If you’ve been through breast cancer and cancer treatment, you’ll know that it can have a huge impact on your physical, mental and emotional health.
Many women who have been diagnosed with breast cancer require a mastectomy. Breast reconstructive surgery aims to rebuild your breast or breasts after a mastectomy — helping you to regain your original appearance as much as possible and feel more like yourself again.
Breast reconstruction surgery can often feel like a turning point for women who have suffered from breast cancer, bringing confidence and normality back into their lives.
What is breast reconstruction?
Breast reconstruction is surgery to make a new breast or breasts after mastectomy, double mastectomy, or lumpectomy.
If you’ve been treated for breast cancer, it may result in partial or full removal of the breast. Breast reconstruction surgery can rebuild breasts and match them as closely as possible to the original, natural breast. You may have surgery to reconstruct both breasts or to rebuild one breast and shape it to match the other. Your breasts will be a similar shape and size to before.
There are many different types of breast reconstruction and techniques used. The right one for you will depend on a few different things.
Breast reconstruction can be done at the same time or straight after your cancer surgery (immediate reconstruction) or afterwards (delayed reconstruction). Delayed reconstruction can take place months or years later surgery.
Breast reconstruction surgery is a very personal choice. Some people choose to have this surgery after cancer treatment, but there are plenty of people who don’t. For those that choose it, reconstructive surgery can feel like a turning point in their cancer journey and help them to move forward.
Types of breast reconstruction
There are several types of breast reconstruction. The right type of reconstruction for you will depend on a few different factors, such as the type of surgery you’ve had, and the size and shape of your breasts.
Not all methods of reconstruction are suitable for everyone — or there may be a reason why one type of breast reconstruction is better for you. Your surgeon will be able to go through your options with you and suggest the best route for you.
Body tissue or ‘flap’ reconstruction
Body tissue reconstruction — also known as autologous or ‘flap’ reconstruction — uses tissue transplanted from another part of your body to rebuild the breast.
This tissue includes skin, fat and sometimes muscle, which is used to make a new breast. The tissue may be taken from the lower abdomen (TRAM or DIEP flap), buttock (SCAP flap), inner thigh (TUG) or back (LD flap).
Body tissue reconstruction is more difficult to perform and will leave more scarring than other types of reconstruction. However, they will give a more natural feel to breasts and don’t typically cause any issues long-term.
Implant reconstruction uses an implant to replace all or some of your breast tissue. This operation involves inserting a silicone gel or saline (saltwater) silicone balloon to recreate the shape of the breast shape after removal.
Implant reconstruction is much simpler than other types of breast reconstruction and also causes less scarring. However, they are more prone to problems over time than body tissue reconstruction and can require additional surgery to correct any issues.
Implants may be inserted above or below the chest muscle, or a tissue expander used first to gradually stretch your skin before implants are inserted. Sometimes, a combination of an implant and your own body tissue is used.
Implant reconstruction is not always possible, such as if you’ve had radiotherapy.
Oncoplastic surgery (or oncoplastic lumpectomy)
When only a small amount of breast tissue has been removed, oncoplastic surgery may be used. This will be if you have had a lumpectomy, rather than a mastectomy, in which only the tumour and some surrounding tissue is removed.
This type of reconstruction reshapes the remaining breast tissue to fill the space left behind. Sometimes, the indentation may be filled by injecting fat, which is taken from the lower part of the abdomen.
This type of breast reconstruction usually combines reconstructive techniques with lumpectomy surgery at the same time, which is why it is sometimes called oncoplastic lumpectomy.
Breast reconstruction surgery focuses on the rebuilding of the breast. The majority of the time, this means there will be no nipple, unless you have a nipple-sparing mastectomy.
There are a few options for nipple reconstruction — either having a nipple made from your own body tissue, having a nipple tattoo, or using a stick-on nipple.
If you’re having reconstructive surgery on one breast, your surgeon will always aim to make your new breast match your other as closely as possible. However, in some cases, you may wish to have breast asymmetry surgery on your other breast too, to ensure they match. This may be to make the breast smaller or larger or to lift it to avoid drooping.
Breast reconstruction recovery
Breast reconstruction recovery can vary from person to person, and will also depend on the type of breast reconstruction surgery you have.
Typically, you will need to stay in the hospital or centre you’ve had your surgery in for as long as a week. This will allow your healthcare team to keep an eye on how you’re getting on and make sure that your breasts heal. During this time, you may need to wear a surgical bra or bandages to support your breasts as they heal and reduce swelling.
On leaving, your surgeon, doctor or healthcare team will give you guidance to follow on how to manage any pain after your surgery and look after yourself. They may also prescribe you medication to control the pain.
Breast reconstruction recovery time
Everyone’s breast reconstruction recovery time is different. Recovery time after breast reconstruction will vary depending on the type of surgery you have, your general health, and other factors.
With any surgery, you’ll probably be quite tired and sore for a few weeks afterwards, which is very normal. Swelling and bruising may not go down for a few months as your breasts heal.
You’ll need to avoid certain activities such as lifting and exercising for a while to give your body time to heal. Most people can start to get back to ‘normal’ activities within six weeks to two months after their surgery.
The type of breast reconstruction you have can affect your recovery time. Implant reconstructions typically heal quicker than flap reconstruction.
Your healthcare provider or team can give you guidance on when it is best to get back to the activities you enjoy and how long your recovery time should last.
Breast reconstruction complications and risks
As with all surgical procedures, there can be some risks.
There is a small chance that you may experience breast reconstruction complications such as:
- A difference in breasts if you are having both breasts reconstructed (such as differences in size, shape, firmness or nipples)
- Blood clots (more likely to occur following certain methods of flap reconstruction)
- Breasts that are a different size or shape. One may feel more firm than the other. The nipples and areolas may not be symmetrical.
- Infection or poor wound healing
- Necrosis (death) of transplanted tissue after flap surgery
- Problems with implants in the cases of implant reconstruction (such as wrinkling, rippling and ruptures in the implant)
- Problems with the donor site after flap reconstruction (such as weakness, pain, sensitivity or loss of sensation)
At The McIndoe Centre, we do everything we can to minimise the risk of breast reconstruction complications. Your surgeon will talk to you about any possible specific complications before you decide to have your operation.
Breast reconstruction surgery at The McIndoe Centre
Breast reconstruction can rebuild breasts matching them as closely to the original, natural breast, helping you to feel more confident and comfortable.
We offer breast reconstruction surgery tailored to your individual requirements. To get a better understanding of what the procedure is like from a patient’s point of view, take a look at Helen’s breast reconstruction journey.
Our team is more than happy to answer any questions you may have regarding breast reconstruction surgery — make an enquiry to arrange a consultation and speak to one of our specialist breast reconstruction surgeons today.
Alternatively, you can call our free helpline for more information and professional advice on 01342 488054.