Dr Atul Ingle

Breast Reconstruction

Breast reconstruction surgery aims to restore the shape, appearance, and symmetry of the breasts following mastectomy or lumpectomy due to breast cancer or other conditions.

It involves reshaping the breast, usually with the aid of an implant or flap reconstruction, from tissue available elsewhere on your body.

This surgery helps women regain a sense of normalcy and confidence after the physical and emotional challenges of cancer treatment.

When is the Surgery Performed

Breast reconstruction surgery can be performed during your mastectomy (ie: your plastic surgeon performs the reconstruction during the same surgical session as your mastectomy, once your breast cancer surgeon has finished their part of the operation) or delayed until a later date, depending on the patient’s health, treatment plan, and personal preference.

Breast reconstruction is primarily considered by women who have undergone or are planning to undergo mastectomy or lumpectomy as part of their breast cancer treatment. The decision to undergo reconstruction is personal and can be influenced by various factors, including:

  • Medical Necessity: Reconstruction can address physical deformities caused by cancer treatment, providing a more natural breast shape.
  • Psychological Well-being: Restoring breast symmetry can significantly improve self-esteem and emotional health.
  • Lifestyle and Activity Level: Active women may seek reconstruction to maintain their body image and comfort in various physical activities.

There are several options for breast reconstruction, each tailored to meet the unique needs and goals of the patient. The choice of technique depends on factors such as the patient’s health, body type, and personal preferences.

Implant-Based Reconstruction

  1. Silicone Implants:
    • Procedure: Silicone implants are the most commonly used type of implant used to reconstruct the breast. Involves placing a silicone gel-filled implant under the chest muscle or breast skin. A tissue expander may also be used in some cases.
    • Advantages: Provides a more natural look and feel. Less likely to ripple compared to saline implants.
    • Disadvantages: Requires a slightly larger incision. In the rare event of a rupture, the silicone may stay within the implant shell or escape into the breast implant pocket.
  2. Saline Implants:
    • Procedure: Involves placing a saline-filled implant under the chest muscle or breast skin. Often, a tissue expander is used initially to stretch the skin and make room for the implant.
    • Advantages: Shorter surgery time and recovery period compared to flap reconstruction. Allows for size adjustments during surgery.
    • Disadvantages: May feel less natural compared to silicone implants and have a higher risk of rippling.

Autologous (Flap) Reconstruction

  1. TRAM Flap (Transverse Rectus Abdominis Myocutaneous Flap):
    • Procedure: Uses tissue from the lower abdomen, including skin, fat, and muscle, to create a new breast. The tissue is moved to the chest area, and its blood supply is maintained by keeping it attached to its original blood vessels.
    • Advantages: Provides a natural look and feel. Can also result in a flatter abdomen, similar to a tummy tuck.
    • Disadvantages: Longer surgery and recovery time. Potential for complications at the donor site, such as abdominal weakness.
  2. DIEP Flap (Deep Inferior Epigastric Perforator Flap):
    • Procedure: Similar to the TRAM flap, but only skin and fat from the lower abdomen are used, sparing the muscle. Microsurgery is used to connect the blood vessels to those in the chest.
    • Advantages: More natural look and feel. Reduced risk of abdominal weakness compared to the TRAM flap.
    • Disadvantages: Longer and more complex surgery. Requires a skilled microsurgeon.
  3. Latissimus Dorsi Flap:
    • Procedure: Uses muscle, fat, and skin from the upper back, which is moved to the chest area to create a new breast. The tissue remains attached to its original blood supply.
    • Advantages: Reliable and versatile technique. Can be combined with an implant for additional volume.
    • Disadvantages: Can cause some weakness in the back and shoulder area. Longer surgery and recovery time compared to implant-only reconstruction.

Combination Reconstruction

  1. Implant with Flap:
    • Procedure: Combines implant-based and autologous techniques. An implant can be used along with a flap (such as a latissimus dorsi flap) to achieve better shape and volume.
    • Advantages: Combines the benefits of both methods, providing better aesthetic outcomes and a more natural look.
    • Disadvantages: Involves more complex surgery and recovery.

The Breast Reconstruction Procedure in Australia

The Breast Reconstruction Procedure in Australia
In Australia, breast reconstruction surgery is a well-regulated and widely performed procedure by experienced plastic surgeons. The process typically begins with a comprehensive consultation to discuss the patient’s goals, examine the breasts, and determine the most suitable reconstruction options.

During this consultation, the surgeon will explain the risks and benefits of each technique and set realistic expectations for the outcomes.

Patients are usually advised to:

  • Avoid certain medications, such as aspirin or anti-inflammatory drugs, which can increase bleeding.
  • Stop smoking, as it can interfere with healing.
  • Arrange for someone to drive them home and assist them for the first 24-hours post-surgery.

Breast reconstruction surgery is typically performed under general anaesthesia. The duration of the surgery can vary depending on the chosen technique and the complexity of the procedure. Implant-based reconstructions usually take less time than autologous flap procedures.

  • Implant-Based Reconstruction: Involves placing an implant after creating a pocket either under the pectoral muscle or the breast skin. Tissue expanders may be used initially to prepare the site.
  • Autologous Reconstruction: Utilises the patient’s own tissue, which is harvested from another part of the body and used to reconstruct the breast. This often involves microsurgery to connect blood vessels.
  • Combination Reconstruction: Involves both an implant and tissue from another part of the body to create a more natural and fuller breast appearance.
  • Wound Care: Patients will receive instructions on how to care for their surgical wounds to prevent infection and promote healing.
  • Pain Management: Patients may experience mild to moderate discomfort, which can be managed with prescribed pain medication.
  • Follow-Up Visits: Regular follow-up appointments are necessary to monitor healing and ensure the best possible outcome.

Recovery times vary depending on the type of surgery and the extent of the reconstruction. Most patients can return to normal activities within a few weeks.

Swelling and bruising typically subside within a few months, and the final results become more apparent as healing progresses.

The results of breast reconstruction are generally long-lasting, providing significant improvements in breast symmetry and overall appearance. Most women find that reconstruction helps them regain a sense of normalcy and confidence after cancer treatment.

Undergoing breast reconstruction surgery not only addresses the immediate physical concerns but can also provide significant psychological relief. Patients often feel a sense of reassurance and confidence knowing their cancer has been effectively treated and their breast appearance restored.

Conclusion

Breast reconstruction surgery is a safe and effective procedure for women seeking to restore their breast shape and symmetry after mastectomy or lumpectomy. In Australia, experienced plastic surgeons perform this procedure with great success, helping patients achieve a more natural and balanced breast appearance.

Whether addressing the effects of cancer treatment or congenital conditions, breast reconstruction surgery can provide transformative results.

For more information or to schedule a consultation, please contact our clinic. Dr Atul Ingle has significant experience performing breast reconstruction surgery and is dedicated to helping you achieve your aesthetic goals and enhancing your overall quality of life.

Dr Atul Ingle is a Specialist Plastic and Reconstructive Surgeon based in Townsville.

He has 20+ years of experience in plastic and reconstructive surgery and holds two Master of Surgery Degrees. He is the Head of the Plastic and Reconstructive Surgery Department at Townsville University Hospital.

If you have a question about a condition or treatment, or would like to book an appointment, please contact us and one of our friendly staff members will happily assist you.

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Dr Atul Ingle

(07) 4413 7118

47 Fulham Road
Pimlico, QLD, 4812

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