Breast Reconstruction Surgery in Sydney
What is breast reconstruction?
Breast reconstruction is surgery to rebuild a breast, and is most commonly done for women who have had breast cancer surgery. There are various surgical options for women who have had a cancerous lump removed from a breast (oncoplastic breast surgery). However, some women with breast cancer will require removal of the entire breast. These patients may choose to receive breast reconstruction surgery, either at the same time as mastectomy, or at a later stage.
Why is breast reconstruction important?
For many women, breasts represent femininity, motherhood and sensuality. The loss of a breast may affect a woman’s self-esteem and confidence.
Breast reconstruction after a mastectomy has been shown to be beneficial in improving psychological and social wellbeing. The diagnosis of breast cancer can be quite distressing, so it’s important to look after yourself!
There have been numerous studies demonstrating the safety of breast reconstruction in cancer surgery. In fact, Cancer Australia guidelines state “it is not appropriate to perform a mastectomy without first discussing with the patient the options of immediate or delayed breast reconstruction”.
Is it better to do a breast reconstruction at the same time as cancer surgery?
This is usually a matter of personal choice.
Research has shown that patients who have immediate breast reconstruction have improved body image and self-esteem, as well as lower levels of depression and anxiety, than those who opt to have reconstructive surgery done later.
However, some women may prefer to focus on the initial cancer treatment and have reconstructive surgery done later. Others may not be able to have an immediate reconstruction because of their individual medical and cancer treatment needs. Some types of reconstructive surgery are done in stages, and require more than 1 operation.
What is the difference between a skin/ nipple sparing mastectomy, and a total mastectomy?
In a total mastectomy, the breast skin and nipple need to be removed. In a skin/ nipple sparing mastectomy, the breast tissue is removed but the skin and/or nipple are preserved. Some types of cancer require a total mastectomy.
If the skin and/or nipple are preserved, this makes reconstructive breast surgery easier. Patients who have had a total mastectomy are eligible for nipple reconstruction surgery. Nipple reconstruction is a small operation, and is usually done a few months after the reconstruction of the breast shape. The new nipple can be tattooed to match the colour of the other nipple.
What are my options for breast reconstruction?
Breast reconstruction can be either prosthetic (using an implant) or autologous (using tissue from your own body).
An implant is a pouch that is filled with silicone, or less commonly, with saline. If there is enough skin tissue left on the chest to cover the implant, reconstructive surgery can be done in a single operation (Direct to implant reconstruction). A mesh or soft tissue matrix may be needed to cover the implant in that case. However, if there is not enough skin, a two-step operation may be required. In the first operation, a balloon-like device is inserted under the skin. Saline is injected (through a port) into the balloon every couple of weeks, to stretch the skin. Several weeks later, a second operation is done to replace the balloon with a silicone implant.
A flap reconstruction uses your own muscle, fat and skin to reconstruct your breast. Commonly, a flap is taken from the lower abdomen or the back. This means that you will have 2 surgical sites, and 2 scars once the wounds have healed.
There are pros and cons of each type of reconstructive surgery. Depending on your medical conditions, previous operations or type of cancer, certain types of reconstruction may not be suitable for you. Your specialist at Sydney Surgical Clinic will assess your suitability and discuss the options with you in detail.
