Breast Reconstruction Surgery
Overview
When you have to undergo Breast Cancer Surgery, your doctors also advise you to a breast reconstruction surgery to rebuild your breasts.
They can perform breast reconstruction surgery simultaneously as your mastectomy (immediate reconstruction) or at a later date (delayed reconstruction). This decision is often based on several factors, including your overall health and well-being, the type of mastectomy you have, and your personal preferences.
There are many types of breast reconstruction surgeries. The right option for you will depend on your body type, the extent of your cancer surgery, and your personal preferences. Your plastic surgeon will work with you to help you choose the best option for your individual needs.
The most preferred type of breast reconstruction surgery is breast implants. Breast implants can be placed under the chest muscle (submuscular) or over the chest (sub-glandular). Your plastic surgeon will help you decide which placement is best for you based on your body structure, age, and goals.
Everything You Need To Know Breast Cancer Reconstruction
Types of Breast Reconstruction Surgeries Include:
Diep Flap Surgery
The DIEP flap procedure, or Deep Inferior Epigastric Perforator flap procedure, is a type of breast reconstruction surgery that uses tissues from the lower abdomen to reconstruct the breast. This procedure is often chosen by women who have undergone mastectomy to treat or prevent breast cancer.
The key advantage of the DIEP flap procedure is that it uses the patient’s own tissue, reducing the risk of rejection and providing a more natural look and feel compared to implants. However, it’s worth noting that this procedure is quite complex and requires a highly skilled surgical team. Recovery times may also be longer compared to other types of reconstruction.
The DIEP flap procedure involves taking skin, fat, and blood vessels from the lower abdomen area and transferring them to the chest to create a new breast. This tissue is usually taken from the area below the belly button, as it contains an abundance of blood vessels that can be used for reconstruction. The surgeon will carefully select and disconnect these tissues before reattaching them to the chest.
One of the main benefits of the DIEP flap procedure is that it preserves the abdominal muscles, unlike other types of flap procedures which may require sacrificing them. This can lead to a faster recovery and fewer long-term complications such as abdominal weakness or hernias. The reconstructed breast also has a more natural look and feel compared to those created with implants.
Recovery from DIEP flap surgery can take several weeks, and during this time, patients may experience discomfort, swelling, and bruising. It’s important to follow the post-operative care instructions provided by the surgical team and attend any follow-up appointments to monitor progress. Physical activity should also be limited during this time to allow for proper healing.
In addition to breast reconstruction after mastectomy, DIEP flap surgery can also be used to correct asymmetry in breasts or to improve the appearance of a previously reconstructed breast. It is important for patients considering this procedure to have realistic expectations and to understand that it may not result in a perfect match with their natural breast.
Overall, the DIEP flap procedure offers an alternative option for breast reconstruction that preserves muscle and provides a more natural result. It is important for patients to discuss their options with a qualified plastic surgeon to determine if this procedure is the best choice for them. Other factors such as medical history, body type, and personal preferences should also be taken into consideration when making a decision about breast reconstruction.
It’s also important to note that DIEP flap surgery can be a lengthy and complex procedure, and it may not be suitable for everyone. It is important to have a thorough consultation with your surgeon and discuss any potential risks or complications before undergoing this surgery.
In conclusion, breast reconstruction after mastectomy is an important aspect of the physical and emotional healing process for many women. The DIEP flap procedure offers a unique option that can provide natural-looking results and improved overall quality of life. As with any surgery, it is important to carefully consider all options and make an informed decision in consultation with a qualified medical professional. So, if you or a loved one are considering breast reconstruction after mastectomy, be sure to do thorough research and consult with a trusted oncoplastic breast surgeon to determine the best course of action for your individual needs.
Latissimus Dorsi Flap Surgery
The Latissimus Dorsi Flap Surgery is another effective method for breast reconstruction post mastectomy. It involves the use of muscle, fat, and skin from the back, specifically the latissimus dorsi muscle, to construct a new breast.
The flap of tissue is tunnelled under the skin to the chest area, creating a pocket for an implant or to shape the breast itself. This method is often chosen when there is insufficient tissue in the abdomen for a DIEP flap procedure. While it may lead to some weakening in back strength, most patients do not notice significant functional loss.
However, a potential downside is the additional scar on the back. As with any surgical procedure, it’s crucial to understand the potential risks and benefits and discuss these thoroughly with a trusted surgeon before making an informed decision.
Ultimately, the choice of breast reconstruction method depends on a variety of factors, including the individual’s medical history, body type, and personal preferences. The Latissimus Dorsi Flap Surgery is just one option among several others, such as implants or TRAM flap surgery.
Pedicled Flap Surgery
Pedicled Flap Surgery is another type of breast reconstruction that involves the use of tissue from a nearby area, such as the back or abdomen, to create a new breast. Unlike other methods, this procedure keeps the blood supply attached to the flap, so it remains connected to its original location. This reduces the risk of complications and improves healing time.
While pedicled flaps can provide a more natural look and feel compared to implants, they may not be suitable for all patients. For example, individuals who have undergone previous surgeries in the abdomen or back area may not have enough tissue to use for a pedicled flap.
Additionally, this method may not be feasible for women with larger breasts as there may not be enough tissue available to create a new breast of the desired size.
Free Flap Surgery
Free flap surgery, also known as microvascular surgery, is considered the most complex and technically demanding type of breast reconstruction. It involves taking tissue from one part of the body, such as the abdomen or buttocks, and transplanting it to the chest area using microsurgery techniques to reattach the blood vessels.
This allows for a larger amount of tissue to be transferred, making it suitable for women with larger breasts or those who have undergone previous surgeries in the breast area.
While free flap surgery may result in a more natural-looking and feeling breast, it also has a higher risk of complications due to the complexity of the procedure. Additionally, this method requires longer hospital stays and recovery time compared to other reconstruction methods.
Allogeneic (donor) tissue: In this type of reconstruction, healthy tissue is taken from a donor (usually a family member) and used to create a new breast. Allogeneic reconstruction is not as common as autologous flap (flap taken from the patient’s body) surgery.
Nipple Reconstruction
In addition to reconstructing the breast mound, nipple reconstruction can also be performed to create a more natural-looking breast. This procedure involves using skin from the reconstructed breast or another part of the body to create a new nipple. Tattooing may also be used to add colour and texture, giving the appearance of a real nipple.
While nipple reconstruction may not be necessary for all patients, it can often provide the finishing touch to a breast reconstruction, helping to improve self-image and confidence. However, not all women are suitable candidates for this procedure, especially those with underlying medical conditions that may increase the risk of complications.
Acellular Dermal Matrix
Acellular dermal matrix (ADM) is a type of graft material that can be used in breast reconstruction surgery. It is derived from donated human tissue and has been processed to remove cells and other components, leaving only a supportive scaffold for new tissue growth.
ADM can be used to support the reconstructed breast mound, providing additional strength and structure. It may also help improve the overall appearance and shape of the reconstructed breast. This material is gradually absorbed by the body over time, with new tissue replacing it for long-term support.
Implant Surgery
Implant surgery is another commonly used method in breast reconstruction. It involves the use of a saline or silicone implant to replace the breast tissue that has been removed. The process may be performed immediately after mastectomy or at a later date, referred to as delayed reconstruction. Implant surgery typically involves two stages.
First, a tissue expander is inserted under the skin and chest muscle where it is gradually filled with saline over several weeks or months to stretch the skin in preparation for the implant. Once the skin has stretched enough, a second surgery is performed to replace the expander with the implant.
While implant surgery can offer a shorter recovery time than other reconstruction methods, potential risks include implant rupture, capsular contracture (hardening of the scar tissue around the implant), and changes in breast sensation.
Revision Surgery
After a breast reconstruction procedure, some women may require revision surgery to make adjustments or improvements to their results. This can include correcting any asymmetry, addressing scar tissue, or improving the overall aesthetic appearance of the breast.
Revision surgery may also be necessary due to complications or changes in a woman’s body over time. It is important for patients to have realistic expectations about the results of their breast reconstruction and understand that additional surgeries may be needed in the future.
Expanders and Implants
Expanders and implants form an integral part of breast reconstruction surgery, offering a route to regain physical symmetry and aid psychological recovery post-mastectomy. Tissue expanders function as temporary placeholders that prepare the breast area for the eventual implant by stretching the skin and muscle. This saline-filled device can be precisely controlled to expand at a comfortable rate for the patient, ensuring minimal discomfort.
The final implant, either silicone or saline, is put in place once sufficient expansion has been achieved. Silicone implants are often praised for their natural feel, while saline implants offer the advantage of adjustable size post-surgery.
Each option has its benefits and drawbacks; hence, the decision should be made in consultation with the medical team, considering the individual’s physique, health condition, and personal preferences. Patients should be aware that, while the results can be transformative, it’s a process that might require future adjustments and revisions.
Why Undergo Breast Reconstruction Surgery?
Women choose to undergo Breast Reconstruction Surgery because of various reasons. Some women feel that reconstructing their breasts will help them regain their sense of femininity and self-confidence after cancer surgery.
Others believe that reconstruction surgery will help them feel “whole” again. Still, others may want to avoid using a prosthesis (false breast). Before undergoing breast reconstruction surgery, it is essential to discuss your motivations and expectations with your plastic surgeon.
Then, they will be able to tell you if breast reconstruction is right for you and help you choose the best type of reconstruction for your individual needs.
Risks associated with breast reconstruction surgery
Breast reconstruction surgery is generally safe, but it comes with certain risks like any other surgery. The most common risks include:
- Infection: Infection can occur at the surgical site or in the breast implant. Symptoms of an infection may include redness, swelling, warmth, and pain. If you develop an infection, it will probably require treatment with antibiotics.
- Bleeding: Bleeding is a common complication of surgery. Although bleeding is controlled during surgery most of the time, some bleeding may occur after surgery. If you have heavy bleeding, you may need a transfusion.
- Scarring: All surgeries result in some scarring. The amount of scarring depends on the type of surgery performed and your healing process.
- Numbness: Numbness is a common side effect of surgery. The amount of numbness depends on the type of surgery performed. Most numbness improves within a few months to a year.
- Asymmetry: Asymmetry is a common concern after breast reconstruction surgery. One breast may appear larger or smaller than the other or have different shapes. In some cases, additional surgery may be required to correct the asymmetry.
- Changes in sensation: Changes in sensation are common after breast reconstruction surgery. There may be a loss of sensation based on the type of surgery performed and the nerves spared during surgery.
- Delayed healing: Delayed healing is a common complication of surgery. Your incisions may take longer than expected to heal. You may also have skin necrosis, which is when the skin around your incisions may turn blue, and the cells of that area may die.
- Fluid accumulation: Fluid accumulation, also called seroma, can occur after surgery. Common symptoms of a seroma include swelling and pain. If you develop this condition, it will likely require treatment that helps drain the excess fluid.
- Implant rupture: Breast implants are not designed to last a lifetime. They may break or leak over time. If your implant ruptures, you will probably need surgery to remove and replace the implant.
- Capsular contracture: Capsular contracture is a common complication of breast reconstruction surgery. It occurs when the scar tissue around the implant tightens and squeezes the implant causing pain, changes in the breast’s shape, and hardening of the breast.
If you develop capsular contracture, you may need surgery to release the scar tissue.
What to Expect After Breast Reconstruction Surgery?
After your surgery, you are closely monitored in the recovery room for a couple of hours. Once you are awake and alert, you will be discharged. Make sure you have someone drive you home and stay with you for the first few days after your surgery.
During the first week after your surgery, it is important to rest as much as possible. In the initial few days, you may have some pain and discomfort, which can be controlled with medication. In addition, your incisions will be covered with dressings that will need to be changed regularly.
You may also have drains at the incision site to help remove any excess fluid accumulation at the surgical site. These drains are usually removed within one to two weeks.
It is important to keep your incisions clean and dry. You will need to avoid strenuous activity and heavy lifting for at least six weeks. Your plastic surgeon will let you know when it is safe to return to your normal activities.
Most women are delighted with the results of their breast reconstruction surgery. The new breasts look and feel natural, and they don’t interfere with future mammograms. In addition, reconstruction surgery can help restore your self-image and confidence after a mastectomy.
If you have any questions or concerns about breast reconstruction surgery, make sure you have it all discussed with your plastic surgeon. They shall clear all your queries and help you decide whether reconstruction surgery is right for you.
Questions to ask about Breast Reconstruction
It’s important to feel comfortable asking your surgeon questions about breast reconstruction.You may want to ask about:
- What are my breast reconstruction options?
- What are the pros and cons of each option?
- How will breast reconstruction affect my overall treatment plan?
- What are the risks and complications associated with each option?
- What is the expected recovery time for each option?
- How will breast reconstruction affect my body image and self-esteem?
- Can I see before-and-after photos of previous patients?
- Will I need to have additional surgery in the future?
- How much will breast reconstruction cost?
- Do you have experience performing the type of reconstruction I’m interested in?
Your surgeon should be able to answer all of your questions and address any concerns you have. If you don’t feel comfortable with your surgeon, it’s OK to get a second opinion.
Besides asking your surgeon questions, you may also want to ask your family and friends for their support and advice.
If possible, it can be helpful to speak with someone who has gone through breast cancer treatment and reconstruction. You can also join a breast cancer support group to connect with other women facing similar challenges.
You can book an appointment with our experts to know more about breast reconstruction surgeries.
Breast Cancer
Treatments
Needle Localization
Wire/needle localization is a minimally invasive surgical technique used to locate and remove breast
Nipple Sparing Mastectomy
In this type of mastectomy, the surgeon removes the cancerous breast tissue and leaves the skin
Sentinel Node Biopsy
A sentinel node biopsy is a minimally invasive surgical procedure that determines whether cancer has
Breast Cancer Reconstruction
When you have to undergo breast cancer surgery, your doctors also advise you a breast
Breast Biopsy
A breast biopsy is a diagnostic procedure during which a small sample of breast tissue is removed
Mastectomy
When you are diagnosed with breast cancer, you will have a lot of decisions to make. One of the most
Breast Reconstruction Surgeries
There are different types of breast surgeries that are used for several breast issues and concerns.
PROFILE
About Dr. Jay Rashmi Anam
Dr Jay Anam is one of the best surgical oncologists in India. Dr. Jay is Breast Cancer Specialist in Mumbai, and he believes in world class cancer care for all the patients.
Dr. Jay Anam focuses on Breast Oncology, and his scope of work includes:
Expertise
- Breast Cancer surgeries, including Mastectomy, Breast Conservation Surgery, Aesthetic and Cosmetic Breast reconstruction–Oncoplasty to retain breast shape and size during the treatment of breast cancer.
- Sentinel Node Biopsy to limit the extent of the node dissection in early breast cancers.
- Sono-Guided and Wire- localized Breast Surgeries for screen-detected Breast Cancers.
- Flap reconstructions for advanced Breast Cancers.
- Aesthetic Breast Surgery for benign breast tumours.
Patient Treated By Dr. Jay Anam
People heavily rely on reviews from other patients when choosing a healthcare provider
Dr. Jay Anam is a warm, kind, sympathetic, and brilliant doctor who handles his patients with dignity and respect, in my opinion. He has an incredible talent for motivating his patients and inspiring them to give more than 100% confidence. "Ruma, enjoy this voyage and you will be OK!" he said, and I still remember his words. These words have struck a chord in my heart throughout my wellness voyage, and I am a warrior. Dr. Jay Anam comes across as a terrific friend, and he makes you feel at ease throughout the procedure as if you've known him for years. He is forthcoming and available 24/7 for any queries.
I got operated in Nov 2021. The word cancer can be so daunting and brings loads of stress in a patient's life. But i was fortunate that I met the right surgeon - Dr Jay Anam, post meeting him was relaxed and knew I am in safe hands. He explained the surgery in minute detail and patiently answered all my queries. Post surgery outcome was also discussed and nothing was left to guessing. He was on time for the surgery and i have to admit that the cuts and scars are minimal and it was a very clean n neatly done job. Post surgery he was always available on phone for any issue I faced. Post surgery follow up visit was also handled professionally.
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