Breast Reconstruction

Why have a breast reconstruction?

Breast reconstruction, rebuilding the shape of the breast, is most common after a woman has undergone a mastectomy – removal or part removal of one or both breasts.

Mastectomies are performed for a known diagnosis of breast cancer or as a preventative measure if there is an increased genetic risk to develop breast cancer.

A breast reconstruction can be done at the time of the mastectomy or at a later date – even years later.

Tissue reconstruction is typically our preferred type of breast reconstruction to undertake. This is known as a DIEP flap breast reconstruction.

How is a DIEP flap breast reconstruction performed?

A DIEP (deep inferior epigastric perforator) flap breast reconstruction rebuilds a breast shape by moving skin and fatty tissue only (no muscle) from the abdomen to the chest.

Breast reconstruction can be done using your own skin and fat. Tissue is used from your abdomen (abdominoplasty). The arteries and veins that supply this tissue are then attached to the blood supply of the chest wall via microsurgery and the transferred flap is fashioned into a breast.

A breast reconstruction is major surgery- it takes up to eight hours and requires two surgeons to do a DIEP flap breast reconstruction. Mr Rafael Acosta-Rojas (MED0001642629) Registered medical practitioner, specialist plastic surgeon (specialist registration in Surgery – plastic surgery) is a pioneer of DIEP flap breast reconstruction and practices at Australian Skin Face Body, Geelong.

Once the initial monitoring stage of the transferred flap is complete and the flap has “taken” – generally the results will just get better with time. Over the coming months the incision lines fade, the transplanted tissue blends in, softens and with time and the breast becomes more aesthetic and natural.

A further option is to undergo an areola reconstruction and this can be done using the tissue on the new breast or a skin graft from another part of the body.

The areola can be tattooed by a cosmetic and paramedical tattooist to give a natural appearance to finish off and complete the breast reconstruction process.

Typical timeline for DIEP flap breast reconstruction:

• Breast reconstruction surgery, with five to six days recovery in hospital.
• You require lots of rest for first six weeks – big recovery after a long anaesthetic and potentially double surgery- abdominoplasty as well as breast surgery.
• After six weeks, most women are able to return to work and most activities (sometimes with physical restrictions such as lifting).
• Nipple reconstruction is generally performed eight to ten months after the initial operation as a day procedure surgery.
• Areola tattooing may be performed three to four months after nipple reconstruction.
• Regular check – ups will occur following the procedure

Breast reconstruction with implants

Occasionally there may be instances where reconstruction is performed using an implant. This is a much quicker procedure, much less downtime, and a much quicker recovery than a DIEP flap breast construction.

Implant reconstructions are not generally possible for women who have had radiation treatment. They are often not a long term solution due to the nature of implants. We can discuss this further at your consultation.

What are the risks of breast reconstruction surgery?

All procedures carries risks. You need to weigh up the potential benefits with the risks.

There are two main categories of risks to consider when considering breast reconstruction surgery.

The first category of risks apply to all forms of major surgery and include: infection, bleeding and an adverse reaction to the anaesthetic.

The next category of risks which are more specific to breast reconstruction include:  delayed wound healing (including death of tissue) and, asymmetry.

Your Surgeon will discuss these risks, and how you can reduce them before and after surgery, in your consultation.