How is breast reconstruction surgery done?

Breast reconstruction surgery helps to achieve a balanced appearance following breast cancer treatment.

During breast reconstruction surgery, the shape, volume, and feel of the breast are all reconstructed. The surgery requires the use of tissue that is moved from other parts of the body, silicone implants, or a combination of the two.

What is involved in breast reconstruction?

When it comes to breast reconstruction, Dr Samuel Yang typically sees patients who have already seen another surgeon for the treatment of breast cancer. These patients often require a mastectomy, a procedure in which the breast tissue is removed. Sometimes these patients require a partial mastectomy or skin-sparing mastectomy, which means that the breast tissue is removed but the breast skin is retained. In other cases, patients undergo a nipple-sparing mastectomy, which means that the skin and nipple are spared, but the breast tissue is removed. Breast cancer patients consult with Dr Yang either before or after their mastectomy surgery to discuss reconstruction.

There are different forms of reconstruction — it is sometimes possible to use the patient’s own tissue; implants can be used, or a combination of the two works best. Each technique has its own set of advantages, and Dr Yang takes the time to thoroughly discuss all options before going ahead with the procedure. The treatment that is right for you will depend on a number of factors, such as whether or not the reconstruction is immediate (occurring at the same time as a mastectomy), or whether it is a delayed reconstruction (occurring after mastectomy and other breast cancer treatment). The breast reconstruction technique that is chosen will also depend on the type of mastectomy that is performed and whether both breasts require reconstruction as part of one procedure or if just one breast needs to be reconstructed to match the remaining breast. The nature of the surgery will affect the length of the procedure, as well as the outcomes of the procedure and any long-term maintenance that might be required.

What kind of tissue is used for breast reconstruction?

In most cases, abdominal tissue, which includes skin and fat, is used in breast reconstruction surgery. Harvesting this tissue involves microsurgery, which means that skin and fat are taken from the abdominal area along with an artery and a vein in order to keep the tissue alive. The entire piece of tissue is moved to the chest, where it is re-joined to the artery and vein in this area of the body. The abdominal tissue is then reshaped and remoulded to recreate the shape of the breast. The shaping of the breast tissue is critical when it comes to achieving an aesthetically pleasing result. The goal of the procedure is to create a breast that looks and feels just like a natural breast, and elements like projection and fullness are key.

How do you know which breast reconstruction technique to choose?

Each patient is different and a complex conversation is always required at an initial consultation with Dr Yang. Ultimately, Dr Yang always ensures that he takes the time to find out what the patient wants because a lot of people have specific preferences or choose not to have implants. Dr Yang will explain all of the available options, which may include taking tissue from the upper thighs or using muscle from the upper back, particularly in cases where patients don’t have a lot of excess abdominal tissue. If a patient has a specific volume in mind, and if they don’t have enough of their own tissue to create that volume, implants may be required. Deciding on the best course of treatment requires a lengthy conversation with Dr Yang, in which he will explain the various advantages and disadvantages of each option.

What does nipple reconstruction involve?

The nipple reconstruction part of a breast reconstruction usually happens at the end of the procedure, when both Dr Yang and the patient are happy with shape of the new breast and its position on the chest wall. After the breast has been reconstructed, it changes over the course of the next six months or so as the tissue softens. For this reason, Dr Yang doesn’t place nipples within six months following breast reconstruction surgery. When the shape and size of the breast is stable, nipple reconstruction can take place.

Nipple reconstruction is a minor procedure, which generally takes around half an hour to complete. The procedure involves lifting and folding a little bit of skin to form the shape of a nipple. Patients are then referred to a medical tattooist around three months following the procedure who will ensure the colour of the areola is natural-looking.

If you would like to find out more about breast reconstruction, please don’t hesitate to get in touch to arrange a consultation with Dr Yang.

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