Breast reconstruction Case Study 25
This lady has previously underwent a mastectomy and immediate reconstruction with a temporary spacer. Following completion of her oncological treatment she wished to undergo a breast reconstruction. A free flap reconstruction can bring tissue with its own blood supply to recreate the breast. The commonest of these forms of reconstruction are by taking the tissue from the abdomen and transferring the tissue to the breast. Thus the principles of breast reconstruction are similar to the mommy makeover procedures.
By isolating the blood vessels within the abdomen one can reduce the extent of the muscle damage and preserve the function of the abdomen. The form of reconstruction in this case is called a DIEP flap or Deep Inferior Epigastric Flap with the name derived from the blood supply to the tissue.
The abdominal wound is closed in a similar way to an abdominoplasty and the postoperative result is seen at 2 years postop when all the scars have settled.
The breast tissue once transferred is often not the size and shape as the other side and often some form of contralateral surgery is required. This can be on the reconstructed side and could involve autologous fat transfer, liposuction, mastopexy or breast lift, breast reduction. These techniques may also be required on the opposite or contralateral side and very occasionally one may consider pros and cons of breast augmentation with breast implants or a combination of implants with a lift.
Following the initial free flap surgery and after contralateral surgery patients may consider nipple areola reconstruction which may involve nipple reconstruction and may involve nipple sharing / grafts and tattooing.
This lady has underwent a DIEP reconstruction but did not require any contralateral / opposite side surgery. She opted for a nipple reconstruction and nipple areola tattooing. The final result of her breast reconstruction following total mastectomy are shown at 2 years postop and show how a symmetrical result can be obtained.
At a consultation, it is important to run through all the pros and cons and the various options of breast reconstructive options surgery so that you can be empowered to proceed. Mr Ross will show you various preoperative and postoperative results so that you can understand what can be achieved and what is to be expected.
Mr. Ross is a plastic surgeon that underwent specific training in plastic surgery. Mr. Ross successfully completed his FRCS (plast), obtained his CCT and is listed on the GMC specialist Register for Plastic surgery (Number 4220633). Mr. Ross has a vast training in aesthetic surgery throughout his plastic surgery training including the techniques utilized in “cosmetic surgery”. Mr. Ross is a full member of the British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS); British Association of Aesthetic Plastic Surgeons (BAAPS), American Society of Plastic Surgeons (ASPS) Association of Breast Surgeons (ABS) and is regularly appraised on an annual basis. Mr Ross is the only plastic and cosmetic surgeon in Manchester, the North West of England and the United Kingdom in full time private practice, who is a full member of BAAPS, BAPRAS and ABS.