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Breast reconstruction

Breast reconstruction is a surgical procedure following the removal of a breast ( mastectomy).

This procedure may be carried out at the same time as the breast removal, or at a later stage, called a delayed reconstruction. The decision to have reconstructive surgery is a personal one for a woman to discuss with her health care team.

The goal of reconstruction is to restore symmetry between the two breasts by replacing skin, breast tissue and the appearance of the nipple and areola area.

The surgeon may recommend a breast implant as part of the procedure.

Why should I consider breast reconstruction?

Restoring the breast is not considered cosmetic surgery. Operations performed to restore anatomy and symmetry, like breast reconstruction after a mastectomy, are considered reconstructive surgery. Since breast reconstruction after mastectomy is part of the treatment of a disease and not cosmetic surgery, the NHS normally covers the cost of the procedure.

Breast reconstruction not only changes your physical appearance, but has psychological benefits as well. It can help promote a sense of wellness for you and your family.

When should breast reconstruction be performed?

Whenever possible, women are encouraged to begin breast reconstruction at the same time they are having their mastectomy. For many women, immediate reconstruction reduces the trauma of having a breast removed as well as the time and discomfort of two major operations.

It is also possible to do the reconstruction months or years after a mastectomy. If any chemotherapy or radiotherapy treatments have been started, reconstruction is usually postponed until they are completed. Your surgical team can help you decide the appropriate timing for reconstruction.

What are the different breast reconstruction options?

A variety of reconstructive techniques are available that offer cosmetically appealing results. Multiple factors, such as the patient's goals, medical condition and previous surgery, are considered when choosing between reconstruction using breast implants or flaps of tissue moved from other parts of the body.

One procedure to consider after breast reconstruction is nipple reconstruction. Usually, the nipple and areola (the dark area around the nipple) are removed during a mastectomy operation because they are breast tissue and therefore at risk of cancer recurrence.

Nipple/areola reconstruction is usually done after reconstruction of the breast. This allows the new breast tissue to heal and settle into place so minor adjustments in size and position can be carried out when the nipple and areola are reconstructed.

Tissue for the nipple/areola is often taken from the newly constructed breast. To match the colour of the other nipple and to create the areola, medical tattooing may be done.

The prosthetic nipple is another option that may be temporary or permanent. The surgeon makes a copy of your natural nipple and colours the areola. It can be stuck to the breast using prosthetic glue and re-glued every week or so.

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