Who is it suitable for?

For women who have had their whole breast or part of their breast removed for breast cancer.

What does it involve?

Breast reconstruction is a process that takes several operations to reconstruct the breast mound, achieve symmetry or balance between the breasts and to reconstruct the nipple-areola complex.

The process of creating the mound can be started at the time of mastectomy (immediate reconstruction) or any time down the line (delayed reconstruction).

The main methods for creating the breast mound are:

• Insertion of a prosthesis (silicone implant or expandable prosthesis)
• A flap of tissue from the back, abdomen, buttock, inner thigh or flank
• Free fat transfer or lipomodelling
• Combination of the above methods

Prosthetic based procedures use either 1) a temporary expandable prosthesis that is exchanged at a later date for a fixed volume silicone implant or the patient’s own tissue, or 2) a fixed volume silicone implant that lasts 10-15 years and can be exchanged.

A flap consisting of the patient’s own skin or fat or muscle or a combination of these can be transferred from a different area based on it’s own attached blood supply (eg Latissimus Dorsi or LD flap from the back) or by joining up the tiny blood vessels from the flap itself to vessels in the breast area behind the breast bone or in the underarm area using microsurgery. A popular flap used for breast reconstruction is the DIEP (deep inferior epigastric artery perforator) flap from the lower abdomen which leaves a ‘tummy tuck’ scar and gives a soft warm reconstructed breast mound that feels like normal breast tissue while preserving the underlying muscle in the abdomen.

Lipomodelling uses a person’s own fat that is harvested from areas where there is an excess, using liposuction. The fat is processed and then injected in small packets into the area to be reconstructed. It usually requires more than one operative procedure. If more than one procedure is required, there is the option of ‘fat banking’ where the whole required amount of fat is harvested under the one general anaesthetic and subsequent fat injections are done under local anaesthetic.

Achieving symmetry between the breasts sometimes requires adjustments to the opposite breast to enhance or reduce the volume or lift the breast (mastopexy).

Nipple areola reconstruction is usually done as the final step where the areola is tattooed using medical grade pigments and the nipple projection is created with a small local flap of nearby skin and tissue or as a free graft shared from the remaining nipple or labia minora. A prosthetic nipple can be custom made to match the opposite nipple or bought ‘off the shelf’.

Frequently asked questions