Project Description

Breast cancer is a devastating illness.  Life saving surgery can be disfiguring and lead to serious loss of self-esteem.  Reconstructive surgery not only replaces the tissue that has been removed but can also improve the overall appearance of both breasts.

I recommend implant reconstruction only for a bilateral mastectomy, where autologous tissue reconstruction is difficult.  The two implants age at the same rate, so there is no discrepancy.  However, in all cases, if radiotherapy has been applied to the mastectomy site an implant reconstruction is not possible.  In all cases fat grafting may be reqiured post operatively to enhance the result. In other patients I use tissue from the back (a latissimus dorsi flap), in this case an implant may be required or the opposite breast can be reduced to aid size matching.

 

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Breast Reconstruction is the final step for a woman wanting to put a breast cancer experience behind her. Although more surgery ... it can be the most satisfying and empowering step a woman takes.

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The Right Tissue

The best tissue for breast reconstruction comes from the abdomen as TRAM or DIEP Flap.  This is a long operation that needs a considerable surgical team and usually the support of Public Hospital.  I personally don’t do this operation but can recommend another surgeon who does.

When a single breast is reconstructed with an implant, differences between the new and natural breast can become obvious over time – the implant can harden as the natural breast sags.  Natural tissue feels like a breast and ages like a breast, which why I believe this is the best option.

Bilateral Reconstruction with implants is a very common procedure.  I prefer to provide a delayed reconstruction allowing the tissue to settle before inserting breast expanders and begining the expansion process.

Considerations

Undertaking Breast Reconstruction requires a long term commitment from the patient and often a strong mental attitude towards the outcome of the surgery.  The journey from begining to end may take upto six months depending on the expansion and sometimes even longer.

It starts with the insertion of the breast expanders, this is performed under General Anaesthetic anaesthetic and will require an overnight stay and two weeks off work.  Dr Taylor will put between 100-200ml in the expander in the surgery and will only add more once the sutures are out and the breasts are coping.  Expansion can be weekly or fortnightly.  Generally we allow this process to be driven by the patient and their comfort level following expansion.  Once the implants are fully expanded to the size where both Dr Taylor and the patient are happy, surgery will be schedule for the removal of the expander and the insertion of the new breast implants.

Again surgery will require an overnight stay, two weeks off work and six weeks of light duties.  No physical activity or contact sport..

Some surgeons prefer to perform this surgery as a day case, at CAPS we believe in providing an overnight stay.  We want our patients to take their time to rest and recover.  It also provides us an opportunity to ensure their pain relief and post op nausea (if present) is well controlled before being discharged to the care of their family or friends. 
Dr Taylor uses drains postoperatively.  The use of the drains provides a number of benefits to the patient.

Following surgery, fluid builds up around the expander or the implant, drains remove this fluid and therefore the swelling and stretching is reduced as is the pain associated with this.  The fluid can hinder the attachment of the implant to the breast and therefore the risk of rotation is lower and finally the drains provide Dr Taylor with a clear picture of what is happening inside – if there is a problem it can be seen in the drain and acted on immediately rather than when you are at home and not sure what to do.

In the excitement of the surgery patients often overlook the importance of preparing for it.  What  patients do in the lead up to surgery and knowing how to plan appropriately for your recovery can make the difference between an anxious process or a more relaxed one.

Because we were frequently approached by patients who wanted to know what they could do in preparation for the surgery we put together a “pre-surgery program”.  Now seven years later we know the value of this program and offer it to our patients as part of the service we provide.

If your surgeons doesn’t offer this then you can do it yourself.  We use a multivitamin to ‘detox’ the body which aids recovery getting patients back on their feet faster.  We also use a herbal medication to reduce the bruising and swelling associated with the surgery, again we have found this to be highly effective.

Knowing what to expect is vital to the planning of your recovery.  Understanding what you can and cannot do will ensure you are not put in a position where you put yourself or the success of your surgery at risk.  All this will depend on your personal situation.  How much time do you need off work? Do you need to drive?  Do you live alone?  Do you have a family that relies on you? Do you have small children? Do you have to lift children or heavy objects in your day to day life? Do you play sport? What is going on in your life for the first six weeks after surgery?

Again answering these questions will ensure you have planned appropriately for your surgery and your recovery.

With the operation behind you, you may be feeling sore and anxious about how you will cope over the next few weeks. The best thing you can do is REST. The body cannot heal and function at the same time – that is why you need to SLEEP.

Taking regular pain medication will ensure you remain comfortable – follow the instructions given to you at discharge – DON’T BE HERO – there are no prizes for not taking it.

Results may be compromised by complications, always contact us if you;

  • are unable to cease or slow bleeding of the wound after applying pressure to the area.
  • feel any heat or increasing pain developing in your wound.
  • notice excessive swelling and bruising accompanying pain and tenderness.

Rapid intervention will reduce the chance of a complication becoming a real issue.  Ensuring you have planned appropriately for your recovery will make an enormous difference.

Most importantly – Relax and ENJOY IT.  When else are you going to get the opportunity to catch up on the lastest DVD series or read that book getting dusty in the corner?

 

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If you have questions about how Breast Reconstruction surgery may benefit you, please contact us using the form below or call us on 6282 1177.

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Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner (eg. your GP).