Reduction Mammoplasty, commonly referred to as breast reduction, is probably one of the oldest procedures that have been sought by female patients to improve their shape. While many procedures were de...Continue Reading
Mastectomy – Breast Reconstruction Surgery
Female Image Gallery Mastectomy – Breast Reconstruction Surgery
About The Procedure
Breast Reconstruction / Mastectomy
Mastectomy for breast cancer can leave a woman not only physically distressed but psychologically wounded as well. Dr. Hodgkinson has a special sensitivity for these patients and has over 30 years experience in reconstructing women’s breasts using a multitude of techniques. These techniques range from the use of an implant to flap surgery using the patient’s own tissues to create a new breast mound.
Breast Reconstruction Techniques
The two common types of flaps are the latissmus flap which takes tissues from the back and the tram flap which takes tissues from the stomach so that the woman receives a tummy tuck or abdominoplasty at the same time that she received a new breast created from her own tissues.
In the case that the remaining breast is drooping or too large a breast lift or reduction can be carried out on the remaining breast at the same time as the reconstruction to create an overall more attractive and symmetrical appearance.
Patients who have not undergone radiation therapy can also be candidates for tissue expansion.
The nipple areolar complex is also reconstructed as a secondary procedure for all women requiring reconstruction.
What techniques are used for breast reconstruction after mastectomy?
There are basically two options for patients who want a reconstruction: to use your own tissues to make a new breast or to try to get more skin and then place an implant under the skin (the expansion technique).
Post-operative treatment following a mastectomy, such as radiation or chemotherapy, might impact on the available options. If the patient has not had radiation, then the expansion method can be used. This involves placing a silastic balloon underneath the residual skin on the chest wall. Every two weeks, more saline solution is added to the balloon in order to stretch the skin. Once the required amount of skin has grown, a gel implant is positioned.
In the method that uses your own tissue (autogenous), the tissue can be brought from the back or the abdomen to make the new breast. We use both these techniques for breast reconstruction.
Before and After Breast Reconstruction (Latissimus) by Dr Hodgkinson
Where are the breast implants inserted?
Breast implants can be inserted through many different incision sites, including endoscopically through the navel (saline only). The most common incision sites are under the breast, around the nipple or in the armpit. Interestingly, saline implants can be inserted through smaller incision sites than silicone implants.
The choice of incision site needs to be discussed with your surgeon as just with the type of implant, the location of the incision site can affect the look that you will achieve. For example, while the armpit avoids any potential scarring on or around the breast, it makes if very difficult to achieve cleavage. It is important to choose a highly experienced breast surgeon and to discuss your expectations with him or her to ensure that they have the ability to use multiple types, sizes and shapes of implants through a variety of incision sites to customise each patient’s result to their body shape and desires. Remember, one size does not fit all.
Before and After Breast Augmentation: C cup 240 cc Round Smooth Saline Breast Implants by Dr Hodgkinson
What type of implant do you prefer for breast enhancement?
I’m often asked this question. In contrast to many surgeons who prefer to use one particular type, I use every sort of implant *as well as a wide range of incisions to insert them. This flexibility is important to meet the patient’s desires and obtain the optimal result. The choice is contingent upon the patient’s shape, the condition of the breast tissue, whether there is droop (ptosis) of the breasts and the overall figure shape. In over 90% of cases, I use a saline implant. The smooth-walled saline is ideal for the younger patient who has never had an implant, has very little ptosis of the breasts and wants to have a C or C+ brassiere size. A gel implant is used if patients want a more generous size or they are quite thin and have little breast tissue to cover the implant.
* (except for textured polyurethane breast implants which are under suspicion due to links to ALCL anaplastic large cell lymphoma)
Before & After Breast Implants by Dr Hodgkinson
What would be a suitable breast implant for my thin build?
Both the type and size of breast implant that are appropriate for you depends not only on the shape and size you wish to achieve but need to be measured against your existing breasts and your chest wall to determine what will work best to give you the result you desire. Breast implants come in many shapes and sizes, from round to tear drop, asymmetrical and anatomic and can be inserted through a variety incision sites all of which are factors in the ultimate shape and look.
When considering which implant will give a patient the look that they want, many things must be factored in along with the patient’s desires including their physical shape e.g. current size and shape of the breast, elasticity of the breast skin, position of the nipple, and the shape and bony contour of her chest wall. For women who are very thin, generally placing silicone gel filled breast implants partly under the chest muscles is often a better choice to avoid implant show through the skin.
Before and After Breast Augmentation: D cup 400 cc Round Smooth Gel Breast Implants by Dr Hodgkinson
Do breast implants shift once inserted?
Breast implants should not shift in position once they are inserted if the implants are responsibly chosen to fit the patient’s build and the surgery is performed properly. The surgeon’s challenge is to make the pocket the exact size of the implant if not a little firm to avoid movement or rotation. The problem with the tear drop shaped implants is that in the hands of the less experience surgeon is if the pocket is not perfect and they rotate, resulting in an unnatural shape to the chest… In placing any implant—whether it is a breast, cheek, chin or calf implant—the aim of the procedure is to make the pocket the correct size and shape for the proposed implant. A pocket which is proportional to the chest wall diameter will allow the implant to sit nicely and protects the implant from displacement.
Before and After Breast Augmentation: D cup 400 cc Round Smooth Saline Breast Implants by Dr Hodgkinson