Other women with breast cancer require a mastectomy, where the whole breast is removed. Although this is a successful and safe way of treating cancer, it does cause a significant negative change in a woman’s body. This can lead to depression and body dysmorphia. Through A/Prof. Damian Marucci’s work, women with all kinds of post-operative breasts can be reconstructed, with the goal of giving them back their confidence and feminine form.
What is breast reconstruction surgery?
Breast reconstruction is a general term for surgery that reshapes the breasts. For a variety of reasons, the breasts may become lopsided, scarred, or damaged in a way that creates an unaesthetic appearance. The most common reason for breast reconstruction surgery is reconstruction from breast cancer treatment – whether that be a lumpectomy or a full mastectomy. A breast reconstruction can be performed in three basic ways – either using implants, the patient’s own tissue (which is moved from elsewhere in the body), or a combination of the two.
What kinds of breast reconstruction procedures are available?
A/Prof. Marucci offers all kinds of breast reconstruction procedures. With
implant-based reconstruction, A/Prof. Marucci will create a new breast out of silicone implants to help reconstruct the breast mound and shape. With flap reconstruction, the patient’s own tissue from another area of the body to help create the breast shape. Some patients don’t have enough of their own tissue to reconstruct a breast, so a flap is placed over an implant. If needed, A/Prof Marucci may reconstruct parts of the nipple and areola if those were harmed or removed during the cancer treatment procedures.
When creating a new breast, A/Prof. Marucci will factor in the patient’s weight, breast shape, whether the patient has had radiotherapy and the amount of tissue removed during the previous procedure. Through a detailed medical history, physical examination and detailed discussion of the options, A/Prof. Marucci will determine with the patient what breast reconstruction procedure is the best option for them.
What happens on the day of the surgery?
For implant based breast reconstruction, an implant is placed underneath the muscle on your chest. Drains are placed around the implant and all the wounds are closed with dissolving sutures. Patients usually go home after a few days with the drains, which stay in for a few weeks.
If you are having a flap procedure performed, A/Prof. Marucci will remove a small portion of skin tissue, muscle, and fat from another part of your body and transplant it onto your breast. The most common flaps are the latissimus dorsi flap (from the back) and the TRAM or DIEP flap (from the tummy). The TRAM or DIEP flap uses tissue that would normally be thrown away as a part of a tummy tuck and moves it onto the chest. The blood vessels keeping the tissue alive are joined to blood vessels in the chest using microsurgery. The tummy wound is closed just like a tummy tuck is.
With a latissimus dorsi flap, the large muscle of the back can be swung around to the front with some overlying skin and fat. In most patients, you can’t reconstruct a whole breast this way and an implant is required underneath the flap. This reconstruction technique is good for patients who are too thin for a tummy tuck type flap, but have had radiotherapy, so need some sort of flap to cover an implant.
A/Prof Marucci follows his breast reconstruction patients very carefully after their surgery, usually for a number of years. Minor touch up surgery is common, such as nipple reconstruction, and usually done on a day-only basis.
