Breast Reconstruction

Losing a breast to cancer is a traumatic experience and a blow to one’s self-esteem. Breast reconstruction can be achieved through several different techniques. The aim is to reconstruct a new breast that is similar in shape and appearance to what has been lost.

Some patients opt to have the breast reconstructed immediately, at the time of mastectomy. Other patients seek breast reconstruction a year or more after mastectomy. These patients often talk about how their self-esteem suffered as a result of losing a breast. For them, reconstructing the breast helps them to feel complete again, and is an important part of their recovery from breast cancer surgery.

The procedure is performed using the body’s own tissue, with or without an implant. Factors that are taken into consideration include the original breast size and shape, the availability of the patient’s own tissues, the patient’s general health, and requirements for radiotherapy.

Although we aim to reconstruct a breast that is near-normal, there are certain limitations such as: the reconstructed breast will not have the same feel or sensation of a normal breast; there may also be visible scars or incision lines on the reconstructed breast. If the patient’s own tissue is used, there will be some scars in the donor areas. Sometimes, secondary or touch-up procedures need to be performed to optimise the breast shape and size.

In breast reconstruction, we aim to achieve symmetry, which sometimes means that corrective procedures may need to be done on the opposite breast to achieve symmetry.

What are my options in breast reconstruction?

The main options are:

1) Using your body’s own tissue
a. TRAM flap – using tissue from the abdomen. This is the gold standard in breast reconstruction. It gives a more natural appearance and the softness mimics the feel of a natural breast.
b. LD flap – using tissue from the back. This is suitable for smaller breasted ladies as there is less volume of tissue on the back.

2) Using an implant – this may not be suitable for all ladies

3) Combination – with this method, our breast surgeon, Dr Sng uses an LD flap from the back together with an implant. The implant provides added volume for larger breasted ladies, while the LD flap optimizes the coverage of the implant with your body’s tissue.

What is the recovery time?
This depends on the type of reconstruction and your own recovery. Using an implant only, you could return to work about 7-10 days later. With an LD flap, you will find that it is easier to move about but you will have more shoulder stiffness. We will recommend exercises to ease this. You should be back to work in about 2 weeks. With a TRAM flap, it may be difficult to get out of bed in the beginning, but this gets easier over 1-2 weeks. You could be back to work in 3 weeks.