Breast reconstruction surgery

Breast Implant Reconstruction

Breast implant surgery is often contemplated by women who are not happy with the size and shape of their breasts. However, this is not always the case. There are many women who are recommended for breast implants as they have had surgery which requires their breasts to be reconstructed.

The most common reason a woman requires breast reconstruction surgery is if she has undergone treatment for breast cancer that has resulted in a mastectomy (removal of the breast).

Some women who are considered as high risk for contracting breast cancer may also opt for a mastectomy even if their breast tissue is currently healthy, especially if they are found to have a genetic mutation such as BRCA 1 or 2.

As a result, there is a need for surgeons to help women look and feel happy and confident with their bodies following the decisions they make and the future risks posed.

The location of the implants in breast implant reconstruction

With a ‘normal’ breast augmentation, women can choose where the implant is inserted. It can either go underneath the pectoral muscle (this gives a softer look and feel to the breasts but is a more complex operation) or they can go on top of the pectoral muscle (this gives a firmer, more rounded look to the breasts and is an easier operation to conduct).

When breast implant reconstruction is performed after a mastectomy in one breast, then the procedure is dictated by the breast you are trying to match. If you have undergone a double mastectomy then implants are typically placed underneath the pectoral muscle and the procedure may be combined with lipofilling to smooth the area and ensure the most natural and aesthetically pleasing look possible.

When will a breast implant reconstruction be performed?

Some women will choose to have implants inserted at the same time that the mastectomy (breast removal operation) is carried out. As soon as the surgeon has removed the affected breast tissue, the implant is inserted into the space vacated by the natural tissue. This means that the overall surgery will be slightly longer, but you will only undergo one operation. This approach is known as ‘immediate reconstruction’.

Others may choose, or be recommended, to stagger their operations. First, the mastectomy is carried out and then the implants are added at a later date. If that approach is taken then we may insert a temporary tissue expander which slowly stretches the tissue of the chest wall to a suitable size and shape. The tissue expander keeps the space available for a permanent implant to then be inserted at a time following the first operation. The delay can be due to the need for follow-up treatments such as radiotherapy, or if tissue from another area of the body is planned to be used in the future to complete from another area of the body to complete the reconstruction process.

Breast implant reconstruction can be an excellent procedure, particularly for younger patients, but it is important for them to understand they are then committing to a lifetime of implant surgery, particularly as capsular contracture can be more of an issue for breast reconstruction patients.

In some cases, fat transfer or lipofilling can be a preferred, more natural alternative or as an adjunctive procedure, although a number of procedures may be required to produce the desired volume. All of this will be discussed in full before going ahead.

What my patients say about me

Having had the upset of being diagnosed with breast cancer and having opted to have a skin and nipple sparing double mastectomy, I was very keen to ensure that the cosmetic result that would be achieved when replacing the expander implants for permanent ones was as good as humanly possible.

I am a very fussy individual and after much research, I narrowed down my search to three top plastic surgeons. Two in the UK and one in the US. Mr Ramsey was the last of the surgeons I saw. His approach was very different to the others: he did not seem to think that I had ‘to make do’ with the result I had because I was a cancer patient who had had a double mastectomy.

I had two consultations, and he was incredibly thorough, patient and kind. He explained everything in great detail and never made me feel that I was asking too many questions (I always do!).

He was careful to manage my expectations. Frankly, there was no need. The result is near perfection, and this is not a qualified statement. Even if I had elected to have breast surgery for aesthetic rather than medical reasons, I would be completely delighted with the result. Mr Ramsey is a genius!

Mrs A BrakeBreast Reconstruction After Double Mastectomy