Most commonly, breast reconstruction is performed during or after breast cancer surgery.
This procedure can also be performed on people with congenital defects and abnormalities.
At AR Plastic Surgery we offer a personalised and holistic service. We are here to listen, gently guide you and ensure you make the right decision for you.
Our specialist plastic surgeon, Dr Cheng, collaborates with a multi-disciplinary team of specialists and allied health including breast surgeons, breast care surgeons, psychiatrists, cancer support staff, geneticists, oncologists and radiologists, to manage the complexities of each individual situation. This procedure can make a real and positive difference to the lives of women.
Dr Cheng draws from both reconstructive and cosmetic disciplines to deliver aesthetic results that consider your personal preference as well as your unique anatomy. Our highly experienced team will provide support every step of the way, in a safe and caring environment.
A mastectomy involves the removal of all the breast tissue and is performed by a Specialist Breast Surgeon. Your mastectomy may also involve the removal of lymph nodes under the armpit depending on the type of breast cancer you have and at the recommendation of your Breast Surgeon.
This depends on the type of breast cancer, your previous history, family history and potentially genetic testing. Your Breast Surgeon will be able to provide advice if a prophylactic mastectomy of the other breast is recommended.
Dr Cheng (Specialist Plastic Surgeon) will work together with your Breast Surgeon to reconstruct the breast after mastectomy. The more common method for breast reconstruction is the use of temporary tissue expanders. When you have your mastectomy, due to the removal of all the breast tissue, the skin is tight and needs to be gradually stretched to eventually accommodate a permanent breast implant. Tissue expanders can be placed in the same surgery as your mastectomy (immediate reconstruction), or at a later date (delayed reconstruction).
Other methods for breast reconstruction include; Latissimus Dorsi Flap, a Transverse Rectus Abdominus Muscle Flap (TRAM) and Deep Inferior Epigastric Perforators Flap (DIEP). At your consultation with Dr Cheng, you will be able to discuss all the possible reconstruction options available to your individual case. Dr Cheng will take into account your diagnosis, your medical history, your availability of abdominal tissue, if radiation treatment is required and your desired aesthetic outcome to achieve the best possible result.
If you are having an immediate reconstruction (mastectomy with either a tissue expander, latissimus dorsi flap, or TRAM) it will be performed at the Wesley Hospital and will require both your Specialist Breast Surgeon and Specialist Plastic Surgeon to be available for a combined procedure. As we don’t have permanent scheduled days for combined procedures, we appreciate your flexibility whilst your two surgeons and anaesthetist liaise together to organise a suitable time appropriate for your individual case.
This depends on which type of reconstruction you will be having. Breast reconstruction with tissue expanders is usually performed as two stages. The first stage involves your mastectomy with the Breast Surgeon, and insertion of temporary tissue expanders by Dr Cheng. These expanders will be progressively filled to their volume capacity to stretch the skin to accommodate your future permanent implants. Tissue expanders can be exchanged with permanent breast implants after a minimum of 8 weeks after your last tissue expander fill.
Your first tissue expansion fill will likely be performed 4 - 5 weeks following your initial surgery. Your tissue expansion will be performed in our clinic rooms by Dr Cheng or one of his nurses on a weekly - fortnightly basis until we reach the volume capacity of your expander or until you are happy with the size. Your individual circumstances may alter the progression of these fills.
You may be able to have tissue expander fills during your chemotherapy treatment, depending on the type of treatment and how you are feeling. We would usually perform the fill just before the commencement of each chemotherapy session, whilst you are feeling well. If you don't require radiation treatment in addition to chemotherapy, we will generally wait until you finish your chemotherapy to commence your tissue expansion. After your last chemotherapy session, Dr Cheng will wait approximately 6 months before exchanging your tissue expanders for permanent implants.
Ideally, we would aim to complete your tissue expander fills prior to the commencement of radiation due to the effect radiation can have on the skin. Your exchange of tissue expanders for permanent implants normally occurs after a period of at least 6 months after you complete your radiation treatment.
We would not recommend strenuous activity before 6 weeks post-operatively. You will likely be given exercises to assist with your range of motion by the physiotherapist during your hospital stay. You will be able to discuss your return to activity with your nurse and Dr Cheng at your post-operative appointments.
Unfortunately, swimming increases the risk of infection in a newly healing wound. It is not recommended that you go swimming (either the pool or the beach) until your wound is completely healed. This is generally not before 6 weeks after your procedure.
After the first stage of your reconstruction with tissue expanders, you won’t require a special bra. You are able wear anything that is comfortable, or no bra at all. You may find a soft singlet/camisole comfortable. After your second stage of reconstruction with permanent implants, you will be fitted by our nurses for a supportive post-operative bra that you will wear full time for the first 6 weeks after your surgery. If you are having a TRAM procedure, you will be fitted for a bra at your first post-operative appointment.
If you are having only one breast operated on, you may need to visit a special Prosthetics and Lingerie Service offered through Choices. Your nurse will be able to provide you with these details.