Breast Reconstruction

Breast Reconstruction with an Implant or Tissue Expander

Your surgeon will use a breast implant or tissue expander (expandable implant) to recreate the shape of a breast. 

Various types and sizes of implant are available. All implants are made of an outer layer (shell) of silicone or polyurethane. They can be filled with silicone or saline (salt water). The silicone gel used to fill the implant comes in different grades of firmness (cohesiveness). Softer silicone and saline implants give a softer and more natural feel but are more prone to kinking or rippling. More cohesive silicone implants give a firmer feel, hold their shape more and are less prone to kinking or rippling. They are used in implants that look more natural (anatomical implants), so they are often recommended to people who are having a breast reconstruction.

If you have already had a mastectomy or your surgeon thinks your breast skin is unsuitable for a prosthesis straight away, they may need to use a tissue expander. Over a number of weeks your surgeon will gradually fill the tissue expander with saline through a small tube (port) to stretch your skin and make your breasts similar in size. This is changed over in a simple procedure once your skin is stretched enough.

Breast Reconstruction with Abdominal Tissue Flap (DIEP)

This operation involves moving a flap of skin and fat from your lower abdomen to your chest and using it to recreate a breast shape. The success of the reconstruction depends on maintaining a good blood supply into and out of the flap. Blood vessels are moved with the flap and connected to blood vessels behind one of your ribs or in your armpit using microsurgery techniques.

Your reconstructed breast shape may not have the same sensation as a normal breast but using tissue from your body will help give your breast a more natural shape and feel. Occasionally nerves can be connected within the flap of tissue moved to allow you to regain sensation to the tissue if these are available.

Most women who have a successful breast reconstruction are more comfortable with their appearance.

Breast Reconstruction with Latissimus Dorsi Flap

Your surgeon will recreate a breast shape using the latissimus dorsi back muscle, with some fat and skin from your back. This operation can be combined with a breast implant to make a breast that is bigger than the back muscle and skin would make. Your surgeon will tell you whether the muscle alone will be big enough or if an implant will also be required. If an implant is used this may be a fixed volume (silicone) implant or an expander (adjustable size).

Following your reconstruction your breasts will be more even and you will be able to wear better-fitting clothing as a result.