Stephen McCulley, Reconstructive and Aesthetic Surgeon. MBChb, FCS(SA)Plast, FRCS(plast)

Breast Cancer & Reconstruction

Breast Cancer Treatment
Surgical treatment for breast cancer has a very high success rate and 80% of all women are treated successfully. The appropriate course of treatment will depend on the type of cancer and the stage it has reached which will be discussed at the initial consultation. Different types of surgery are on offer including lumpectomy where only a part of your breast is removed, and mastectomy where the whole or both of your breasts are removed. Axillary surgery is also an option where only the lymph glands are sampled or removed. Further treatment post-surgery may be necessary including chemotherapy or hormone therapy.

Oncoplastic Breast Surgery
Stephen McCulley is a leading world expert in this field of breast cancer surgery. Oncoplastic breast surgery uses plastic surgery techniques to treat breast cancer. In essence, oncoplastic surgery removes the cancer whilst reshaping or reconstructing the breast within the same procedure using plastic surgery techniques. Therapeutic mammoplasty is one kind of oncoplastic surgery where the cancer is excised and the breast is re-shaped in one go.

Breast Reconstruction Overview
If you’ve had a mastectomy, breast reconstruction is an option open to you. There is no right or wrong as to whether you should have reconstructive surgery after a mastectomy and ultimately this decision rests with each individual, though you should receive advice after your mastectomy operation relating to reconstructive surgery. Breast reconstruction can be performed at the same time of the mastectomy or at a later date using an implant or tissue from the patient’s own body.

Using Implants
Using implants instead of your own tissue avoids scarring in other parts of the body and often gives patients a breast shape they really like. The recovery rate for the operation is also relatively quick. The procedure will either involve placing a temporary implant initially which is then replaced by a permanent implant after 3-6 months, or an implant can be carried out in one operation if appropriate.

Using the Tummy
Using your own tummy tissue to reconstruct your breast will mean that it closely resembles normal breast texture and movement and will sit naturally. This kind of reconstruction normally improves over time as the breast changes in size and shape and world-wide it is considered one of the most successful types of reconstructive surgery. The same skin and fat taken during a tummy tuck is removed and then implanted with microsurgery used to reattached blood vessels.

Using The Back
Using back tissue to reconstruct a breast carries only a 1% risk of failing, the operation can be safely carried out in conjunction with radiotherapy and it often results in an excellent breast shape which is more natural than implants.

Using the Thigh, Buttock and Other
Though it is most common to take tissue from the tummy and back other areas of the body can be used during breast reconstruction, including the inner thigh and buttock.

Nipple Reconstruction
Nipple reconstruction is a relatively minor operation which can finish a breast reconstruction. Nipples can either be constructed out of grafted skin or prosthetics. The areolar is tattooed around the nipple about 8-12 weeks after surgery.