Ask the Expert - Breast Reconstruction

You are not alone:

Many women in the UK each year are diagnosed with breast cancer. You are not alone. Like you, many women have the option of breast reconstruction after mastectomy. There is a growing popularity for breast reconstruction among mastectomy patients as patients can experience an increase in self-confidence and emotional well being, renewed body image and have a better sense of femininity and sexuality.

What is breast reconstruction?

Breast reconstruction is the process of recreating a breast mound to match the remaining natural breast. There are several options available to create a breast and in recent years breast reconstruction has made great strides forward. Reconstructions are now more aesthetically breast shaped and look and feel more like real breasts.

When can I have a breast reconstruction?

Breast reconstruction can be performed at the same time of the mastectomy (immediate) or it can be months or years following the mastectomy (delayed).

The benefits of immediate reconstruction include having only one anesthetic, one hospital stay and one recovery period. However, the anesthetic and operation recovery period may be longer than if you just have a mastectomy.

The benefits of delaying reconstruction gives you time to focus on treatments, and research the type of reconstruction that best suits your needs.

The timing of reconstruction depends on your personal choice as well as your situation and the treatment you will have after surgery. Not all women are candidates for immediate reconstruction. If you're considering reconstruction, find out about your options. Your GP, breast surgeon and breast care nurse will be able to advise you.

You have options

There are two main types of reconstruction. These are prosthetic reconstruction, where implants filled with saline or silicone are used and autogenous, where tissue from elsewhere in the woman’s body is used to create the breast mound.

In an autogenous reconstruction, tissue is moved from the back, abdomen, buttocks or thighs to the chest. It is shaped under the skin to make the new breast.

There is no one best reconstruction method. There are advantages and disadvantages to each method. For example, breast implants require less extensive surgery than procedures using your own body tissues, but the results may look and feel less natural.

Your body shape and anatomy may affect the types of breast reconstruction likely to give you the best results.

Will the new breast match?

Your surgeon will match your new breast as closely as possible to your existing breast. In some cases, women may consider surgery on both of their breasts to ensure a good match. This can involve uplifting the existing breast, or making it larger or smaller.

How soon can I have my nipple reconstructed?

Occasionally, nipple reconstruction is done at the same time as the breast reconstruction. However, if it can't be done then, the nipple will be reconstructed about six months after breast reconstruction so that the breast has the time to heal and settle into shape. This means your surgeon can position the new nipple accurately in line with the one on your other breast.

The nipple may be reconstructed by folding skin on the new breast into a nipple shape or by taking part of the nipple on the natural breast and placing it on the new breast - a nipple sharing graft. Both procedures are usually done under a local anaesthetic and you should be able to go home the same day.

You may need further treatment to tattoo the nipple and dark skin around the nipple (areola) to give it the right colour. This is usually done about six to eight weeks after nipple reconstruction.

The reconstructed nipple will look slightly different to your natural nipple and won't respond in the same way to temperature changes or touch or have the same sensation as a natural nipple.

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Advice provided by:
Mr M Ellabban

MSc, MD, FRCS(Ire), FRCS(Eng), FRCS(Plast)

Read more about Mr Ellabban, Consultant General Surgeon, Spire Parkway Hospital

To make an appointment please call: 0121 704 1451

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