Breast Reconstruction

Most breast reconstruction methods involve several steps. Dr. Date will help you weigh the pros and cons and select the method to benefit you the most. The basic options for breast reconstruction are:

• Using breast implants (silicone):In this option, a tissue expander is inserted beneath the skin and chest muscle, forming a skin-muscle envelope. The tissue expander is a modified saline implant with a valve, allowing more saline to be added after the first surgery. Serial injections of saline through the skin into the valve slowly fill the implant and will subsequently expand your breast mound. During office visits over two to six months, the skin-muscle envelope is slowly stretched until it reaches the size you want for the final implant.
• Reconstructing the breast using your own skin, fat and muscle: Reconstruction using skin and tissue flaps from your own body (autologous tissue) can look and feel more like a natural breast than reconstruction with implants. The most common natural flap procedures use tissue from the back, abdomen or buttocks. In some procedures an entire muscle needs to be moved to reconstruct the breast. Autologous fat grafting or fat transfer is another option for treating radiation-damaged tissues or small areas of contour irregularities.
• Skin-sparing mastectomy:If you are having immediate breast reconstruction, your surgeon may perform a skin-sparing mastectomy to keep as much of your breast skin intact as possible. The tumour and clean margins (areas free of cancer cells) are removed along with the nipple, areola (pigmented skin surrounding the nipple), fat and other tissue that make up the breast. What remains is much of the skin that surrounds the breast. This skin can then be used to cover a tissue flap or an implant. The major benefit of a skin-sparing mastectomy is that it avoids using skin from other body parts for reconstruction, which can have a different colour, texture and thickness compared with natural breast skin.
• Nipple-sparing mastectomy:This is a procedure that removes the tumour and clean margins as well as the fat and other tissue in the breast, but leaves the nipple and areola intact, improving the overall look of the reconstructed breast. Not all women are candidates for this and there may be other complications.

Dr. Date will discuss how long it will be before you can return to your normal level of activity and work. After surgery, you will receive detailed instructions about your post-surgical care, including information about:

• Drains, if they have been placed
• Normal symptoms you will experience
• Potential signs of complication

It is vitally important that you follow all patient care instructions provided. This will include information about wearing compression garments, care of your drains, taking an antibiotic if prescribed and the level and type of activity that is safe.

Every procedure involves inherent risks. Although serious complications are extremely rare, Dr. Date educates every patient about potential risks.

Those risks can include scarring, the opening of the wound, discomfort for several days, bruising around the surgical sites, infection, bleeding, skin necrosis and general anaesthesia-related issues.