The Harley Street Breast Clinic

Routine and rapid breast screening with same-day diagnosis, advice and treatments for all breast problems.

3rd Floor, 148 Harley Street, London, W1G 7LG

Reconstructive Surgery

Every woman who is having a mastectomy has the option of breast reconstructive surgery. It is only very rarely that a breast reconstruction is not advisable. Breast reconstructive surgery can often be carried out at the same time as the mastectomy.

The main benefit of this type of surgery is to enable a woman to confidently and comfortably wear any type of clothes including low-cut tops and swimming costumes, and to produce a normal look with a natural cleavage.It is important to carefully consider which type of reconstruction operation is most suitable for you, and to be aware of the advantages and disadvantages of each. In brief, the principle reconstructive techniques that you might be offered if you were considering reconstruction are:

Solid Silicone Implant

The simplest form of breast reconstruction uses a solid silicone implant to replace the volume of the breast tissue that has been removed. This is only applicable to patients who have an immediate reconstruction where all of the breast is removed but the breast skin remains. A teardrop shaped solid silicone implant then replaces the volume of the inside of the breast. The results can look very good and the advantage of this type of surgery is that it is relatively simple, and you do not have a scar in another part of your body. The drawbacks are that it uses an implant which can become infected or can harden (capsule formation) over a period of years.

Expandable Implant

This is done when there is not enough skin remaining on the chest wall to form a new breast. A collapsed and flat implant is therefore inserted at surgery. This is attached to a small valve which lies just under the skin at the side of the chest. In the weeks following surgery it is possible to inject saline through the into the valve so that the implant slowly expands and stretches the skin in the shape of the new breast. This is again a simple procedure but is only suitable for reconstructing small breasts and cannot usually be carried out on patients who have previously had radiotherapy. Overall the reconstructed breast is quite firm.

Latissimus Dorsi Reconstuction

Particularly in patients who are undergoing delayed reconstruction, extra skin and tissue from another part of the body can be used to make up for the skin that has been previously lost. One place to take the skin and tissue from is the upper part of the back on the same side as the mastectomy. This is called a latissimus dorsi flap, the name referring to the muscle that is moved together with its overlying skin and fat. In the majority of cases the tissue from the back is not enough to recreate a large enough breast, and this type of reconstruction is therefore usually combined with a small solid silicone implant placed underneath the natural tissue from the back. The end result is a softer breast with some degree of droop. Of course, this type of reconstruction does leave a scar on the back although this is usually placed at a level where it will be too low to be easily seen or will lie underneath a bra strap.

TRAM Flap and S-Gap Reconstruction

More tissue can be harvested from the lower abdomen (or buttock).  Because this is a large amount of tissue and it has to be moved from further away it is a very complicated operation. The great advantage of this type of surgery is that there is often enough tissue on the lower abdomen (or buttock) to build the new breast to the correct size without the use of an additional implant. The net result is a soft breast made out of your own tissue with a similar shape to the normal side. The disadvantage is that this operation leaves you with a scar, low on the abdomen or buttock (although the resulting flat tummy is a bonus). The overall cosmetic result is the best of all the types of breast reconstruction.

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Contact our Breast Care Team

If you would like to book an appointment or if you are a doctor who would like to refer a patient then please call our Breast Care Team on +44 (0)20 7908 6071 or email us here.