breast cancer treatment is a complex and often a multi-staged process, in which plastic surgery has a vital role to facilitate optimal reconstructive outcomes.
Surgical techniques in this field have developed considerably over recent years and it is vital that patients are offered the most appropriate option, individually tailored to their situation.
Mr Harris has extensive experience in breast reconstruction and is acknowledged as one of the leading surgeons in the UK for this specialised area. He has published and lectured extensively, and continues to work closely as part of a multi-disciplinary team.
Click to download Your Guide to Breast Reconstruction produced by the British Association Of Plastic, Reconstructive & Aesthetic Surgeons (BAPRAS)
Implant-based Reconstruction
Implant surgery is the most straightforward way of creating a new breast after mastectomy, without taking tissue from elsewhere on the body. Either a saline filled (expander) or a silicone implant is inserted under the muscle and skin to replace the breast that has been removed at the time of mastectomy. This is a relatively simple operation and can be performed at the same time as mastectomy (immediate) or later (delayed). It does not produce the most natural looking or feeling breasts. This procedure may be suitable if both breasts (bilateral) are to be reconstructed or if other procedures are not deemed appropriate.
Implant surgery is the most straightforward way of creating a new breast after mastectomy, without taking tissue from elsewhere on the body.
Acellular Dermal
Matrix (ADM)
Patients undergoing implant reconstruction may want to consider a one-step procedure. The use of an acellular dermal matrix, such as Surgimend ™, can enable this. These collagen sheets are created from donated human, or calf skin from which the cells have all been removed and hence there is no rejection response. Instead of spending weeks undergoing tissue expansion after mastectomy, the ADM can be used to create the space required for and be used to fully cover the implant at the same time as the mastectomy operation. ADMs may also be used to sculpt any rippling or defects in a previous breast implant reconstruction.
DIEP Flap
A DIEP (Deep Inferior Epigastric Perforator) flap is tissue composed of the fat, skin and blood vessels from the lower abdomen and is used to create a new breast. Because DIEP flaps give warm, soft and pliable reconstructed breasts that resemble natural breast tissue, they are considered the gold standard for breast reconstructive procedures. In addition, the removal of tissue from the abdomen results in a flatter tummy, similar to the result of a tummy tuck (abdominoplasty). It requires a complex operation that takes about 5-7 hours. Mr Harris performs approximately 50 DIEP flap procedures every year and is renowned for his expertise in this area.
Mr Harris performs approximately 50 DIEP flap procedures every year and is renowned for his expertise in this area.
Mr Harris has pioneered the use of two TUG flaps (one from each thigh) connected to each other in order to maximise the breast volume and reduce the impact on the thighs.
TUG Flap
A TUG (Transverse Upper Gracilis) flap breast reconstruction utilises some of the skin and fat from the inner thigh, thus leaving a relatively discreet scar in the groin. The tissue that is transferred with microsurgical techniques is based on a small muscle of thigh called the gracilis. This muscle is the most superficial muscle of the inner thigh and its loss does not result in hernia formation or functional disability.
It is a complex operation that takes about 5-7 hours to complete and results in warm, soft, pliable reconstructed breasts that resemble natural breast tissue. It is a good choice for patients who have small breasts and who do not have adequate skin and tissue in the abdomen or buttock region, or have had previous abdominal surgeries that may have interfered with blood vessels that the DIEP flap requires.
Nipple Reconstruction
Breast reconstruction methods create a smooth breast shape with no nipple. Once optimal symmetry between the breasts has been achieved, the nipple reconstruction can be undertaken. This is usually the final step in the reconstruction pathway and can have a very positive impact on the appearance of the breast(s). The nipple is usually created from the tissue of the breast without surgery elsewhere on the body. The areolar (pigmented area around the nipple) is then usually coloured in at a later date using medically licenced tattooing techniques.
Lipofilling
Lipofilling, often referred to as liposculpture or fat transfer, involves the collection of fat cells from a donor site on the patient’s body (typically the abdomen, thighs or bottom) and are then re-injection in multiple small quantities in the breast. Lipofilling plays a valuable role in reconstructive breast surgery given its ability to fill small and large volume deficiencies.
The use of a patient’s own body fat to fill and sculpt the breast can assist in producing a more natural look and is commonly used in conjunction with either implant-based or flap techniques.
Benefits of Breast Reconstruction after Cancer
Breast reconstruction after cancer, whether it follows a mastectomy or lumpectomy, offers numerous physical, emotional, and psychological benefits to women who have undergone breast cancer treatment. These benefits extend beyond the restoration of physical appearance, playing a vital role in the overall recovery and well-being of breast cancer survivors. Here are the key benefits of breast reconstruction after cancer:
Restoring Physical Appearance: Breast reconstruction allows women to regain a sense of normalcy by restoring their physical appearance. It can help recreate a natural-looking breast mound, alleviating the emotional distress often associated with breast loss after surgery.
Enhancing Self-Esteem and Body Image: Breast reconstruction can significantly improve a woman’s self-esteem and body image. It empowers survivors to feel more confident about their bodies, aiding in the emotional healing process after the trauma of cancer treatment.
Reclaiming a Sense of Wholeness: Breast cancer treatment can create a feeling of incompleteness in many women. Breast reconstruction offers a path to regaining a sense of wholeness, allowing survivors to move beyond the physical and emotional scars of cancer.
Improved Emotional Well-Being: Emotional well-being is an essential aspect of recovery, and breast reconstruction plays a vital role in this. It offers survivors the opportunity to regain a positive self-image, leading to improved emotional well-being and a sense of empowerment.
Choice and Personalization: Women have the opportunity to choose the type of reconstruction that aligns with their preferences. They can select the type of implant, the size, shape, and even the placement of the implant, ensuring a personalized approach tailored to their aesthetic goals and body type.
Reduced Clothing Limitations: Breast reconstruction opens up more clothing options for survivors. They can wear a wider range of clothing styles with greater comfort and confidence, as the reconstructed breast closely resembles the natural breast.
Minimizing Psychological Distress: The emotional distress associated with breast loss can be alleviated through breast reconstruction. By regaining a more familiar physical appearance, survivors can reduce feelings of anxiety, depression, and insecurity.
Reclaiming Control: Breast reconstruction empowers survivors to regain control over their bodies and their lives. This sense of control can be a crucial factor in the emotional healing process and the restoration of personal agency.
Support Network: Many survivors find that breast reconstruction fosters a sense of community and connection with others who have gone through similar experiences. Sharing stories, advice, and support can be invaluable in the healing process.
Improved Quality of Life: The physical and emotional benefits of breast reconstruction contribute to an overall improvement in the quality of life for breast cancer survivors. It enables them to move forward with greater confidence and positivity.
Potential for Immediate Reconstruction: In some cases, breast reconstruction can be performed immediately following a mastectomy, reducing the emotional impact of immediate breast loss. This option is available to many women and provides a smoother transition.
Long-Term Satisfaction: Studies have shown that women who undergo breast reconstruction report high levels of satisfaction and improved quality of life over the long term. This indicates that breast reconstruction not only restores physical appearance but also enhances emotional and psychological well-being.
Reduced Need for Prosthetics: Breast reconstruction can reduce or eliminate the need for external prosthetics or breast forms, simplifying daily routines and increasing comfort.
In conclusion, breast reconstruction after cancer is a valuable option for women who have undergone breast cancer treatment. It not only restores physical appearance but also brings about emotional healing, improved self-esteem, and a renewed sense of wholeness. The choice of reconstruction is deeply personal, and women should have access to information and support to make the decision that best suits their individual needs and preferences. Ultimately, breast reconstruction empowers women to move beyond the physical and emotional scars of breast cancer, embracing life with confidence and strength.
