In the majority of cases, reconstruction of the breast involves several procedures (stages).
The first stage is to create a breast mound. This can be done using your own tissues (autologous reconstruction) , using an implant or a combination of the two (composite reconstruction).
The second stage if required, usually occurs several months after the first stage (minimum 8-12 weeks). After this initial recovery period, the timing for surgery is generally determined by the patient’s motivation to proceed to the next procedure. Other factors such as the need for postoperative chemotherapy or radiotherapy will also affect this timing.
Some of the common secondary procedures include:
Replacing a tissue expander for a permanent implant
Following adequate expansion of the tissue expander in the clinic, you will be booked to have the tissue expander exchanged to a permanent silicone implant. Tissue expanders can remain in situ for months, even years but are generally more uncomfortable than permanent implants which are softer and smoother.
Enhancing symmetry of the breasts.
This may involve surgery on the reconstructed side, the normal side or both. Procedures here include
- Breast Lifting – this is done for the more ptotic (or droopy) breast.
- Breast Reduction – where the reconstructed breast is larger or smaller than the other breast, a reduction can be performed on the larger breast.
Revision of scar or contour irregularities
- Fat grafting – fat is aspirated from a donor site (inner thighs or flanks usually) and injected into areas of contour depression
- Liposuction – more pronounced areas of irregularities may be evened out with liposuction
- revision of surgical scars on the breast or donor site (abdomen/back).
Dr Teh uses the skin and tissue from the reconstructed breast to create a new nipple. Once this is healed, the areolar and the reconstructed nipple can be tattooed to match the colour of the other nipple.
This procedure if performed in isolation, can be done as a day case under local anaesthesia.