Breast Reconstruction 2020-03-22T22:51:00+00:00
– ACADEMIC, SCIENTIFIC, CREATIVE –

Breast Reconstruction

WHAT IS A BREAST RECONSTRUCTION?
Breast reconstruction is the restoring the form of the breast after malignant or benign breast disease.

BREAST CANCER
Breast cancer is a common condition, affecting women of all ages.  With major advancements made in the last years, breast cancer is a very treatable disease with good outcomes.

Simply stated, breast cancer is the uncontrolled growth of breast cells.

Breast cancer differs by individual, age, and the type of cells of the breast.  Treatment varies depending on the size, type and stage of the disease.  There are different types of breast reconstruction depending on the extent of the tumor and the patients’ individual preferences.

WHAT IS A MASTECTOMY?
A mastectomy is the removal of all the breast tissue of the breast. Mastectomies nowadays preserve the skin (skin sparing mastectomies) or preserve the nipple as well (nipple-sparing mastectomy). By preserving the breast envelope, the aesthetic outcome is superior when performing the breast reconstruction.

BREAST RECONSTRUCTION TIMING
Breast reconstruction can be done during the same time as your mastectomy (immediate reconstruction), or it can be done weeks, months or even years after your mastectomy.  This is known as a delayed reconstruction.

WHAT TYPES OF BREAST RECONSTRUCTIONS ARE THERE?

There are different ways to reconstruct your breast.  The method you and your surgeon choose will be based on different factors:

  • Your health and lifestyle
  • Your body type
  • Your breast size
  • Your personal choice
  • The extent of the tumour and remaining skin and tissue
  • Radiation therapy

Breast reconstruction can be done using your own body tissue, or by using implants or a combination of both.

    1.  Autologous breast reconstruction (own tissues)

When using your own tissues to reconstruct the breast, a flap (piece of tissue with its own blood supply) is harvested from a different area of your body and used to re-create a new breast. Donor areas include the abdomen (tummy), buttocks, thighs and sometimes the back. Using your own tissues creates a life-long, natural feeling breast.

During a mastectomy the breast surgeon removes the breast tissue leaving a thin layer of skin envelope.  An implant is inserted into the breast pocket to recreate the breast.

This can be done in either a single-stage or a 2 -stage procedure.  This depends on the amount of skin, and the quality of the skin left behind after the mastectomy.

Implant based reconstructions are a good option in patients who don’t need radiation therapy and don’t have enough tissue for an autologous breast reconstruction.

    2.  Implant based reconstruction

During a mastectomy the breast surgeon removes the breast tissue leaving a thin layer of skin envelope.  An implant is inserted into the breast pocket to recreate the breast.

This can be done in either a single-stage or a 2 -stage procedure.  This depends on the amount of skin, and the quality of the skin left behind after the mastectomy.

Implant based reconstructions are a good option in patients who don’t need radiation therapy and don’t have enough tissue for an autologous breast reconstruction.

    3.  Nipple and Areola Reconstruction (NAC)

The final stage of breast reconstruction is the NAC reconstruction.

The nipple is created from a local flap from the breast.  It can also be created from sharing a nipple from the contra-lateral breast.

The areola is created from a medical tattoo, with a very natural looking result.

FAT GRAFTING OF THE BREASTS IS A VERY USEFUL ADJUNCT TO ANY TYPE OF BREAST RECONSTRUCTION, AND IS USUALLY DONE IN THE SECOND AND THIRD STAGE.

Dr Dimitri Liakos is a member of the College of Plastic and Reconstructive Surgeons of South Africa and a member of the Association of Plastic, Reconstructive and Aesthetic Surgeons of South Africa (APRASSA).

He is a member of the World Society of Reconstructive Microsurgeons (WSRM) and the International Society of Aesthetic Plastic Surgeons (ISAPS).