Breast reconstruction is one of the most rewarding surgical procedures designed to restore the shape and appearance of the breast following mastectomy (removal of the breast). New techniques and devices have made it possible for surgeons to create a breast that can come close in form and volume to matching a natural breast. The reconstruction can be performed immediately following the mastectomy or as a delayed procedure.

One in eight women will be diagnosed with breast cancer during their lifetime. This may lead to surgical removal of part of the breast or the entire breast. Mr. Prinsloo believes that every woman who had a mastectomy should have a chance to consider breast reconstruction to help restore self-confidence and feelings of femininity, attractiveness and sexuality.

Any patient who is medically fit and psychologically stable is a suitable candidate for reconstruction. The best candidates are women whose cancer, as far as can be determined, seems to have been eliminated by the mastectomy. Ideally you r breast surgeon and your plastic surgeon will work together to develop a strategy that will put you in the best possible condition for reconstruction. Sometimes the patient may wish to wait before going ahead with further surgery in order to cope with the diagnosis and the recommended treatment of breast cancer. Some patients may be advised by the surgeon to wait, particularly if a more complex reconstruction procedure is required. Women with other health conditions such as obesity, high blood pressure, or smoking, may also be advised to wait.

There are three main types of breast reconstruction:

• Reconstruction using tissue expanders or breast implants • Tissue flap reconstruction

A flap of skin, muscle and fat from your back or abdomen (tummy) is tunnelled through to the chest to create a new breast. The latissimus dorsi muscle flap is usually combined with a silicone breast implant.

• Free flap reconstruction

A flap of skin, muscle and fat is removed from the original area on the lower abdomen and grafted to the breast area. The blood supply has to be restored using microsurgery.

Stage 1:
Reconstruction immediately following mastectomy or as a delayed procedure some time after both the mastectomy and possible further treatment (radiotherapy and chemotherapy).

Stage 2:
Nipple reconstruction on the reconstructed breast plus a balancing procedure on the opposite breast to create symmetry if required.

Stage 3:
Nipple areola tattooing.

It may take you four to six weeks to recover from a combined mastectomy and reconstruction or from a flap reconstruction alone. If expanders or implants are used, the recovery time may be less. The second and third stages of the reconstruction will also have a far shorter recovery time.

As with all other breast surgery procedures there are risks involved with breast reconstruction. Possible complications may include bleeding, haematoma, fluid collection, infection, scarring, wound healing problems, problems with anaesthesia and capsular contraction around the breast implant which may require a scar-releasing procedure. Mr. Prinsloo will explain how the possible risks will apply to you.

Chances are your reconstructed breast will feel firmer and look rounder or flatter than your natural breast. It may not have the same contour as your breast before mastectomy, nor will it exactly match your opposite breast. Your plastic surgeon will do everything possible to meet your expectations. Most mastectomy patients will agree that breast reconstruction dramatically improved their appearance and quality of life following surgery.