Breast reconstruction surgery is performed typically after a mastectomy or lumpectomy. Navigating breast cancer is challenging and can bring forth plenty of emotions. You may have just been diagnosed with breast cancer or come out of a long protracted course of chemotherapy and radiotherapy. Whichever stage you’re at, barring any further complications of cancer, rest assured that I will do everything to assist you in returning to your natural shape. You will be able to fill out a bra again, you will be able to go to the beach again, and you may even feel like yourself again.
Breast reconstruction is a complicated topic, so it may be best to understand a few things before undergoing the procedure:
1. How long after the removal of my tumour can I have my reconstruction?
You could either have your reconstruction done simultaneously with the tumour excision, or it could be done later once all your chemotherapy and radiation courses are complete. Having your reconstruction done at the same time comes with some conditions, which I will explain to you in detail at your consultation
2. I have a small tumour and big breasts. What kind of reconstruction is best for me?
If your tumour is well localised to one part of the breast, and it’s a specific type of tumour called a ductal type, you and your general surgeon could discuss removing the tumour and leaving the rest of your breast behind. But, of course, this is only possible if it completely removes all the tumours. In these cases, radiation is needed without exception.
If this happens, I will use the remaining breast and rearrange the tissue around the defect to reconstruct it using techniques similar to that of a standard breast reduction. However, you will naturally end up with a smaller breast on the tumour side, and therefore the opposite side would also need to be reduced to achieve symmetry. The procedure is called breast-conserving therapy (BCT) and will be explained in more detail at your consultation.
3. What type of reconstruction is best for a full mastectomy?
If you have a mastectomy, two options for reconstruction are potentially available - implant reconstruction or autologous (your tissue) reconstruction. These two are also often combined, but the choice is almost always dependent upon whether you have radiation or not. Depending on the type of tumour, the size of the tumour and the number of glands under your arms that have tumours, you will receive radiation. Your general surgeon will explain this in detail to you.
Generally speaking, if you have radiation, then an autologous reconstruction is preferred. The reason is that radiation destroys the blood supply to the skin. In addition, an implant is a foreign body and is prone to extrude through the damaged, irradiated skin and may become infected. If this happens, I will make use of the breast-conserving therapy technique.
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