Breast Reconstructions

Dr Tony’s years of experience means you are in excellent hands

Breast reconstruction surgery restores the appearance of a natural breast and replaces breast tissue lost during a mastectomy. The aim is to either match the remaining breast as closely as possible, or create a pair of symmetrical and natural-looking breasts.

Breast reconstructions can increase self-confidence and help you regain a sense of control and comfort in your own skin. There are many methods and aspects of breast cancer reconstruction surgery to consider.

 

The decision to reconstruct

It is never easy to make important surgical decisions following a breast cancer diagnosis. It is normal to have a lot of questions, and Specialist Breast Clinic can assist by answering them in a clear and understandable manner. We can explain the requirements involved with breast reconstructions and discuss your expectations for what is to be accomplished.

Once a decision has been made to proceed with a mastectomy, the next natural step is to explore the option of breast cancer reconstruction.

Some women will choose not to have a breast reconstruction after mastectomy, which is certainly a satisfactory option. Others may opt to wear a prosthetic breast in their bra rather than proceed with further surgery, or they may choose to defer breast reconstructions until they are in a better position to make this significant decision.

If you do choose to have a breast reconstruction, you will want to choose a surgeon who is qualified, experienced, and knowledgeable in both oncological and reconstructive aspects.

Dr Tony Palasovski has many years of experience in breast care, breast reconstructions, and breast cancer surgery. He can provide you with the information you need about breast reconstructions, and clarify your personal goals and priorities.

 

Timing of breast reconstructions

If you have decided to have breast cancer reconstruction surgery, you will need to determine your ideal timing — immediate breast reconstruction (performed at the same time as the mastectomy) or delayed reconstruction (performed after recovery from surgery and associated treatments).

 

Immediate breast reconstructions

Immediate breast reconstructions offer several benefits:

  • More of the breast skin, and sometimes the nipple, can be preserved.
  • The cosmetic results are typically better with minimal scarring.
  • You will not have to spend any time without a breast mound, which can be confronting for many women.

However, not everybody will be suitable for immediate breast reconstructions. Women with overall good health and early-stage breast cancer are the optimal candidates for immediate reconstructive surgery. If you suffer from high blood pressure, diabetes or obesity, or if you are a smoker, you will likely be advised to wait.

Postoperative radiation therapy may also be a contraindication to immediate breast reconstruction, as radiotherapy has unpredictable impacts on the outcome of both implant-based and tissue-based reconstruction.

It is important that the decision to have your breasts reconstructed is entirely yours, and not the result of meeting anyone else’s desires or trying to fit an ‘ideal’ image. If you feel pressured or are unable to come to a decision, it may be wise to opt for a delayed reconstruction.

 

Delayed breast reconstructions

Some benefits of delayed breast reconstructions include:

  • You have more time to decide whether breast cancer reconstruction surgery is right for you.
  • You can commence your cancer treatment without delay.
  • You can focus on your recovery now, with one less thing for you to deal with.

When radiotherapy is required, breast reconstructions will often be delayed by a minimum of 6 to 12 months. This allows for tissue healing and a better understanding of the post-radiation damage to the tissue.

Breast cancer patients are candidates for delayed breast reconstruction after mastectomy, even if the mastectomy was performed many months or years ago.

 

Types of breast reconstructions

There are three main types of breast reconstructions:

  1. Implant-based reconstruction
  2. Tissue-based (autologous) reconstruction
  3. A combination of both

There are numerous factors that will influence the choice of techniques, including:

  • Your personal preference
  • Your breast size and body type
  • The breast size you would like to achieve
  • Your overall health
  • Any scarring from previous operations
  • The amount of tissue that has been removed
  • The quality of the remaining skin
  • Whether you have had or anticipate having radiotherapy

 

Implant-based reconstruction

Implant-based breast reconstructions, or IBBR, are performed as either one-stage (direct-to-implant) or two-stage (tissue expander and implant) technique. Women who have undergone radiation therapy, are morbidly obese, or are active smokers will typically be poor candidates for prosthetic reconstruction.

The more traditional two-stage approach of implant-based breast reconstruction involves inserting a saline-filled tissue expander into a pocket under your skin and chest muscle. In the weeks or months following the initial procedure, saline solution is injected into the expander through a valve. This will gently and gradually fill the expander and stretch the muscle and skin to match the desired breast size. At Specialist Breast Clinic, we also have experience with AirXpanders, which are a patient-controlled no-needles method of creating the implant pocket.  Once the desired size has been reached, a second operation will replace the tissue expander with a permanent implant.

Read more about  AirXpanders.

Tissue-based reconstruction

Autologous breast reconstructions are generally more complex than implant-based breast reconstructions. But this is a great option for women who would prefer to avoid the use of implants. Tissue-based breast reconstructions are performed using ‘excess’ tissue from the patient’s stomach, back, buttocks or thigh. The tissue is transferred to the mastectomy area and shaped into a new breast. The transferred tissue will adjust to changes in your body weight and will be subject to natural ptosis.

Combination reconstruction

Breast reconstructions can also be performed with a combination of techniques, using an implant and your own tissue in the creation of the breast. This option can be suitable for women who would prefer implant reconstruction, but lack sufficient tissue to provide a healthy cover. Combination methods can also allow a surgeon to augment a tissue transfer with an implant to provide greater fullness than autologous reconstruction could achieve on its own.

 

Dr Tony Palasovski is experienced and knowledgeable in breast reconstructions using expert implant-based techniques. Operating through our Wollongong Practice or our Miranda Practice (Integrated Specialist Health Care), Specialist Breast Clinic can talk you through your options and help you determine the choices that are right for you. Whilst we don’t do autologous breast reconstructions, we would be happy to refer you to other surgeons we work with to ensure a seamless pathway through your breast cancer treatment.

Our goal is to improve your confidence and help you look and feel like yourself. Contact us to learn more about breast reconstructions or book an appointment.

This 28yr old previously well patient presented with a 2.5cm breast cancer in the upper outer apect of the... Read More

Bilateral nipple sparing mastectomy with direct to implant reconstruction. In this particular case the 33yr old patient had previously undergone... Read More

30yr old otherwise well patient with left breast cancer. Treated with chemotherapy first (neoadjuvant) to help shrink the breast... Read More