Breast reconstruction is the surgical process of rebuilding the shape and look of a breast, most commonly in women who have had surgery to treat breast cancer. It involves using autologous tissue, prosthetic implants, or a combination of both with the goal of reconstructing a natural-looking breast. This process often also includes the rebuilding of the nipple and areola, known as nipple-areola complex (NAC) reconstruction, as one of the final stages.
What Is Breast Reconstruction Surgery?
Breast reconstruction is a surgical procedure that helps forming or restoring one or both breasts to near normal shape, appearance, symmetry and size after one undergoes a mastectomy, lumpectomy or any congenital deformity. Mastectomy is a surgery performed to remove the breast(s) to treat or prevent breast cancer.
Who Is An Ideal Candidate For Breast Reconstruction Surgery?
Dr. Abizer Kapadia, a Board Certified Plastic Surgeon, has provided guidelines as to who can receive Breast Reconstruction surgery:
What To Expect At The Consultation With Dr. Abizer Kapadia?
Dr. Abizer Kapadia gives the utmost importance to the consultation as it is the step where you understand the procedure, all the aspects of it, and analyze your comfort level with the doctor and his/her staff. During the consultation, Dr. Abizer Kapadia will guide you through the whole process with all the details and will discuss how to prepare for the surgery, its recovery process, helping you make an informed decision. Dr. Abizer will also discuss and understand your reasons for getting surgery and help you have realistic goals and expectations from the surgery.
During the consultation, you should prepare yourself for a physical examination and discuss your medical history, previous surgeries, drug allergies, medical conditions, and other such topics concerning your health. Dr. Abizer also urges his patients to ask questions and queries to resolve any doubts they may have regarding the surgery, procedure, risks involved, and results as his utmost priority lies in the safety and satisfaction of his patients.
Before / After Images
What Are The Categories Of Breast Reconstruction Surgery?
Implant based reconstruction is done using silicone breast implants filled with silicone gel or saline water. If implants are used as a reconstructive method, it may involve stretching of skin with a tissue expander and after a few weeks, the implant is inserted in second stage.
Flap Reconstruction is done by taking a section of one’s own tissues from another area of the body, most commonly from abdomen, but in some cases from back or thighs and using it to create a new mound to reconstruct the breast. This procedure is also known as Autologous tissue breast reconstruction. A new Technique known as deep inferior epigastric perforator (DIEP) flap is specialised by Dr. Abizer Kapadia. In a DIEP flap procedure, flap, fat, skin and blood vessels are taken from the lower abdominal wall and are used to reconstruct the breast. This technique of breast reconstruction ensures that the strength in the abdomen is retained and in fact the abdomen shape and contours are improved. Also the breast looks and feels almost like natural and actual breast.
This has become more popular recently, but requires expertise and microsurgical experience to harvest as the tissue can be taken only once from the abdomen. Such surgeries are known as microvascular surgery. Breast reconstruction is a complex procedure and must be performed by a board certified plastic surgeon only.
How Breast Reconstruction Surgery Is Performed?
Breast reconstruction procedure may take 1 to 7 hours depending on the type of Reconstruction chozen and is usually done under general anaesthesia.
The breast reconstruction procedure can start at the time of the removal of the breast or mastectomy (Immediate reconstruction) or can be done at a later (delayed reconstruction), depending on the disease and the medical condition of the patient.
In some cases, it may also require multiple operations that would be performed in stages to ensure the best possible outcome in terms of breast size, shape and symmetry of the breasts. If the surgeon suggests a two-stage procedure, the first stage would involve placement of the implant expander and the second stage would involve completing the tissue reconstruction with autologous tissue or a permanent implant.
Post the reconstruction of breast, patients may consider nipple reconstruction as well, if their nipple and areola was removed during the mastectomy to lower the chance of cancer recurrence. This is an outpatient procedure and is usually done under local anaesthesia. It is advisable for the tissue to heal after the breast reconstruction surgery before undergoing nipple reconstruction surgery. The surgeon uses the tissue taken from abdominal flap or back to reconstruct the nipple and then it is tattooed to make it look as natural as the colour of the nipple.
Only in some cases, if the surgeon is sure that the nipple is cancer free, the nipple from the original breast can be preserved during the mastectomy known as Nipple Sparing Mastectomy , which adds natural look to the newly reconstructed breasts.
There are many different reconstruction techniques available. Take the time to learn about the breast reconstruction options.
Consult a plastic surgeon who’s board certified and experienced in breast reconstruction following mastectomy. The breast surgeon & the plastic surgeon should ideally work together for the best possible reconstruction strategy
What To Expect From Breast Reconstruction Surgery?
The final result of a breast reconstruction surgery helps to lessen the physical as well as emotional impact of a mastectomy. It gives contours to the breast to match it natural breasts and improves the symmetry, so the breasts look similar under clothing. It helps improve self-esteem and body image. However, one must have realistic expectations with the surgery.