Breast Reconstruction

Breast reconstruction is achieved through several plastic surgery techniques that attempt to restore a breast to near normal shape, appearance and size following mastectomy.

The First Step

All Surgeons working with Health Horizon Holidays fulfill the criteria below:

•    Have completed at least five years of surgical training with a minimum of ten years in plastic surgery.
•    Is trained and experienced in all plastic surgery procedures, including breast, body, face and

     reconstruction.
•    Operates only in accredited medical facilities
•    Adheres to a strict code of ethics.
•    Fulfills continuing medical education requirements, including standards and innovations in patient safety.
•    Is board certified by MAPACS (Malaysia Association of Plastic, Aesthetic and Craniomaxillofacial

Breast reconstruction is a physically and emotionally rewarding procedure for a woman who has lost a breast due to cancer or other condition.

The creation of a new breast can dramatically improve your self-image, self-confidence and quality of life. Although surgery can give you a relatively natural-looking breast, a reconstructed breast will never look or feel exactly the same as the breast that was removed.

Breast reconstruction is a highly individualized procedure. You should do it for yourself, not to fulfill someone else’s desires or to try to fit any sort of ideal image.

Breast reconstruction is a good option for you if:

• You are able to cope well with your diagnosis and treatment
• You do not have additional medical conditions or other illnesses that may impair healing
• You have a positive outlook and realistic goals for restoring your breast and body image
• Breast reconstruction typically involves several procedures performed in multiple stages.

It can:

• Begin at the same time as mastectomy, or
• Be delayed until you heal from mastectomy and recover from any additional cancer treatments
• It’s important that you feel ready for the emotional adjustment involved in breast reconstruction. It may take some time to accept the results of breast reconstruction.

The success and safety of your breast reconstruction procedure depends very much on your complete candidness during your consultation. You’ll be asked a number of questions about your health, desires and lifestyle.

Be prepared to discuss:

• Why you want the surgery, your expectations and desired outcome
• Medical conditions, drug allergies and medical treatments
• Use of current medications, vitamins, herbal supplements, alcohol, tobacco and drugs
• Previous surgeries
• The options available in breast reconstruction surgery
• The likely outcomes of breast reconstruction and any risks or potential complications
• The course of treatment recommended by your plastic surgeon, including procedures to achieve breast symmetry

Your surgeon may also:

• Evaluate your general health status and any pre-existing health conditions or risk factors
• Examine your breasts, and take detailed measurements of their size and shape, skin quality, and placement of nipples and areolae
• Take photographs for your medical record
• Discuss your options and recommend a course of treatment
• Discuss likely outcomes of breast reconstruction and any risks or potential complications

Prior to surgery, you may be asked to:

• Get lab testing or a medical evaluation
• Take certain medications or adjust your current medications
• Stop smoking well in advance of surgery
• Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding
• Special instructions you receive will cover:
• What to do on the day of surgery
• The use of anesthesia during your breast reconstruction
• Post-operative care and follow-up
• Breast implant registry documents (when necessary)

Breast reconstruction is achieved through several plastic surgery techniques that attempt to restore a breast to near normal shape, appearance and size following mastectomy.

Although breast reconstruction can rebuild your breast, the results are highly variable:

A reconstructed breast will not have the same sensation and feel as the breast it replaces.
Visible incision lines will always be present on the breast, whether from reconstruction or mastectomy.
Certain surgical techniques will leave incision lines at the donor site, commonly located in less exposed areas of the body such as the back, abdomen or buttocks.

A note about symmetry: If only one breast is affected, it alone may be reconstructed. In addition, a breast lift, breast reduction or breast augmentation may be recommended for the opposite breast to improve symmetry of the size and position of both breasts.

The decision to have breast reconstruction surgery is extremely personal. You’ll have to decide if the benefits will achieve your goals and if the risks and potential complications are acceptable.

Your plastic surgeon and/or staff will explain in detail the risks associated with surgery. You will be asked to sign consent forms to ensure that you fully understand the procedures you will undergo and any risks or potential complications.

The possible risks of breast reconstruction include, but are not limited to, bleeding, infection, poor healing of incisions, and anesthesia risks. You should also know that:

Flap surgery includes the risk of partial or complete loss of the flap and a loss of sensation at both the donor and reconstruction site.
The use of implants carries the risk of breast firmness (capsular contracture) and implant rupture.
Breast implants do not impair breast health. Careful review of scientific research conducted by independent groups such as the Institute of Medicine has found no proven link between breast implants and autoimmune or other systemic diseases. Visit www.breastimplantsafety.org for current information.

Surgery for your breast reconstruction is most often performed in a hospital setting, possibly including a short hospital stay, and your doctor will likely use general anesthesia.

Some follow-up procedures may be performed on an outpatient basis, and local anesthesia with sedation may be used.

These decisions will be based on the requirements of your specific procedure and in consideration of your preferences and your doctor’s best judgment.

Step 1 - Anesthesia

Medications are administered for your comfort during the surgical procedure. The choices include intravenous sedation and general anesthesia. Your doctor will recommend the best choice for you.

Step 2 - Flap techniques reposition a woman’s own muscle, fat and skin to create or cover the breast mound.
Sometimes a mastectomy or radiation therapy will leave insufficient tissue on the chest wall to cover and support a breast implant. The use of a breast implant for reconstruction almost always requires either a flap technique or tissue expansion.

A TRAM flap uses donor muscle, fat and skin from a woman’s abdomen to reconstruct the breast. The flap may either remain attached to the original blood supply and be tunneled up through the chest wall, or be completely detached, and formed into a breast mound.

Alternatively, your surgeon may choose the DIEP or SGAP flap techniques which do not use muscle but transport tissue to the chest from the abdomen or buttock.

A latissimus dorsi flap uses muscle, fat and skin from the back tunneled to the mastectomy site and remains attached to its donor site, leaving blood supply intact.

Occasionally, the flap can reconstruct a complete breast mound, but often provides the muscle and tissue necessary to cover and support a breast implant.

Step 3 - Surgical placement of a breast implant creates a breast mound.
A breast implant can be an addition or alternative to flap techniques. Saline and silicone implants are available for reconstruction.

Your surgeon will help you decide what is best for you. Reconstruction with an implant alone usually requires tissue expansion.

Step 4 - Grafting and other specialized techniques create a nipple and areola.
Breast reconstruction is completed through a variety of techniques that reconstruct the nipple and areola.

Following your surgery for flap techniques and/or the insertion of an implant, gauze or bandages will be applied to your incisions.

An elastic bandage or support bra will minimize swelling and support the reconstructed breast. A small, thin tube may be temporarily placed under the skin to drain any excess blood or fluid.

A pain pump may also be used to reduce the need for narcotics.

You will be given specific instructions that may include: How to care for your surgical site(s) following surgery, medications to apply or take orally to aid healing and reduce the risk of infection, specific concerns to look for at the surgical site or in your general health, and when to follow up with your plastic surgeon.

Be sure to ask your plastic surgeon specific questions about what you can expect during your individual recovery period.

What medication will I be given or prescribed after surgery?
Will I have dressings/bandages after surgery?
When will they be removed?
Will there be drains? For how long?
When can I bathe or shower?
When can I resume normal activity and exercise?

Healing will continue for several weeks as swelling decreases and breast shape and position improve. Continue to follow your plastic surgeon’s instructions and attend follow-up visits as scheduled.

The final results of breast reconstruction following mastectomy can help lessen the physical and emotional impact of mastectomy.

Over time, some breast sensation may return, and scar lines will improve, although they’ll never disappear completely.

There are trade-offs, but most women feel these are small compared to the large improvement in their quality of life and the ability to look and feel whole.

Careful monitoring of breast health through self-exam, mammography and other diagnostic techniques is essential to your long-term health.

If you experience shortness of breath, chest pains, or unusual heart beats, seek medical attention immediately. Should any of these complications occur, you may require hospitalization and additional treatment.

The practice of medicine and surgery is not an exact science. Although good results are expected, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single surgical procedure and another surgery may be necessary.

Following your surgeon’s instructions is key to the success of your surgery. It is important that the surgical incisions are not subjected to excessive force, abrasion, or motion during the time of healing. Your doctor will give you specific instructions on how to care for yourself.

Cost is always a consideration in elective surgery. Prices for breast reconstruction can vary widely. A surgeon’s cost for breast reconstruction may vary based on his or her experience as well as geographic location.

Costs include:

• Surgeon’s fee
• Hospital or surgical facility costs
• Anesthesia fees
• Prescriptions for medication
• Post-surgery garments, and
• Medical tests and x-rays

Breast reconstruction surgery after breast cancer is considered a reconstructive procedure and should be covered by health insurance. However, your coverage may only provide a small part of the total fee.

When choosing a plastic surgeon for breast reconstruction, remember that the surgeon’s experience and your comfort with him or her are just as important

Women who consider breast reconstruction surgery tend to be either breast cancer survivors who have had single or double mastectomies or women who have had their breast tissue removed as a way of reducing the risk of breast cancer due to a significant family history of the disease. Women who have had lumpectomy procedures do not need reconstructive surgery.

Breast reconstruction is a surgical procedure, performed by a plastic surgeon that restores the appearance of a breast by rebuilding the breast contour. Women can also opt to reconstruct the nipple and darker area around the nipple called the areola. Reconstruction will not restore the normal feel and sensation of your breast.

Breast reconstruction can be done at the same time as your mastectomy. The main benefit of immediate reconstruction is one less surgical procedure to endure.

Your surgeon will examine you and advise you what procedure is best in your case, as well as giving you all the information about the surgery. 

Breast reconstruction is permanent, however, breast size and shape will change with gravity over time and during the normal stages of life - pregnancy, weight loss and gain and ageing. It is also important to remember that scars are permanent, although they will fade over time.

Your surgeon will make every effort to make your scars as inconspicuous as possible. Still, it's important to remember that breast reconstruction scars may be extensive and permanent. They often remain lumpy and red for months, then gradually become less obvious, sometimes eventually fading to thin white lines. Fortunately, the scars can usually be placed so that you can wear even low-cut tops.

Contact Us for further information on Breast Reconstruction