TREATMENT TIME: 3-58HOURS
LONGEVITY: Changes in natural breast will be different than the other breast.
RECOVERY TIME: 6-18 WEEKS
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Everything you need to know about Breast Reconstruction
What is Breast Reconstruction?
Breast reconstruction is the rebuilding of a breast after removal of the breast or part of the breast during mastectomy or lumpectomy.
It is also known as reconstructive mammaplasty or postmastectomy surgery.
Why do people have Breast Reconstruction?
Breast reconstruction is most commonly performed on women who have undergone either a mastectomy, where one or both breasts have been removed, or lumpectomy, where a part of the breast tissue has been taken away. This could be as a result of a cancer diagnosis to remove the breast or the tissue that is deemed to be putting your health at risk, or it could be a preventative measure for those women who are diagnosed as carrying the BRCA1 gene and therefore have a high likelihood of developing breast cancer.
Whilst breast reconstruction is designed to restore the physical appearance, for many women, this is a key part of their recovery, helping them to regain their self-esteem and improve body image.
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How much does it cost?
This procedure usually cost between £3,500 – £10,000+ plus the cost of any consultations or follow-up care that may not be included in the price.
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You may be able to get your breast reconstruction surgery with NHS. The starting point is for you to have an appointment with your General Practitioner (GP) who will undertake a full clinical assessment and advise whether you can have surgery at the NHS.
If you choose to go private, we can help you spread out the cost of your treatment.
What are the key drivers for Breast Reconstruction cost?
Breast reconstruction costs can widely vary depending on the surgeon’s experience, the type of procedure used, the type of breast implants used, anesthesia, the geographic location and operating room facilities.
Generally, higher surgeon experience and location in an area with a high cost of living, would generally mean higher costs. At the same time, higher experience may translate into lesser risks for you.
The cost of the surgery also varies depending on how the surgery is conducted and the type of implants used. Fat Transfer based reconstruction can be costlier than implants based reconstruction. In Implants based reconstruction, silicone implants are more costly than saline implants and gummy bear implants are most expensive of the silicone implants.
Am I a good candidate?
Past medical history and current stage of treatment decide whether you are a suitable candidate. Naturally your general fitness is always reviewed, as you will need to be strong enough to undergo reconstruction. Any serious health problems, such as heart disease or autoimmune diseases, can increase the risk during the surgery and can complicate recovery. Your surgeon will discuss your past medical history in determining whether this surgery is suitable for you.
Timing wise, if you are undergoing or planning to undergo chemotherapy or radiation treatments, it is usually advised to postpone reconstruction. However, there are two key options which should be weighed up.
Firstly, you can undergo ‘immediate reconstruction’, which is where you have the surgery to reconstruct in the same surgery session as the mastectomy. In this case, the cosmetic result is often better as more of the skin of your breast can be preserved and scarring is reduced. Whilst it may feel overwhelming to have two key procedures at once, many women prefer the combined recovery period and just the single hospital stay. Not to mention, for many, the fact they are never without a breast helps them to keep their physical identity intact.
‘Delayed reconstruction’ is the second option, with the surgery carried out weeks, months or even years after the initial mastectomy. In some cases, immediate reconstruction isn’t deemed appropriate, usually because of the need for further treatment. In this scenario, your cancer treatment can proceed without any delay, and having two shorter surgeries can mean recovery is less intensive. However, this format does require some time spent without breast(s) which can have a significant impact on confidence and self-esteem.
Finally, it is very important that you are in good health, have a positive attitude and realistic expectations, before undergoing this procedure.
What are my options?
Breast reconstruction can be done either by inserting a breast implant (implant reconstruction) or by using tissue from another part of your body to create a new breast (flap reconstruction).
In flap reconstruction, a flap of patient’s own tissue is used to provide coverage or replacement of the radiation-damaged tissues with healthy, non-irradiated tissue.
In implant reconstruction, in the first stage, a tissue expander is inserted to expand the breast mound to reach the size required for the implant (usually within six to 10 visits). In the next stage, the expander is removed and replaced with a breast implant.
How long does the surgery take?
Preparation for the procedure, including getting anesthesia, may take 2 hours. Once it begins, the reconstruction will take anywhere from 1 to 6 hours. After your procedure is completed, you will be taken into a recovery area, where you will continue to be closely monitored.
Flap reconstruction surgeries usually require a hospital stay of one to six nights, depending on your general health, the type of flap procedures performed, the blood supply to that flap and how your recovery progresses.
Is Breast reconstruction painful?
Breast reconstruction surgery is not painful as it is generally performed under general anesthesia (although local anesthesia or intravenous sedation may be desirable in some instances). When the anesthesia wears off, you may have some pain and feel discomfort after your surgery. This can be controlled with medication. If the pain is extreme or lasts long, please contact your physician.
Are there any risks I should look out for?
All surgical procedures have some degree of risk. Fortunately, with breast reconstruction, significant complications are infrequent.
Some risks specific to breast reconstruction are outlined below:
- Scar: If you have a delayed reconstruction, your surgeon will remove most of the breast skin through a long incision across your chest. The resulting scar is permanent. While the the implant or tissue flap is placed through the mastectomy scar, the scar remains on the reconstructed breast, but grows pale over time. If you have an immediate reconstruction, most of the breast skin is preserved to hold the implant or tissue flap and mastectomy incisions may be hidden in the inframammary fold under the breast or around the areola. Flap reconstruction does leave a lengthy scar at the donor site, but these scars become less noticeable over time, but never disappear completely.
- Capsular contracture: As part of natural healing process, a capsule forms around the implant. However in some cases this capsule tightens and compresses the implant distorting the breast shape. In such cases the surgeon performs another surgery to either replace or remove the implant.
- Implant rupture: In some cases, breast implants may rupture due to surgical technique, trauma or fatigue. Ruptured silicone implants can cause breast pain or changes in the breast shape. In such cases the surgeon performs another surgery to either replace or remove the implant.
- Cancer: In some cases women may develop ALCL, a lymphoma, adjacent to a breast implant. Breast implant associated ALCL is very rare and is highly treatable in majority of patients.
- Mammography shadows affecting breast cancer detection.
- Breastfeeding: Breast implants are placed either above or below the pectoral muscle. Placement of the implant underneath the pectoral muscle may interfere less with breastfeeding.
How do I find a surgeon I can trust for my breast reconstruction?
Choosing your surgeon is a hugely important step. This is THE person who is going to help you achieve the change you want and trusting in their abilities is key. Here are the three top things to consider when making your selection:
Breast augmentation should be done by a Plastic Surgeon who has a FRCS (Plast) or FRCS qualification and should be on the Uk’s General Medical Council (GMC) specialist register for plastic surgery. This ascertains that your cosmetic surgeon has received six years of training in plastic surgery on top of their general medical training.
Make sure your surgeon is experienced in breast augmentation. The field of cosmetic medical treatments is rapidly advancing, whether it is the latest treatment techniques, products or services, an experienced surgeon is the best way to ensure comfort, safety, and satisfaction.
You are putting your trust in another individual and that means you need to find a practitioner that makes you feel in safe hands. Personality and respect is key, make sure you have a strong connection with your practitioner and that they listen to you and give honest, open advice in good measure.
We can help you find a surgeon you can trust. Click here to get started.
What does the initial consultation entail?
After finding a surgeon who is experienced in performing breast reduction, you will need to make an appointment for your consultation.
During your consultation, your surgeon will discuss your goals and medical condition, and evaluate you as a candidate for breast reconstruction. Your plastic surgeon will examine, measure and photograph your breasts for your medical record. Please go prepared and ask all your questions.
The session generally lasts between 30 to 60 minutes and at the end of the session your surgeon may recommend a treatment plan and you may be able to book the surgery.
Make sure that the consultation you attend is with the Plastic Surgeon. This is to be distinguished with free consultations offered by many places with Nurses or Patient Advisors/ Coordinators whose consultations are actually a pre-consultation before you see a Plastic Surgeon. Generally, because of the in-depth nature of the consultation with a surgeon, there is a cost associated with this initial appointment.
What is a Breast Reconstruction Cooling off period?
Breast reconstruction surgery is an important decision. It is essential that you are making the appropriate choice and understand all the implications of the surgery. If you are not offered a cooling-off period of around 2 weeks, or you are put under pressure to proceed, you should walk away and look elsewhere.
Would I be required to do anything prior to the surgery?
Before your surgery your surgeon may require you to:
- Follow the instructions given to at your preoperative appointment. These will likely include having blood tests, a chest x-ray and an electrocardiogram (ECG).
- Stop smoking at least six weeks before undergoing surgery to promote better healing.
- Avoid taking aspirin, certain anti-inflammatory drugs and some herbal medications that can cause increased bleeding.
- Regardless of the type of surgery to be performed, hydration is very important before and after surgery for safe recovery and good outcomes.
What is the recovery like?
Your surgeon will give you detailed care instructions, including normal symptoms you will experience, potential signs of complication, and the level and type of activity that is safe. The amount of time it takes for recovery varies greatly among individuals, but the below gives a broad idea:
The first week
Immediately after surgery you should take light walks every other hour. Any surgical dressings and external sutures will be removed within the first week but you may be instructed to wear a compression bra.
Two to six weeks
You should be able to do most activities within two to three weeks. It usually takes about six weeks for the wounds to heal, if your wounds feel like itching as they heal do not scratch them.
For safety, as well as the best outcome, it’s important to return to your plastic surgeon’s office for follow-up evaluation at prescribed times and whenever you notice any changes. Do not hesitate to contact your surgeon if you have any questions or concerns.
How long do the results last?
For single breast reconstruction, changes in the natural breast (likely to sag over time) will be different than the other breast. For bilateral reconstruction, results will last longer.
You would lose some volume after a flap reconstruction. This is because some of the fat implanted leaves the breast area. Also the breast reconstructed using tissue flaps may not age the same as the natural breast because the tissues are from other parts of the body.
With implant reconstruction, the results are intended to last your lifetime. However, replacement may become necessary after around 10 years due to childbirth, ageing, weight gain or loss, hormonal factors and gravity.