If you need a mastectomy you may be suitable for a breast reconstruction.
A breast reconstruction can take place either at the same time as your mastectomy (immediate reconstruction) or later on, after the rest of your treatment is complete (delayed reconstruction). Our surgeons use either a high-quality breast implant, or tissue from another part of your body to create a new breast shape. Your surgeon will discuss options for reconstruction with you.
It will also be discussed whether an immediate breast reconstruction at the time of the mastectomy is appropriate for you. This decision is made on an individual patient basis and will be determined by factors such as whether you want to consider any form of reconstruction, your general health and fitness, the type of breast cancer that you have, the need for other treatments such as chemotherapy and radiotherapy and whether you are a smoker. Sometimes it is recommended that the reconstruction be done as a delayed procedure after the rest of your cancer treatment has finished. If you remain fit and suitable for a breast reconstruction there is no time limit after your surgery that this has to be done by – it can be many years later if this is what you wish.
We are fortunate at MFT to have the Manchester Centre for Plastic Surgery and Burns on site. This specialist service is one of the country’s leading plastic surgery centres. Two surgeons from the centre hold joint clinics with our breast surgeons on a regular basis and are available for consultation if needed.
The main types of breast reconstruction are:
In this procedure a breast implant is placed usually underneath the pectoralis major chest wall muscle to re-create a breast shape. It will be discussed with you whether an additional internal sling or hammock is needed to give a better breast shape. Sometimes it is possible to use some of your own skin to create the internal hammock (dermal sling) or else the internal hammock suggested may be specially processed tissue that has come from an animal source (Acellular Collagen Matrix), although synthetic hammocks are also available. Your breast surgeon will advise you if this is possible. The implant that is used may be a permanent silicone implant or a water filled bag (expander) that can be adjusted in volume at clinic appointments after your procedure, and switched to a permanent implant at a later stage.
Pedicle flap based
A pedicle flap reconstruction is where part of your own tissue – often a large muscle from your back called the Latissimus Dorsi(LD) is lifted up with an area of overlying back skin which is then passed through a tunnel in your armpit to create a new breast shape. This is often done in combination with a breast implant underneath, but sometimes, if you were to have enough back tissue, an implant may not be needed.
Free flap based
For this operation you would be referred to the on-site plastic surgeons. An area of fat and overlying skin is taken often from the tummy, but sometimes from the inner thigh or gluteal (bottom) region and re-plumbed into blood vessels in your chest wall. This donated area of fat and skin is used to recreate a breast shape, no implant is usually used in these procedures. Only certain people are suitable for this operation and it has a long recovery period. Your surgeon will be able to make an assessment as to whether you would be suitable for this procedure and explain it in more detail.
If you are considering either immediate or delayed breast reconstruction you will have the opportunity to discuss all these techniques and your suitability for them with your surgeon and breast care nurse. Your breast care nurse will also be able to show you photographs of other ladies who have had similar procedures to help you make a decision as to the best type of reconstruction for you.
For further information about breast reconstruction, speak to your Consultant or Breast Care Nurse.