BREAST RECONSTRUCTION

One option for replacing the missing breast tissue is to use a silicone implant. During the first stage, at the time of removal of the breast (mastectomy), a temporary implant, also known as a tissue expander, is inserted. The expander serves primarily as a place holder, allowing the breast skin to recover after the mastectomy.

At a second stage, the definitive silicone implant is inserted. Under specific circumstances, the definitive implant may have already been used in the first operation. The implant is placed under the pectoralis muscle. However, as the pectoralis muscle only provides cover to the top half of the implant, an additional matrix is used to provide cover to the bottom half of the implant. The matrix also acts as a hammock, thereby supporting the implant and optimising the position to enhance the results of the reconstruction.

• Expander/ Implant/ Matrix

Breast reconstruction using tissue from another part of the body is known as autologous breast reconstruction. The greatest advantage of this method of reconstruction is avoiding the use of foreign material to reconstruct the breast.

There are several regions in the body which are commonly used for breast reconstruction. These include the lower abdomen, upper thighs, buttocks and flanks. The added advantage is the optimisation of these areas once the tissue has been used, such as a tummy tuck procedure once the lower abdominal tissue has been used for breast reconstruction.

By performing almost 200 procedures per year, we have the highest expertise in this area.

The reconstruction of breast with lower abdominal tissue is the most commonly used method. The fatty tissue of the lower abdomen is ideal for a breast reconstruction because of its nature and can also be used for reconstruction of both breasts simultaneously.

As with an aesthetic tummy tuck, the skin and subcutaneous fatty tissue below the navel are removed. This results in a horizontal scar low down on the abdomen and another scar around the navel. However, with this procedure, there is a very small risk that the abdominal muscles can be weakened.

• Breast Reconstruction Using Abdominal Tissue (DIEP Flap)

The tissue on the inside of the upper thigh is the second most common procedure used for breast reconstruction. This technique is also suitable for reconstruction of both breasts.

The resulting scar on the upper inner thigh offers a similar effect and scar of a cosmetic thigh lift.

• Breast Reconstruction Using Tissue From The Thigh (TMG Flap)

The PAP flap involves using tissue from the back of the upper thigh to reconstruct the breast. This technique is particularly useful if there is excess tissue after weight loss. The resulting scar corresponds to that of a cosmetic thigh lift.

This technique involves utilising the tissue from the upper part of the buttock for breast reconstruction. The SGAP flap is technically challenging and therefore only offered by a few reconstructive surgeons. We have extensive experience with the SGAP flap; thus, you will be in good hands. The resulting scar on the upper part of the buttock is easily hidden by a bikini.

• Breast Reconstruction Using Tissue From The Buttocks (S GAP Flap)

This technique was commonly used for breast reconstruction, but more recently has been surpassed by the previously described techniques. It remains a reconstructive option for special cases. The latissimus dorsi flap involves transferring skin, subcutaneous fat and muscle tissue from the back for breast reconstruction. This procedure results in a scar on the back which can be well hidden in the bra line. 

• Breast Reconstruction Using The Back (Latissimus Dorsi Flap)

This technique involves utilising the tissue from the flank for breast reconstruction. The LAP flap is technically challenging and therefore only offered by a few reconstructive surgeons. The resulting scar is placed in the flank area, which accentuates the waist. With our experience in performing the LAP flap, you will be in good hands.

In selected cases, breast reconstruction can also be performed by lipofilling.

This procedure largely aims to improve the breast envelope, rather than build up the structure of the breast. This technique involves removal of fat from another region of the body, such as the abdomen or the flanks. It is a specially processed and reintroduced around the breast. There is a limit of the amount of fat that can be introduced to the breasts at any one time, as a percentage of the fat usually degrades. Thus, the procedure is usually repeated several times to achieve the desired volume.

• Breast Reconstruction Using Autologous Fat Tissue Transfer (Lipofilling)

The nipple and the areola (coloured area around the nipple) often have to be removed in the surgical treatment of breast cancer. Fortunately, there are techniques which enable us to reconstruct the nipple and the areola (also known as the nipple areola complex).

The nipple is reconstructed using the skin of the breast. The areola can be reconstructed either using the darker skin from the groin, or by tattooing.

• Nipple And Areola Reconstruction