Receiving a diagnosis of breast cancer usually comes as a great shock. Most women I consult feel extremely frightened, anxious and totally overwhelmed by the barrage of information and decisions they face about their impending treatment.
For many women, their breasts are directly related to sexuality, femininity and of course, motherhood, and the loss of a breast or both breasts due to cancer, poses the daunting prospect of life without them. Breast reconstruction is a surgical option available to help restore a woman’s normal body image.
Breast Reconstruction is a procedure performed to restore the appearance of the breast after a partial or total mastectomy. Some patients have no desire to have reconstructive surgery and may choose to use external breast prostheses instead, or indeed nothing at all.
There are many healthcare professionals involved in managing a woman with breast cancer. It is a multidisciplinary approach aiming to ensure the best possible treatment outcomes. There are two types of surgeons involved in the surgical aspect of treatment. The Breast Cancer Surgeon who performs the mastectomy and the Specialist Trained Plastic Surgeon who performs the breast reconstruction.
Once the decision is made to have a mastectomy, I believe the choice regarding a reconstruction should preferably be made prior to the surgery. This is because reconstruction can be immediate and be completed during the same surgery as the mastectomy or delayed and performed at a later date. The decision should be made following a consultation and discussion with a Specialist Trained Plastic Surgeon with experience in Breast Reconstruction procedures. He or She will discuss which form of reconstruction is best for you and its timing.
An immediate Breast Reconstruction means that this occurs during the same procedure as the Mastectomy and is typically performed by a Plastic Surgeon immediately after the breast Cancer surgeon has removed the breast. Commonly, the Plastic surgeon will insert a breast implant (prosthesis) in place of the removed breast tissue. The implant may be a fixed volume implant or a tissue expander.
Alternatively, reconstruction using the patient’s own tissues (skin, fat and muscles from another part of the body) can be carried out instead of using breast implants.
Delayed Breast Reconstruction is performed at a later time following a mastectomy, after the area has healed. Once again the procedure will involve the use of an implant or the patient’s own tissues.
The best time to have the reconstruction and the type of operation varies from patient to patient and their individual situation. In my opinion, a holistic understanding of the patient’s situation is key to an optimal aesthetic outcome. The pro’s and cons of these surgical options must also be considered. The main advantage of an Immediate Reconstruction is that it reduces the number of surgeries and anaesthetics required by the patient. It also reduces the stress and anxiety of the appearance of the chest without a breast. On the down side, there can be an increased level of dissatisfaction with the results when a patient has had little time to fully digest such an emotional event. An optimal aesthetic result may not be achieved If cancer treatments have yet to be completed, or further treatment is required. A Delayed Breast Reconstruction has the advantage of time with the ability to more precisely plan the procedure. The complication rate related to delayed reconstruction is lower and all modalities required for treatment of the cancer can be completed. From my experience, more time allows for a more considered decision and certainly a more pleasing aesthetic result. Most women who have had a breast reconstruction feel the emotional and physical benefits have restored their self-confidence. In summary, Breast Reconstruction is one of the most complex surgical procedures commonly performed by Plastic Surgeons. As such a patient’s individual circumstances, expectations and suitability for reconstruction, have to be thoroughly considered and all surgical options discussed. For these reasons it is important that patients looking to Breast Reconstruction have a thorough consultation with a Specialist Trained Plastic Surgeon to determine how to optimise their outcomes with regards to both their safety and their result.
Dr Newton’s knowledge and experience will
guide you through the process of choosing the
right procedure for your body.