Breast Reconstruction Explained

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For many years, society has held the notion that people who choose to have breast reconstruction must do it solely for vanity. Though improving one’s appearance is certainly an added benefit, many individuals do undergo breast reconstruction procedures to improve various aspects of their overall health. 
The commonest indication for breast reconstruction is to recreate a breast mound after the native breast tissue is removed for breast cancer treatment (mastectomy). Other candidates who are suitable for breast reconstruction include patients who have developmental problems where their breasts did not develop or are unequal or asymmetrical in size, those who suffered burn trauma to their breast or those who lost their breast from severe infections.
Nevertheless, with all the prevalent misunderstandings, it’s possible that people are becoming discouraged from receiving what could be very beneficial surgery. Hence, Dr Jeffrey Chan Chee Yean, Consultant Plastic & Reconstructive Surgeon from Sunway Medical Centre, Sunway City wishes to focus on a heightened awareness of the true nature of breast reconstructive surgeries.
“Patients usually express their hesitancy to undergo plastic surgery, especially pertaining to areas that can be seen as vanity points. In many cases, plastic surgery can help alleviate pain, improve mobility and boost overall self-esteem. Patients who had breast reconstruction are happier because they can get on with their day to day activity such as going to the gym or swimming or attend functions wearing their favourite dress,” he said. 
In speaking with him further, Dr Jeffrey debunks five common misconceptions regarding breast reconstruction:

Myth: Breast implants are the only reconstruction option 

Truth: There are many effective breast reconstruction techniques. They can be broadly divided into two major categories: implant-based reconstruction or tissue-based reconstruction using the patient’s own tissues. 
The surgeon can take advantage of the patient’s extra tissue from other body areas, such as on the abdomen, thighs or buttocks, by transferring tissues from one body area (e.g. excess skin and fat from the abdomen or the thigh) to the chest area to build a breast mound. Using the patient’s own tissues gives a more natural feel and look. 
“Tissue-based reconstruction is expected to last for the patient’s lifetime and does not require revision once completed. In contrast, patients with implant-based reconstruction frequently require further revisional surgeries in later life for long term problems,” Dr Jeffrey said.
“You should be given a range of suitable options for breast reconstruction by your plastic surgeon. To a certain degree, it depends on your body type, medical history, and previous surgeries. Your surgeon will discuss the advantages and disadvantages of each reconstruction method and reach a decision on the best approach that is ideal for you,” he adds.

Myth: My breasts will not be equal after the reconstruction

Truth: A woman’s own natural breasts are never equal between the two sides. Therefore, it can be challenging to match a reconstructed breast to a natural breast. The patient’s own tissue or implant utilised for breast reconstruction is going to feel and look different from the other breast. 
Using the patient’s own tissue (skin and fat from another body area) typically gives a more natural feel and look. When an implant is used, the difference between the two sides is more apparent. Rest assured; one of the top priorities of plastic surgeons is to ensure that your reconstructed breast is as close to the other as possible after the procedure.

Dr Jeffrey Chan

Myth: I don’t have enough tissue to spare, how can I undergo breast reconstruction?

Truth: “As mentioned previously, there are many options available to the patient. For tissue-based breast reconstruction, if there is insufficient tissue available at one site (e.g. the abdomen), the tissues from the thigh or buttock can be considered. Frequently, if the patient is slim, their natural breast is also smaller, therefore, only a small volume of tissue is required from the donor sites (e.g. abdomen, thigh, buttock). Additionally, two donor sites (e.g. abdomen and thigh) can be combined to make a breast mound if necessary although it will be a longer surgery, or it can be combined with an implant,” Dr Jeffrey said. 

Myth: It will look unnatural

Truth: Although a reconstructed breast does not contain breast tissue, it would have the adequate volume and shape to fit into a regular bra. It can be impossible to tell the difference under clothes. The objective of breast reconstruction surgery is to give a natural looking breast mound.  An experienced reconstructive plastic surgeon will shape the transferred tissue to look like a breast and make it to be as symmetrical as possible. Occasionally, symmetrizing procedure needs to be performed on the opposite breast to balance any mismatch in volume or shape.
The timing of breast reconstruction surgery can influence the final cosmetic result. Immediate breast reconstruction (done at the same time as the mastectomy operation) is frequently associated with the best cosmetic outcomes. This is not to say that patients who have delayed reconstruction (done at a different time to the mastectomy operation) have poorer outcomes. Delayed reconstruction can also be impossible to differentiate under clothing from natural un-operated breasts.

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