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Reconstruction Methods -
Overview
A breast can be made from man-made implants, from your own tissue (back, tummy, bottom) or from a mixture of the two. All have advantages and disadvantages.
Implant based reconstruction is the most commonly used. It does usually require two operations over 4-6 months. Advantages are its relative simplicity and hence it does not add large amounts of time to your surgery. It also avoids scars or removal of tissue from elsewhere in the body. It tends to produce a breast mound without any natural droop. This can give good symmetry if the opposite breast is pert or up-lifted. However, implant reconstruction does not match the shape of the opposite breast if it has natural droop. It tends to give better results in thinner patients. The results can last many years. Short-term problems are risk of infection and the need for two operations. Long term the result does change with potential for hardening of the reconstruction. About a third of implant reconstruction may need adjustment or re-doing by 10 years and most have some worsening of appearance over that time. Any patient needing radiotherapy is not suitable for implant only reconstruction as the results can be very poor.
Reconstruction using your own body tissue can give excellent long term results but tends to involve bigger initial surgery and risks. The operation time and hospital stay tend to be longer. Surgery involves taking tissue from the tummy, back or backside (the donor sites). This leaves scars in these areas. Complications can occur with both the reconstruction and the donor site. Advantages are the similarity in the texture and behaviour between the reconstructed breast and the opposite side. This type of reconstruction will much better match an opposite breast that has some natural droop. Both sides will gain and loose weight and change shape together over time (unlike implants). These methods tend to produce a result which improves over the years, and they have a very low rate of needing adjustments later.
Fat Injection techniques
This is a method of increasing fullness or volume by injecting the patients own fat. It is usually used in the breast or face for both cosmetic and reconstructive problems. The fat is removed by liposuction from the thigh or abdomen, specially prepared and re-injected into the area using small needles.
In the breast it has started to be used for breast augmentation and breast asymmetry (differing breast sizes). It is well established in treating defects or depressions following breast cancer removal.
The great advantage of the technique is the ability to permanently enhance these areas with the patients own fat. The disadvantage is the unpredictable survival of the fat. Usually about 50% of the injected fat survives and the treatment may need repeating. There are virtually no scars and depending upon the area to be treated it is performed as a day-case under local or general anaesthetic.
