Breast Reconstruction services at Spire Hull and East Riding Hospital

Breast reconstruction is intended to restore you following surgery for breast cancer or to correct a deformity due to developmental or acquired causes. The majority of patients who have a mastectomy choose to have breast reconstruction, either at the time of their initial surgery (immediate) or afterwards (delayed). The aim is to match the remaining breast as closely as possible or to achieve a better look particularly in patients with large or droopy breasts.

Reconstruction may involve a single method or a combination of techniques:

•Breast Implants & expanders
•Extended latissimus dorsi flap — use of back muscle, fat and skin
•Free Abdominal, Thigh or buttock flaps — fat and skin used.
•Lipofilling; fat transfer from elsewhere to the breast (often an adjunct)
•Therapeutic mammoplasty, a method of reducing the breast size -  adjustment of the breast size and volume with local excision of the cancerous tissue (lumpectomy).

The choice as to the timing (Immediate vs Delayed) and the choice of reconstruction depends on several factors the most important being:

•Patient choice: Since it is your body it is most important that your personal opinion and choice is given primacy in deciding the best reconstructive option.
•The availability of suitable donor sites and your relevant medical history.
•The size and shape of your natural breast and the type of cancer/deformity.
•Whether you have received radiotherapy or you'll need one subsequently.
•Expertise: All reconstructive options should be made available irrespective of local availability to enable you make an informed choice.

All types of reconstructions have advantages and disadvantages. Most people will have two or more reconstructive options they can choose from. Remember that you like most people will make the right decision as to what reconstruction is best for you if empowered to by being given the right information.

Reconstruction: Choice & Timing

The decision to have breast reconstruction is an individual one and your consultation will enable you know your options, if you are not sure you can always have it later. Each method of reconstruction has pros and cons. Two or more reconstructive options are likely to be available to you; however your inclination combined with our professional advice ultimately determines the chosen method.

Immediate Breast reconstruction:

•Often better looking breast
•One anaesthetic and recovery period
•Reconstruction may be combined with reduction/uplift to obtain a better look
•One hospital stay & less disruption
•Smaller breast scars

•Slightly higher risk of minor complications
•Difficult decision making due to limited time
•Possibility of mild delay in commencement of chemotherapy if complications occur.

Delayed reconstruction:

•Time to consider if reconstruction is right for you without delaying cancer treatment
•Higher overall patient satisfaction scores
•No delay in chemo / radiotherapy if needed

•Longer breast scars
•More time away from work
•Multiple hospitalizations

Approved by BDM/matron

Comparison of reconstruction techniques

  Implant/expander Lat. Dorsi +/- lipofilling Abdominal, thigh flap etc
Surgery 2 procedures 3 hours Single 4-5 hr Single 6-8 hr
Hospital stay Overnight 2-3 days 3-5 days
Recovery 2-4 weeks 4-8 weeks 3-8 weeks
Scars Mastectomy only Mastectomy and back Mastectomy and abdomen
Shape & feel No natural sag, firm over time More natural feel and shape Most natural feel and shape
Long term More surgical revisions Less revision Mimics your body
Opposite breast More changes to match Fewer changes to match Fewest changes needed
Complications Infection, changes in shape and firmness, more revision surgery

Minor: Seroma, breakdown, depressed scar - back, stiff shoulder, muscle twitches,

Major: flap loss <1%, volume shrinkage

Minor: Delayed healing, fat necrosis, seroma

Major: <2% flap loss, abdominal muscle weakness

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Consultants offering Breast Reconstruction surgery at Spire Hull and East Riding Hospital

Mr Augustine Akali
Mr Peter Kneeshaw
Miss Penny McManus
Mr Tapan Mahapatra
Mr Kartikae Grover
Mr Ashutosh Kotwal

© Spire Healthcare Group plc (2016)