Breast Reconstruction Surgery
A breast reconstruction is an operation to rebuild a breast. This can be a result of cancer surgery (lumpectomy or mastectomy), injury or in a breast that has never developed. The aim is to recreate the original shape and appearance of the breast and match it to the other side. This can be done at the same time as a mastectomy/lumpectomy or some time after the original surgery. As well as reconstructing the problem breast, we would also consider operating on the other breast to ensure that they are as symmetrical as possible.
A breast can be reconstructed using several techniques, depending on your wishes, how much tissue is missing and what spare tissue is available. It may involve more than one operation.
Once the breast is reconstructed a nipple reconstruction is performed, which is tattooed once this has also settled. For more information on each procedure please click on the relevant icon.
I perform the following reconstruction procedures for the breast:
Breast Reconstruction - DIEP
A Deep Inferior Epigastric Perforator (DIEP) free flap is considered to be the gold standard plastic surgical technique for breast reconstruction. This ‘autologous’ procedure involves completely detaching excess tissue from the abdomen and transferring it to the chest to create a breast. In the DIEP flap, we only take the fat roll from the abdomen with its blood supply, but completely preserve the muscle. Thus, the muscle is undamaged and continues to support the tummy as normal.
Breast Reconstruction - DIEP with VLNT
Patients who have had lymph nodes removed as part of breast cancer treatment are at risk of developing lymphoedema in their arm. Lymph node transfer is a relatively new procedure, which is proving to be very successful in the management of lymphoedema as a result of surgical removal of lymph nodes or trauma. It was originally described by French surgeon Dr Becker and has shown to be of great benefit to patients plagued by lymphoedema. I am one of the few surgeons in Europe offering this technique and have had very promising results with several years follow up.
Fat Transfer for Breast Reconstruction
Fat transfer is minimally invasive surgery. It is a scarless procedure as the fat is injected with a fine needle. Fat is harvested by liposuction in an area where the patient has excess fat. The fat is specially prepared and re-injected into the breast or mastectomy site.
As well as creating a new breast, it can dramatically soften any radiotherapy changes and improve existing scars and skin quality.
Implant / Tissue Expander Reconstruction
Breast reconstruction with implants uses an implant to replace the breast tissue removed during a mastectomy or wide local excision. If a patient has already had a mastectomy, there will not be adequate skin to cover an implant. Therefore, I will need to place a tissue expander into the breast pocket at the first procedure using either the mastectomy scar or an additional scar in the crease underneath the breast.
Latissimus Dorsi (LD Flap) Reconstruction
In this operation, skin, fat and muscle from your back is repositioned (tunneled) to the chest area, while keeping its connection and blood supply intact. The LD flap can be used alone if you only require an A or B cup, but if you are larger then a small implant is often necessary. It gives a good aesthetic result and covers the implant to reduce potential complications. It is therefore particularly useful if you have had or are going to have radiotherapy. As implants are not your own body tissue they may need maintenance in the future as for any patient with breast implants.
Local Tissue Rearrangement Reconstruction
The surgical management of breast cancer and benign breast tumours has significantly evolved over the years. It has shifted away from radical procedures towards methods that achieve complete tumour resection while preserving normal breast tissue.
This change has allowed for improved quality-of-life and aesthetic outcomes for patients. It also maintains previous oncologic safety as well as reducing the risk of lesions returning.
Mastopexy Augmentation Reconstruction
A mastopexy augmentation reconstruction is an operation designed to uplift breasts by removing loose skin and combining this with an implant to replace the breast tissue during a mastectomy or wide local excision.
The procedure is deigned to reconstruct the breast with an implant as well as making them perter and in proportion with the rest of your body. The procedure elevates the nipples to the ideal position, in the centre of the breast as well as inserting an implant. The normal breast is also elevated to match the reconstruction, and an implant can also be added as necessary.
Nipple Reconstruction
This is a simple procedure to recreate a nipple in patients who have no nipple as a result of mastectomy, trauma or congenital absence. Rearranging skin from the surrounding area creates the nipple mound. This is called a local flap. The nipple and surrounding area will be tattooed at a later stage to form the areolar. Thus there are no obvious scars from this technique. If the nipple reconstruction is performed on its own it is a local anaesthetic procedure (you will be awake) but if other work is planned at the same time, it may be done under general anaesthetic (you will be asleep). Tattooing is carried out 3 months after the nipple reconstruction, when the scars have settled.
Breast Reconstruction - Therapeutic Mammoplasty
The surgical management of breast cancer and benign breast tumours has significantly evolved over the years. It has shifted away from radical procedures towards methods that achieve complete tumour resection while preserving normal breast tissue.
This change has allowed for improved aesthetic outcomes and quality-of-life for patients, while maintaining equivalent oncologic safety and reducing the risk of lesions returning.
A therapeutic mammoplasty is designed to remove the breast tumour as part of a breast reduction or breast uplift (mastopexy). The normal breast is also adjusted to make them symmetrical.
