What is breast reconstruction?
Breast reconstruction is a surgical procedure to rebuild and/or reshape breasts. The most common reason for considering breast reconstruction is if you have had a mastectomy.
If you have had a single mastectomy then breast reconstruction might be done at the same time as a breast lift or reduction on your other breast, to make sure your breasts match. Reconstruction after a double mastectomy will rebuild both of your breasts.
The main outcomes from breast reconstruction is to improve the appearance of your breasts and to assist with psychological wellbeing.
Other reasons you might be thinking about a reconstruction are, if you are obviously uneven (asymmetry) or removal of a breast lump has resulted in uneven breasts.
Who is it for?
The reasons for thinking about breast reconstruction are entirely personal. Some of them may include:
- Rebuilding of the breast(s) after mastectomy due to breast cancer.
- Improvement of the breast appearance after surgical removal of breast cancer lump (lumpectomy).
- Marked asymmetry to the breasts – your breasts don’t match each other.
To gain the best outcome from breast reconstruction it is best that you:
- Have completed all cancer treatment, such as chemotherapy and radiation if required.
- Are sure your breasts have finished developing.
- Don’t smoke or have recently quit (smoking impacts recovery from this procedure).
The first step is to make an appointment to see Dr McMillan.
You will meet Dr McMillan at his private rooms in Fernbrae House, Dunedin or in Invercargill to discuss your personal goals in relation to breast reconstruction, and talk though the different options. This is an important step; not only outlining your expectations but also developing your relationship with Dr McMillan as you work together to achieve your goals.
Breast reconstruction can be performed at the same time as other cosmetic procedures such as breast lift, liposuction, breast reduction and tummy tuck (abdominoplasty). Discuss these options with Dr McMillan at the time of your consultation to decide if this is right for you.
There are many factors that will determine the best way to reconstruct your breast(s). The three main types of breast reconstruction are:
- Implant reconstruction – this uses an implant to create your breast shape. Most of the time Dr McMillan uses silicone implants to create a new breast(s).
- Flap reconstruction– using your own tissue to create your new breast. Skin and underlying muscle and tissue can be taken from your abdomen or shoulder blade area and shifted with its own blood supply to form your reconstructed breast.
- A combination of implant and flap based to create your breast shape.
Once you have decided on the best form of reconstruction for you, a date will be booked at Mercy Hospital, Dunedin to have your breast reconstruction.
For more information about breast reconstruction, please read the advice and watch the webinar of the Breast Cancer Foundation.
Breast reconstruction will involve having a general anaesthetic. Once you are asleep the procedure will begin.
The discussions you had prior to your breast reconstruction will determine the actions taken during surgery and the type of implant.
There will be surgical incisions, potentially at several sites depending on the outcomes you are seeking, and type of reconstruction that will take place.
You will likely have small drains placed at the breast surgery site(s) to remove any excess fluid over your hospital stay.
Your new breasts will have dressings applied and be supported with a surgical bra. If you have any ‘donor’ sites these will also be covered in dressings and reviewed prior to you leaving hospital.
The length of stay in hospital after breast reconstruction will depend very much on your own operation, but is usually 2-3 days.
Any drains and bandages will be removed before you leave hospital, but the surgical bra will be your friend for about 2 weeks after surgery while swelling and bruising goes down.
Although movement will be essential during your recovery, there will be a limit to your bending, lifting and exercise for the first few weeks. Depending on the type of work you do you may need between 2-4 weeks time off for recovery.
As the surgery site begins to heal your ability to move and exercise will increase, and at 4-6 weeks it is expected you will be back to normal activity levels, although if you have a flap-based procedure this might be longer.
Breast reconstruction gives you a relatively good immediate sense of how your breasts are going to look. As soon as you wake up from surgery, the overall size and shape will can be seen, even underneath the bandages.
However, it is expected that around 6 weeks after surgery, when most of the swelling will have gone down that you will have a really good idea of what your new breasts will look like.
You will have some scars from this procedure on your breast(s), as well as any donor sites if you had any. They will fade over time and at 6 months after breast reconstruction the final results will be clear.
Risks and complications
As with all surgical procedures there are risks and potential complications with breast reconstruction surgery. Dr McMillan will discuss all of these with you during your consultation and answer your questions.
There is a cost for breast reconstruction done privately. The exact figure will depend on a range of factors but generally the cost is between $10,000 and $35,000 (including anaesthetic and Hospital costs). Breast reconstruction will generally be funded by insurance.
Start the journey of reconstruction; get in contact to make an initial consultation with Dr McMillan about breast reconstruction.