Breast Reconstruction Surgery Bristol

Breast reconstruction surgery
Breast reconstruction surgery is normally undertaken by breast cancer patients following a mastectomy. Breast reconstruction surgery typically achieves the replacement of the tissue which has been removed after the mastectomy procedure. It can either take place straight after a mastectomy (immediate reconstruction), or can be undergone at a later date – this is known as either delayed reconstruction (when reconstruction is undertaken after additional procedures such as radiation therapy or chemotherapy) or staged reconstruction (when some of the reconstruction takes place immediately after the mastectomy and other parts of the reconstruction are delayed).

Breast reconstruction with fat transfer
Breast reconstruction with autologous fat transfer is a relatively new technique which uses fat from the patient’s own body in order to shape a breast following its reconstruction.

Autologous fat transfer which is undertaken with breast reconstruction is also known as fat grafting. In addition to using fat from the patient’s body, there is another technique known as lipofilling which is able to fix less noticeable discrepancies in the position or shape of the reconstructed breast, in comparison to the other breast. It involves the ‘harvesting’ of the fat using traditional liposuction.

Breast reconstruction with fat transfer can be viewed as a ‘safer procedure’ which does not involve major surgery. However, it should be noted that after being injected into the breast area, fat is able to be reabsorbed by the body, meaning that the breast can lose some of its volume over time. Breast reconstruction with fat transfer is recognised as being able to offer attractive and natural looking results.

Autologous breast reconstruction
Autologous breast reconstruction is sometimes also known as autogenous reconstruction. It uses tissue known as a flap, taken from another location on the body, to form a breast shape. This tissue is usually skin or fat, but can also be from muscle. It is normally taken from areas such as the back (LD flap), belly (DIEP flap), inner thighs (TMG flap) or buttocks.

This tissue, used as a “free flap” can be removed entirely from its original blood vessels before it is moved to a new location in the chest. Alternatively, the tissue is moved under the skin to the chest, remaining attached to its blood vessels. This type of flap is known as a “pedicled flap”. Pedicled flaps is a type of surgical technique which has been performed for a longer period of time than free flaps. They are recognised as being easier to perform because the free flap process involves microsurgery in order to attach the vessels in the chest to the tissue flap itself and ensure that there is sufficient blood flow to the newly formed breast. Pedicled flaps are typically more widely available than free flaps.

Breast reconstruction surgery
Breast reconstruction surgery is undertaken for both cosmetic and medical reasons after a mastectomy has been undergone. The objective is to make the breast appear as similar as possible to the other breast by reshaping it.

Not every individual is suitable for each type of breast reconstruction surgery. For this reason, it is important that patients have a full consultation so that they can determine the right path of treatment for them.

Breast reconstruction with fat transfer
Fat transfer is commonly used as a secondary procedure which follows the main breast reconstruction. It uses either an implant or autologous tissue for the purposes of breast augmentation.

The choice to opt for breast reconstruction with autologous fat transfer is made by the patient with the guidance of Elena. A series of consultations will take place, along with pre-surgery investigations which can help assess suitability. Patients will have the potential risks of breast reconstruction with autologous fat transfer fully explained to them, and the procedure will only go ahead with their full signed consent.

Autologous breast reconstruction
Autologous breast reconstruction offers the benefits of using personal tissue which ages naturally and changes minimally. Choosing the best location as a donor site is crucial to the decision-making process which precedes an autologous breast reconstruction. The Breastclinik provides an expert consultancy which includes examinations and discussions pertaining to the various surgical options available.

Breast reconstruction surgery
Breast reconstruction surgery can form a new breast by taking tissue from another body part, or alternatively, a breast implant might be inserted. It also sometimes uses a combination of an implant and a tissue flap. Breast reconstruction surgery treatment can be made up of more than one procedure before a satisfactory result is reached.

The flap procedure involves a tissue being lifted from a donor site – typically the back, belly or buttocks – and moved under the skin to breast, or completely removed from its blood vessels and reattached using microsurgery. The implant procedure involves a silicone or saline implant being inserted over or under the pectoral muscle.

In some cases, it can be preferable to use a combination of both the flap and the implant procedure in order to perform the reconstruction. Fat grafting and tattooing of the nipple/areola are techniques which can also be used as part of a breast reconstruction surgery procedure.

Breast reconstruction surgery typically involves the use of a local or general anaesthetic, with general anaesthetic being more common. Patients will discuss their form of anaesthesia with an anaesthetist before entering the operating room.

Breast reconstruction with fat transfer
Breast reconstruction with autologous fat transfer will typically use fat from the buttocks, thighs or tummy – the fat is harvested with the use of a small cannula, with a technique similar to liposuction. After the fat is removed, washed and prepared, it is injected into the breast in small volumes using diminutive syringes.

Breast reconstruction with fat transfer is normally performed at the same time as a mastectomy (cancer removal), or after the completion of the procedure at a later date, as part of a delayed or staged approach. Elena will be on hand to talk through the options for each patient and agree on the best course of action.

On the day of the breast reconstruction with autologous fat transfer procedure, patients will typically not eat or drink for a six-hour window prior to the treatment. An anaesthetist will be present to discuss the chosen form of anaesthesia with the patient prior to them entering the operating room.

Autologous breast reconstruction
Breast reconstruction involves the complete separation of the tissue from its original blood vessels before it is moved to a new location on the chest. This is typically known as a ‘free flap’. An alternative method keeps the original blood cells attached to the tissue and moves it under the skin to the chest. This is known as a ‘pedicled flap’. The tissue is then shaped and stitched into place.

Treatments can be undergone at the same time as mastectomy, at a later date after mastectomy, or as part of a staged approach which undertakes some of the reconstruction at the same time as a mastectomy, and leaves some of the reconstruction until a later date.

An anaesthetist will be on hand to discuss the chosen form of anaesthesia with the patient prior to entering the operating room. Patients will typically not eat or drink for a period of six hours before the operation.

Later surgery for the purpose of making adjustments is entirely normal in the case of autologous breast reconstruction. This is referred to as ‘finishing work’, and can involve nipple reconstruction, repositioning of an implant or removing the donor site’s extra fat. Some of these adjustments might not be seen as essential, and it is advised that the surgeon and patient talk through adjustment options together so that preferences can be determined.

Breast reconstruction surgery
As with all surgical treatments, there is an element of risk involved with breast reconstruction surgery. Potential complications can include tight scar tissue, leakage of an implant, and alteration to the sensation in the breast. There is also the possibility of revision surgery being required.

Flap surgery involves the potential risk of a loss of the flap – partial or complete – and a loss of sensation at the reconstruction site or donor site. With implants, there is the potential risk of rupture or capsular contracture.

Breast reconstruction with fat transfer
As with all surgical procedures, there is a small element of risk involved with the procedure. Possible complications include bleeding, loss of breast sensation, and the need for revision surgery to be carried out in the future.

In cases where the fat cells injected into the breasts do not survive, there is the possibility that calcification and oil cysts can form. In these cases, there is the potential risk that these calcifications can interfere with mammography screening tests.

Autologous breast reconstruction
As with any form of surgery, autologous breast reconstruction poses potential risks. These can include bleeding, loss of breast sensation and the need for revision surgery.

Although there are low rates of complications which follow autologous breast reconstruction surgery, it should be noted that there is the involvement of two surgical sites – the breast area, and the ‘donor’ site which the tissue comes from. General surgical complications can also include delayed healing of wounds and scar sensitivity.

Breast reconstruction surgery
Breast reconstruction surgery usually requires patients to remain at the hospital for an overnight stay after the procedure has taken place. The recovery period typically lasts from two up to six weeks, with most patients then returning to their daily activities. Full exercise may take longer to resume.

Breast reconstruction surgery patients can be aided in their recovery by a support bra which will surround the breast and also minimise swelling. A small drainage tube may also be placed under the skin on a temporary basis in order to help drain any excess fluid.

Breast reconstruction with fat transfer
Following breast reconstruction with autologous fat transfer, patients can typically resume normal activities after a period of one to two weeks. It may take several months before full exercise can be taken in comfort.

Compression garments can help to reduce swelling during the recovery period. You may be prescribed medications which can help to alleviate some of the soreness after the breast reconstruction with fat transfer procedure has taken place. Swelling should begin to subside significantly after the first week of recovery. It has been found that patients who normally eat a lot of salty foods can benefit from reducing the salt – which can contribute to swelling – in their diet.

Autologous breast reconstruction
It can take two weeks before normal daily activities can be resumed following autologous breast reconstruction. For some patients, full exercise is not possible for several months.

It should be remembered that while healing from autologous breast reconstruction surgery there will be at least two areas of the body which are healing concurrently – including the reconstructed breast and the donor tissue site. The presence of multiple surgical sites means extra care should be taken in recovery. This is augmented when women have additional incisions made due to an axillary node dissection or sentinel node biopsy performed at the same time.

How long will I need to wear a post-op bra?

The amount of time a post-op, soft supportive bra is worn for will vary from individual to individual. While some women will not wear a post-op bra, for others it is necessary for four to six weeks after surgery, especially in the case of wound healing complications.

When can I drive following autologous breast reconstruction?

Driving can be resumed when any drainage tubes have been taken out, and when you have come off any prescription pain medication which was being taken after the operation. Your arms should also have significantly regained their range of motion before getting back behind the wheel.

Operating in several locations in the UK – including Bristol, London and Sussex – Elena is an internationally recognised, award-winning cosmetic surgeon who is recognised for her consultative approach. Patients at the Breastclinik benefit from Elena’s empathetic attitude as an expert female consultant, as well as the cutting edge techniques she employs. The Clinic is noted for its consistency in delivering a superb standard of aftercare.

If your breast reconstruction surgery involves implants, you should note that in 10 to 15 years there is the chance that you may need further surgery in order to exchange or revise the implants. The ‘new generation’ gel implants are known to last for up to a patient’s lifetime.

As a less invasive technique than a complete implant, and one which is also typically faster, there are many benefits offered by breast reconstruction with autologous fat transfer surgery. For some patients, breast reconstruction with autologous fat transfer surgery will offer the best surgical option which produces the best results, although this will vary according to the individual. Reduced recovery time is another potential benefit of breast reconstruction with fat transfer, although this can depend on the number of areas which have been subject to liposuction.

The total cost of the surgery will be confirmed after the first consultation.

The cost includes the hospital, surgeon and anaesthetic fees. It also covers all post-operative visits. The initial consultation fee will be invoiced separately. The prices apply only at the time of publication and are subject to changes without notification.

Surgery costs TBA
Initial consultation fee £150