Breast Reconstruction

As if the breast cancer diagnosis isn’t frightening enough, regaining a sense of normalcy after such an event may be one of the most challenging roads you will ever walk. One of the steps in the recovery process for many women after this journey is breast reconstruction. Dr Teston understands the importance of this process and will work closely with you and your oncologist to ensure your breast reconstruction works with your treatment and gives you the results you are looking for.

Before Breast Reconstruction

Before you begin the reconstruction process, you need to determine whether breast reconstruction is the right choice for you. While this step is an essential one for many women, it isn’t right for every breast cancer patient. Some of the reasons you might choose breast reconstruction include:

• To make your chest look balanced
• To achieve a permanent, aesthetically appealing breast shape
• To avoid the need for external prosthetics
• To move past cancer treatment 

Dr Teston understands that this is a difficult decision, and she will work with you to help you decide if this is the right choice for you.

Making Choices

If you decide to move forward with breast reconstruction, you will have a number of options to consider. Timing of the surgery and the type of reconstruction you want can be tailored to you and your expectations. Dr Teston will spend plenty of time with you to identify your specific needs and your desired results to determine when and how breast reconstruction will be most beneficial.

Some of the choices you will need to make during the breast reconstruction process include:

Timing of Surgery

For some women, breast reconstruction can be performed at the same time as the surgery to remove the cancer or the breast. This is known as immediate breast construction. Some women need to wait for this procedure, to allow for additional treatment to take place. This is referred to as delayed breast construction. In some cases, preparations may be made for the breast reconstruction at the time of the initial cancer treatment and then completed later. This is known as immediate-delayed reconstruction.

Your choice of timing will depend on the type of surgery you have undergone as part of your treatment, and whether additional treatment will be needed. Since chemotherapy and radiation can impact the effects of your breast reconstruction, you may be advised to wait until these treatments are over to commence your reconstruction process. It is important for your oncologist and plastic surgeon to work together to come up with the best plan for you.

Type of Reconstruction

When the time comes for your breast reconstruction, you will have different options here as well:

• Breast Implants – These synthetic implants can be placed into the breast tissue to create natural fullness. This surgery is generally performed in two stages. The first procedure is used to place an expander into the breast tissue to make room for the implants. The second procedure, which is performed once the expander has produced the necessary results, will be used to place the implants into the tissue and create the final breast shape and size. Implants come in a wide range of sizes, shapes, and profiles. This allows us to tailor your breast reconstruction to your unique needs, body proportions and desired result, and Dr Teston will help you make that choice.
• Natural Tissue Flaps – Some women opt for natural tissue flaps instead of synthetic implants. Also known as autologous breast reconstruction, this procedure relies on skin and tissue taken from donor sites like the buttocks, abdomen, back or thigh. The donor flaps may include their own blood supply (known as a pedicle flap) or the blood supply may be restored through microsurgery techniques once the flaps are in place (free flaps).Use of natural tissue flaps tends to result in a more extensive surgical procedure and recovery will be required both for the breasts and the donor site. However, the tissue flaps will never need to be replaced, while implants may require replacement after a number of years. Women also tend to find the tissue flaps provide a more natural look and feel to the breasts.
• Nipple and Areola Construction – It is possible in some situations to have a nipple-sparing mastectomy that leaves the nipple and areola intact as the breast tissue is removed. Other women are not able to retain their nipples and require reconstruction of the nipple and areola to restore a natural look. Dr Teston will discuss your options with you to ensure that your final breast reconstruction results are both natural and satisfactory for you.The choices during breast reconstruction can seem overwhelming, particularly when you are dealing with your diagnosis and treatment options. Dr Teston understands the emotional weight of this process and will work with you to help you make the choices that are most beneficial to you. She will also work with your other doctors to ensure the choices you make are handled correctly and compassionately.

During Breast Reconstruction

Breast reconstruction is performed in an accredited hospital under general anaesthesia. The details of the procedure will depend on the specific type of technique used and the timing of the reconstruction. You will likely spend at least one night in the hospital after your surgery, where you will be cared for by an attentive nursing staff. Once you are released to go home, you may have a compression garment or special surgical bra to keep the breasts in place during the healing process. These garments are also effective in reducing swelling after breast reconstruction surgery so you have a faster and more comfortable recovery.

After Breast Reconstruction

Depending on the specific procedure you choose for your breast reconstruction, you may be able to return to regular activities around two weeks after your surgery. Heavy lifting and strenuous activity will be restricted longer to ensure your breasts have plenty of time to heal. Breast reconstruction offers permanent results in most cases, giving breast cancer survivors an opportunity to regain their appearance and control of their bodies once again.

Potential Risks and Complications

All surgery carries some degree of risk. Some of the possible complications of breast reconstruction include:

• Bleeding and infection
• Allergic reaction to suture materials, tape adhesive or other medical materials and topical lotions or ointments
• Changes in breast and nipple sensation
• Temporary or permanent areas of numbness
• Wrinkling of the skin over the implant
• Keloid, or lumpy scar tissue, which is raised and irregularly shaped and may be inflamed and itchy
• Capsular contracture, where firm scar tissue forms around the implant causing it to lose shape and softness
• Inappropriate implant size
• Implant rupture or deflation
• Asymmetry or unevenness of the breasts
• Calcium deposits in the scar capsule around the implant
• Granulomas, or lumps, in local lymph node tissue formed by leaking silicone
• Breastfeeding difficulties, including reduced milk supply
• Reduced effectiveness of breast cancer screening, as an implant may hide breast tissue (and tumours) during a mammogram
• Movement of the implants from their original position
• Further surgery to treat complications
• Risks of anaesthesia including allergic reaction or potentially fatal cardiovascular complications such as heart attack
• Blood clot in the deep veins of the legs (deep vein thrombosis), which can move to the lungs (pulmonary embolus) or to the brain and may be life threatening

This is not a complete list. For example, your medical history or lifestyle may put you at increased risk of certain complications. Speak to your medical practitioner for more information.

Breast Registry Information for Augmentation and Reconstruction

Patients can have the confidence that all of the information regarding breast implants are recorded into The Australian Breast Device Registry. All of the hospitals that Dr Teston is affiliated with, Kareena Private, St George Private and Bankstown Public will, following your surgery, input your information into the database of the registry. This is so that in the future if you ever require the information about the implants, it can be retrieved from The Australian Breast Device Registry. This information collated includes type of implants used, manufacture, serial numbers, reason for surgery and the technique used and is a secure approved National Register.

Breast reconstruction can be an important part of the healing process for breast cancer survivors. To learn more about your choices in breast reconstruction, contact Dr Teston’s office today at (02) 9708 3511 to set up your personal appointment with Dr Teston.

*The information about Breast Reconstruction was reviewed by Dr Leana Teston. If you have any questions, please don’t hesitate to contact us using our contact form below.