Breast reconstruction

Breast reconstruction is surgery to build a breast shape when a mastectomy has been performed. This can be made using tissue taken from another part of your body, using a breast implant or a combination of both. Women may choose to use a false breast (prosthesis) instead. Breast reconstruction may be performed at the same time as the initial operation (immediate reconstruction), or a few months, or even years afterwards (delayed reconstruction). There is no time limit on when this surgery can be done.

Surgery on the normal (other) breast can be performed to try and match your natural breast to the breast reconstruction.

Here is an overview of just some of the techniques which can be used in breast reconstruction:

  • Skin sparing mastectomy: the breast tissue and nipple are removed but the skin is preserved. This allows for a more natural result with less scarring.
  • Reconstruction using implants: an implant is placed under the skin and muscle that covers your chest to create a breast shape.
  • Reconstruction using your own tissue: skin, fat and muscle are taken from another part of your body to create a breast shape.
  • Combination of both implant and your own tissue: a breast shape is created using both an implant, and skin, fat and muscle from another part of your body.

Recovery after reconstruction may take longer than a lumpectomy or mastectomy alone as this is bigger surgery.

 

For further information on breast reconstruction please visit www.macmillan.org.uk.

·         Lipomodelling or Fat transfer – where fat is removed from under the skin of the abdomen and then carefully injected around a breast reconstruction, or previously operated upon breast, to smooth-out a contour or add some volume.

·         Breast reduction – to achieve symmetry with the other breast after breast cancer treatment

·         Breast augmentation – to achieve symmetry with a breast reconstruction after mastectomy.

·         Nipple reconstruction: usually takes place six months or more following breast reconstruction to allow the breast to settle and the nipple to be positioned accurately. It can usually be performed under local or general anaesthetic.

·         Nipple tattooing: This can be done to give the appearance of a nipple and areola on a breast reconstruction. It can also be used to add colour to a nipple reconstruction. Abscesses: most abscesses are managed with needle-drainage in the breast out-patient clinic. Rarely, surgery is usually required to drain large, deep breast abscesses.

·         Benign breast lumps: surgery to remove non-cancerous lumps from the breast.

·         Gynaecomastia: surgery to remove the excess breast tissue.

These operations are all performed under a general anaesthetic. The majority are performed as a day case procedure. Patients having reconstructions with implants or having a therapeutic mammaplasty generally stay in hospital for one night. Patients having a reconstruction using the tissue from the back (Latissimus Dorsi reconstruction) usually stay for about three nights.

Further information about what to expect after your Breast operation at Royal Bolton Hospital can be found in this patient information leaflet:

http://intranet.boltonft.nhs.uk/Interact/Pages/Content/Document.aspx?id=11055&SearchId=993682

This Breast Cancer Now leaflet has general information about what to expect about before and after having a breast cancer operation:

https://breastcancernow.org/sites/default/files/publications/pdf/bcc151_your_operation_and_recovery_2018_web.pdf

Breast cancer surgery can affect your arm and shoulder movement. You will usually be recommended to do arm and shoulder excercises from the first day after your operation. This will be discussed with you at your pre-op assessment appointment and by your breast care nurse. A post-op exercise programme can be found here: https://breastcancernow.org/sites/default/files/publications/pdf/bcc6_exercises_booklet_2019_web.pdf

Non-cancer operations at Bolton FT

Aesthetic or cosmetic surgery can only be performed if individual funding has been approved by your Clinical Commissioning Group (CCG). In general, funding is only approved if exceptionality can be demonstrated. Your GP can apply for funding for you, or your GP can refer you to the Complex breast clinic where potential options can be discussed and, if appropriate, an application for funding made.

Where funding is in place, our team can deliver breast reduction surgery, correction of congenital asymmetry, breast augmentation and correction of gynaecomastia.