Breast Reconstruction and DIEP flaps
Breast reconstruction is a surgical procedure designed to restore the shape and appearance of the breast following mastectomy or lumpectomy.
| Procedure time | Variable |
| Anaesthetic type | General anaesthetic |
| Day case or overnight | Variable |
| Downtime/recovery | Variable |
Breast reconstruction is a surgical procedure designed to restore the shape and appearance of the breast following mastectomy (removal of the breast) or lumpectomy (removal of part of the breast). The goal is to create a breast that looks and feels as natural as possible. Breast reconstruction encompasses the following types of surgical procedures:
1. Implant based reconstruction
This procedure involves the use of a silicone breast implant to reconstruct the breast. If this is undertaken as a delayed reconstruction (not at the time of your mastectomy) then this may first involve the use of a tissue expander (an inflatable implant) placed beneath the chest wall muscle supplemented with an artificial construct called ADM (acellular dermal matrix) to supplement additional coverage over your tissue expander or implant. Once the tissue expander has been serially inflated to create enough space for your desired implant size it can then be exchanged for a fixed volume silicone breast implant.
2. Autologous (Flap) Reconstruction
This procedure involves creating a breast reconstruction out of excess tissue taken from another part of your body. The commonest type of flap reconstruction is the DIEP (Deep Inferior Epigastric Perforator) flap which uses skin and fat from the lower abdomen to create your breast reconstruction whilst preserving the strength and integrity of the abdominal core muscles. Other types of flap reconstruction include the LD (Latissimus Dorsi) flap using skin, fat and muscle from your back and the TUG (Transverse Upper Gracilis) flap using skin fat and muscle from your upper inner thigh.
These reconstructions are devoid of the complications that can be associated with implants particularly after certain breast cancer treatments such as radiotherapy, and provide a reconstruction that is soft, warm, natural and realistic.
3. Nipple Reconstruction
This procedure involves creating a new nipple using local tissue on the reconstructed breast. It is a procedure that can be performed under local anaesthetic and can be supplemented with subsequent areolar tattooing to provide an authentic reconstruction of the NAC (Nipple Areolar Complex).
Breast reconstruction helps patients to achieve a natural looking breast and has additional emotional and psychological benefits in relation to improved self esteem and body image after prior breast cancer surgery. What type of breast reconstruction options are available to you will depend on your medical history, prior cancer treatments and your individualised goals and expectations and these will all be discussed with you at the time of your consultation. Recovery time varies depending on the type of reconstruction you are undergoing. Implant based reconstruction is typically shorter (a few weeks) whilst flap based reconstruction may take slightly longer (several weeks to a couple of months).
