Types and Methods of Breast Reconstruction Surgery

Breast reconstruction is the term used for any type of rebuilding of a woman's boobs (occasionally men) to create a natural look and feel.

It can also involve creating a nipple and surrounding areola as part of the procedure.
There are two main methods used for breast reconstruction; implants and by using tissue taken from other parts of the body.

Following breast removal surgery, patients will be advised, and in some cases can choose whether to have reconstruction straight away or wait for another time. These two options are known as immediate and delayed reconstruction respectively.

There is little evidence to suggest one is more beneficial than the other and often comes down to preference of the patient or a surgeons advice based on the current health and wellbeing of the patient.

However, in some patients delayed reconstruction can sometimes be more difficult to perform as tissue is often required to be taken from other body parts to achieve the best possible outcome.


Common Methods of Breast Reconstruction

There are a couple of different methods that surgeons use for performing breast reconstruction. Including:

- Expander Implant

The expander implant method is one of the most common in Manchester and the rest of the UK. A surgeon places the expander implant beneath the chest wall and injects salt water solution via a tube over a set period of time. This technique expands the tissue and skin to the required size before final permanent implant placement.

- Back Tissue Reconstruction

Back tissue reconstruction is performed by using the tissue from the patients back known as the latissimus dorsi muscle. The large flat back muscle can be the 'donor site' of the tissue with affecting the function of the muscle itself. This method is sometimes used in conjunction with an implant depending on the breast size.

- Stomach Tissue Reconstruction

A stomach tissue reconstruction is when a portion of skin, muscle and tissue from the abdomen is taken from the patient and transplanted in to the breasts. Whilst this technique is performed less often due to its challenging nature, some patients prefer it as it is often performed at the same time as abdominplasty. In addition, a large section of tissue can be used, which means larger breasts can be constructed without the use of implants.

- Direct Implant

A direct implant reconstruction is when a final permanent implant can be placed in to the breast immediately following removal. Providing the area is suitable after mastectomy, a patient may prefer the direct implant method as it can have less physiological effects on their mental health, especially if only one breast is removed during surgery.

- Nipple Reconstruction

Although in some mastectomy procedures the nipples can be preserved, they are often removed along with the breast tissue during the operation. However, a nipple can be reconstructed using tissue from other parts of the body and tattoo is used to create the surrounding areola.

At the Manchester Private Hospital, our staff understand that some patients find breast reconstruction difficult and awkward to talk about. However, if you have any questions, regardless of nature, we are on hand to provide the answers you could be looking for. Our pressure-free environment puts you in control of your body and your decisions to make informed choices on what is best for you at all times.

Call us today for advice on 0161 507 8822.

How Long Does It Take To Recover From Breast Reconstruction Surgery?

As part of a consultation with a specialist breast surgeon, patients can find out everything there is to know about breast removal procedures and recovery.

Patients should know and if not be informed about the possible side effects and surgical risks as it will allow them to be aware of what to expect and how long recovery will take.

As with all surgical procedures, there are some risks associated with reconstruction surgery and post operation side effects.

Despite the risks of this procedure being relatively low, we outline both the short and long term complications that all patients should watch out for.


Short Term Complications

Short term breast reconstruction complications that occur during surgery or shortly after include:

- Bleeding

- Infection

- Fatigue

- Anaesthetic reaction

- Blood clot

- Pain / Swelling caused by liquid build up.

Longer Term Complications

Longer term complications that patients need to be aware of in the following weeks/months include:

- Loss of breast / nipple sensation

- Asymmetrical breasts

- Loss of strength from muscles

- Numbness

- Implant changes caused by moving or leakage

- Capsular contracture; an immune response to implants, which can tighten and cause pain.

Feeling Yourself After Surgery

When a patient undergoes surgery, there is always a period of recovery that takes place.

Following a breast reconstruction procedure, you will stay in hospital for a few days until your surgeon discharges you. You will most likely have a drain in place to ensure fluid is removed from the area where you had surgery. Each patient is different and your surgeon will see you for regular check-ups to determine when the drain can be removed based on the fluid build-up.

You will be expected to rest for up to 2 weeks and may feel some pain and tiredness during this time. Implants and tissue transplant procedures can affect all patients in different ways. So it is important to listen to your body and do what is best for you at the time.

After the initial recovery period, most patients report that they resumed normal day to day activity after two months and started to feel themselves again after four to six weeks.

Below we outline some points on what to expect and when to expect it. It is important to not get false-hope and ensure that your expectations are unrealistic throughout breast reconstruction recovery.

- Following breast reconstruction, the feeling is often never the same as before the procedure, although some sensation may return over future months/years.

- It is normal for patients to experience swelling and bruising for up to two months.

- Scars can take up to two years to fade and may always be visible to some extent.

- Some bra types may not be suitable following surgery as they can irritate the skin and scars.

- Strenuous activity should be avoided for a minimum of four weeks. However, your surgeon will be able to provide personal advice based on your individual needs and the surgery undergone.

- Give yourself time to process the procedure both emotionally and physically. Talking with other patients who have experienced the same as you can help deal with anxiety and depression.

- Keep an eye out for any changes to your skin and surgery site (breasts) along with changes and feelings in your arms.

Do I Need to have Mammogram Screening?

In most cases, patients who have had a breast removed do not need to have mammogram screenings on the removal side as usually most, if not all of the breast tissue has been removed.

However, the other breast will still require screening and a specialist will be able to advise on a case by case basis whether any cancers are likely to affect any remaining tissues.

Furthermore, if you have a breast implant, mammograms will still be required to screen the remaining tissue beneath or above the implant.

If you have any questions or doubts relating to breast reconstruction surgery, call us today on 0161 507 8822. Our friendly, specialist breast team are on hand to help you cope with any stress that comes with reconstruction decisions. To know more about breast reconstruction surgery, please visit: https://www.manchesterprivatehospital.co.uk/cosmetic-surgery/breast-reconstruction-surgery/

What To Expect from Breast Reconstruction Surgery and How A Tissue Expander Works

If you are undergoing surgery for breast reconstruction due to mastectomy, then your surgeon will be able to advise on the options available to you based on your body and circumstances.

For example, the amount of skin and tissue often determines whether you can have immediate reconstruction or whether it is advised that you wait for 'delayed' breast reconstruction.

When undergoing immediate breast reconstruction, an implant can usually be inserted straight away. This means that there is enough tissue and skin to accommodate the implant so that it looks natural in shape and size.

If during your mastectomy a large amount of skin and tissue were removed, or if you're opting for delayed reconstruction through choice, then your surgeon will look to place an expander under your skin where the breast has been removed.


What Is An Expander?

A breast tissue expander is a type of implant, similar to a balloon, which is placed under the skin and on top of the chest muscle.

The expander stretches the skin over time to make room for the final breast implant.

An expander implant will start in a deflated state when it is inserted, and your surgeon will add fluid to increase its size. The fluid is usually salt water and will be increased over a period of six months.

This time period gives the skin enough time to stretch and accommodate the breast implant.

Mastectomy with insertion of an expander takes around four hours to complete.

If you wish to leave having the expander inserted until a later date, this is also possible but you should seek tailored advice from your surgeon regarding the condition of your skin and tissue.

Some patients still find it possible to have an expander inserted some years later. Although there is a chance that more healing and scarring will have taken place at the surgery site.

In order to stretch the skin further throughout the period of six months, your surgeon will inject saline solution in to the expander. During and after each injection patients sometimes report a feeling of pressure and some pain afterwards. This tends to subside within 24 hours.

Following the process of stretching the skin, you will then be able to have your final permanent implant inserted in place of the expander. This is performed around one and a half months after the last saline injection.

Replacing the expander with an implant can take around one to two hours.

If you are undergoing radiation therapy, then it is possible to still undergo with an expander in. In fact, some surgeons prefer it to be in place as it creates an opportunity to remove scarred tissue from radiation before final permanent implant placement.

However, each case is evaluated on an individual basis and speaking with your surgeon will allow for better judgement.

Furthermore, you will also be able to seek advice on recovery and aftercare.

After breast reconstruction surgery, you will be given an aftercare plan that will help with recovering both physically and emotionally. Exercises are required to reduce stiffness and prevent the build up of too much scar tissue.

For patients who undergo mastectomy with implant placement you can expect to rest and take things easy for 6-8 weeks post operation. However, during this time you will still be advised to perform mild exercises to aid recovery.

For patients who are advised or opt for delayed reconstruction, it is often performed as an outpatient procedure and no overnight may be required. Recovery for delayed reconstruction can vary between 2-4 weeks.

If you have any questions or would like further information, call today on 0161 507 8822. and a friendly member of our team will speak with you in a calm and pressure-free manner. To know more about breast reconstruction surgery, please visit: https://www.manchesterprivatehospital.co.uk/cosmetic-surgery/breast-reconstruction-surgery/