Breast Reconstruction in Sydney

Are you considering breast reconstruction in Sydney?

One on eight women in Australia will develop breast cancer in their lives – Are you one of them? Would you like to get back your breast curves and fill out your dresses again? Did your breast surgeon let you know that breast reconstruction is NORMAL aftercare? And that breast reconstruction is an important step in psychological recovery after a mastectomy?

What is involved?

Breast shape can be reconstructed using a variety of methods. The main determinants of which type of reconstruction is right for you are:-

–    Reconstructing one or two breasts?
–    How much abdominal fat do you have? Where else are you storing fat that could be used?
–    How much exercise do you do, and is it important to remain competitive in your sports?
–    How much risk of additional operations are you prepared to accept?
–    How much recovery time can you allow yourself?

Your Specialist Plastic Surgeon would be happy to discuss your options for a breast reconstruction in Sydney with you, based on your answers to these questions, as well as your medical history and examination.

What are my options?

Breast reconstruction in Sydney can be done in a few different ways. The most common types of breast reconstruction are those that utilize breast implants (the same as used in cosmetic breast augmentation) and those that use existing body fat for volume.

Implants can be used on their own, but some of the time will need some additional skin and soft tissue cover. This is usually supplied by moving the latissimus dorsi muscle (from your back) around to the front of the chest wall with a segment of skin. After healing, most patients do find that there are minimal functional problems, as the other muscles of the shoulder will take over the role of this muscle.

Sometimes, we can avoid using this muscle by expanding the available skin on the chest wall. This involves a preliminary operation where an expander (balloon) is placed under the skin. This is gradually inflated until there is enough skin to accommodate an implant of the desired size. This is not an option for everyone, as it requires healthy skin and patience!

More commonly, abdominal skin and fat is used by Specialist Plastic Surgeons to recreate a breast shape. Abdominal fat is a good match of the ‘feel’ of breast fat, and drapes in a similar way to breast tissue, so is an ideal option.  The amount of abdominal fat that you have, how large you wish to be, and whether you are happy to reduce the size of the other breast to match, will determine if this option is good for you. Too little or excessive abdominal fat will create a result that is less than ideal.  The added bonus of this operation is that the patient receives an abdominoplasty (tummy tuck) as a side effect of harvesting the fat for the breast reconstruction.

The method of carrying this fat to the chest wall is primarily determined by a balance of how much muscle can be used in the reconstruction and the amount of risk you and your team are prepared to accept. Commonly used flaps are the TRAM (Transverse Rectus Abdominis Myocutaneous) and DIEP (Deep Inferior Epigastric Perforator) flaps.

There are other methods of using skin and fat from other parts of the body to recreate breasts. They are less reliable and generally do not have enough volume to create a desirable breast shape in an Australian woman. For breast reconstruction in Sydney, we generally use one of the above methods.

When should I get my breasts reconstructed?

Depending on your type of breast cancer, breasts can be reconstructed at the time of mastectomy, but a delayed reconstruction gives greater assurance of quality and lasting results. Radiotherapy is a common form of adjuvant therapy after breast cancer. The effects of radiotherapy on reconstruction are unpredictable, and can change a great reconstruction into a result that no one is happy with. Additionally, should radiotherapy cause skin changes in the chest wall, those areas may be able to be replaced with healthy skin at the time of reconstruction. Therefore, for those having radiotherapy, we recommend waiting for a breast reconstruction in Sydney until treatment with radiation is completed and some healing has occurred.

My breast cancer surgeon did not discuss breast reconstruction with me. Why?

General / breast / oncological surgeons often report that many of their patients only want to deal with their immediate treatment when they receive a diagnosis of breast cancer. So a breast surgeon may not mention breast reconstruction in Sydney to his or her patients. By the time that many patients are prepared to think about reconstruction, both they and their cancer surgeon have forgotten about it.

There is good evidence that current treatment and surveillance of breast cancer is NOT affected by breast reconstruction. If ongoing surveillance of the chest wall is a concern, the two best options are delaying reconstruction until a disease free period of 1-2 years, or using MRI for surveillance.

Considering breast reconstruction in Sydney?

Sydney Specialist Plastic Surgeon Dr Gavin Sandercoe and his team at Norwest Plastic & Cosmetic Surgery would be more than happy to discuss your options, even if you choose that breast reconstruction in Sydney is not for you at the moment. Dr Gavin Sandercoe no longer performs microsurgery, and would refer you on to one of his colleagues if you decide microsurgical reconstruction is the best option for you. Contact us or make an appointment when you are ready.

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