What is Breast Reconstruction Surgery

Breast reconstruction is a surgical procedure that alters the shape, size, and appearance of the breast after a mastectomy (surgical removal of one or both breasts), lumpectomy (surgical removal of a cancerous tumour or abnormal tissue from the breast), or trauma. The procedure is suitable for patients who have undergone breast cancer treatment, where part or all of the breast tissue has been removed. It is also suitable for those who want to address congenital breast deformities or repair breast tissue damage due to trauma.

Types

Depending on the patient’s medical history, body type, and specific needs, the surgeon may use one of the following types of breast reconstruction surgery:

• Implant-Based Reconstruction: This method involves inserting a silicone or saline implant under the chest muscle to create a breast mound. Depending on the surgeon’s recommendations and the patient’s preferences, the procedure may be performed immediately after surgical removal of one or both breasts or at a later time. In some cases, the surgeon will first use a tissue expander to stretch the skin and chest muscles. Once there is enough room, the final implant will be inserted.
• Autologous (Tissue-Based) Reconstruction: This technique involves using a tissue from another part of your body, such as the abdomen, back, thighs, or buttocks, to reconstruct the breast. Unlike implant-based reconstruction, autologous reconstruction is more complex and requires more time to perform. This is because it involves two surgical sites—the breast and the donor area. Moreover, there is a need to establish blood flow to the transplanted tissue, which may involve microsurgery to connect tiny blood vessels. Autologous reconstruction is suitable for patients who have undergone radiation therapy, which can affect the skin’s ability to accommodate an implant.

Suitable Candidates for the Procedure

Reconstruction of the breast/s is suitable for patients who:

• Have undergone breast cancer treatment, such as a mastectomy or lumpectomy, which results in the removal of part or all of the breast tissue.
• Want to change the appearance of their breasts or address loss of breast tissue following trauma or injury.
• Want to correct congenital conditions, such as Poland syndrome, which results in underdevelopment or absence of breast tissue on one side of the body.

Timing of the Procedure

Reconstruction of the breast/s can be performed at different times. This usually depends on the patient’s health and treatment plan. After a thorough patient assessment, the surgeon may recommend one of the following:

• Immediate Reconstruction: This type of reconstruction is performed at the same time as the mastectomy or lumpectomy. It reduces the number of required surgeries and preserves more of the skin envelope.
• Delayed Reconstruction: In some cases, the surgeon may recommend delaying the reconstruction of the breast/s until all breast cancer treatments are complete. This approach allows the patient to heal from initial treatments (e.g. chemotherapy or radiation therapy) before undergoing the procedure.

Recovery Process and Timeline

The recovery process following the procedure varies based on the type of procedure performed. Patients who had implant-based reconstruction may have a shorter recovery time compared to tissue-based reconstruction. Depending on the extent of the procedure, the initial healing may take a few weeks. However, full recovery and final results can be achieved after several months. Most patients can resume their normal routine within 4-6 weeks.

On the other hand, recovery from autologous reconstruction tends to be longer. This is because the surgery is more complex and requires a donor site as well as good blood flow to the transplanted tissue. Depending on your specific needs and the extent of the procedure, full recovery can be achieved after 6-8 weeks. During the recovery period, you will need to limit physical activities to prevent complications and allow your body to heal properly.

In both types of reconstruction, you will need to attend follow-up appointments to monitor your healing progress, manage pain and other discomfort, and address any concerns you may have.

Potential Risks and Complications

As with any major surgery, reconstruction of the breast/s comes with certain risks and potential complications. These may include:

• Infection
• Implant rupture
• Capsular contracture (hardening of the tissue around the implant)
• Shifting of the implant
• Tissue necrosis (the transferred tissue does not survive due to insufficient blood supply)
• Scarring
• Asymmetry
• Need for revision surgery

Follow-Up Care and Monitoring

After the procedure, you will need to attend all follow-up appointments to monitor your healing progress. During these appointments, the surgeon can assess the success of the reconstruction and identify any potential complications early. This allows for timely intervention in case of any complications.

If you have implants, you will need routine monitoring. The surgeon may recommend imaging studies like mammograms or MRIs to detect implant leakage or rupture, capsular contracture, and other complications. On the other hand, the surgeon may use Doppler ultrasound to evaluate the blood flow to the newly reconstructed breast if you have undergone autologous reconstruction.

Most importantly, you will be advised to commit to a healthy lifestyle after the procedure. It is important to maintain a stable weight as significant weight fluctuations can affect the results. In addition, you will also need to quit smoking as this can affect the healing process as well as the blood supply to the breast tissue.

Reasons to Choose Dr Hunt for Breast Reconstruction Surgery in Sydney

Dr Jeremy Hunt is a Specialist Plastic Surgeon who is a Fellow of the Royal Australasian College of Surgeons (FRACS). He earned his Bachelor of Medicine and Bachelor of Surgery (MBBS) from Sydney University and further developed his skills by completing a Craniofacial Fellowship at the University of Texas in the United States. His qualifications are supported by his role as a spokesperson for the Australian Society of Plastic Surgeons and his positions as a Consultant Surgeon at both Sydney Children’s Hospital and Prince of Wales Hospital. Dr Hunt is also a member of the Australian Society of Plastic Surgeons (ASPS), the Australian Society of Aesthetic Plastic Surgeons (ASAPS), and the International Society of Plastic Surgeons (ISAPS). Additionally, he is a corresponding member of the American Society of Plastic Surgeons (ASPS), serves as the Supervisor of Plastic Surgery Training for the IMG Royal Australasian College of Surgeons, and is a past serving board member of Interplast Australia.

Dr Hunt conducts a thorough assessment of each patient before reconstruction surgery. This includes reviewing the patient’s medical history, evaluating the condition of the breast tissue, and discussing the patient’s treatment plan, such as prior mastectomy or radiation therapy. He assesses the patient’s overall health and discusses options for reconstruction surgery, including implant-based and autologous (tissue-based) methods. Based on the assessment, he tailors the surgical approach to suit the patient’s needs.

Dr Hunt’s approach is based on patient-specific factors, such as body type, health conditions, and the type of mastectomy previously performed. He provides comprehensive follow-up care to monitor healing and ensure that the reconstructed breast is recovering well. This includes regular check-ups to assess the blood supply to the reconstructed tissue, check for signs of infection or other complications, and evaluate scarring. For patients who undergo autologous reconstruction, he monitors both the donor and breast sites to ensure proper healing. Long-term follow-up care includes routine imaging and breast exams to monitor the health of the reconstructed breast.