Beautiful Breasts

Too many women are booked for a mastectomy without reconstructive surgery options being explained to them. Find a surgeon with a special interest in breast surgery and who works closely with a reconstructive plastic surgeon who also has a special interest in breast reconstruction.

Breasts have long been the symbol of womanhood and the loss of a breast is often experienced as losing one’s femaleness or a lack of wholeness. The reconstruction of breasts can provide a new lease on life enabling you to continue with your life as before. For me, as a reconstructive surgeon, this is enormously gratifying.

Every breast cancer is unique, as is every woman. Treatments should be individualised and breast reconstruction tailored to each unique woman. I like to include my patients in the decision making process and view my breast reconstructions as a partnership between the me and my patients. It is advisable to visit the reconstructing surgeon before you have your mastectomy. The surgeon can then inform you of your available options so that you can make an informed decision about your treatment.

The most important fact to consider when reconstructing a breast is the nature of the breast cancer and what treatment you will be receiving. It is of paramount importance that the plastic surgeon understands the nature of your particular cancer and any treatments which you have had or may have in the future. This influences the decision as to what reconstructive options to propose. For example, if you have had, or are going to have, radiotherapy then it is not generally a good idea to insert an implant as this can harden due to the radiotherapy.

Breast reconstruction has to be safe, and should only be performed once the cancer has cleared. The goal of reconstruction is to provide you with two symmetrical breasts (in terms of shape and size) which will enable you to wear whatever clothes you like and to have your breasts looking as similar as possible when you are naked!

Breast reconstruction is either done at the time of the mastectomy, (immediate reconstruction) or at a later stage (delayed reconstruction). The surgeon will use either your own tissue or a prosthesis in the form of an expander or implant. When deciding on the type of reconstruction the surgeon must be made aware of any pending cancer treatments, your general health as well as the availability of tissues with which to reconstruct your breast.

Surgery to the Opposite Breast

As we want to achieve symmetry between the breasts, surgery to the other breast is often needed. The other breast can be lifted, reduced or even augmented – to match the reconstructed side.

Reconstruction of the Nipple and Areola

Nipples are reconstructed either by using the lower half of the opposite nipple or by using local flaps. 

The areola (the coloured part around the nipple) can be tattooed on by a medical tattooist using natural pigments.

This article is an introduction to breast reconstruction terminologies and options. In future issues we shall look at your various options in more detail.

Written by Carla Norval

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