Breast Reconstruction Surgery – Fat Grafting, Flap, Implant and Recovery

Breast reconstruction surgery is a physically and emotionally satisfying procedure that is performed on partially or completely removed breasts, most often after a mastectomy. More common patients in Singapore are women who have diagnosed with breast cancer. The procedure is a combination of plastic surgery techniques that not only create a new breast but significantly improve a woman’s appearance, self-esteem, and quality of life. With the help of this procedure can be achieved natural look and feel of the breast.

Typically, breast reconstruction involves a number of procedures that are performed sequentially in stages. It may be done at the same time as breast cancer surgery or to be delayed until the patient has fully recovered from the mastectomy and other additional breast cancer treatment. It is important for the woman to feel ready for the mental and emotional adjustment that reconstruction requires.

Here we will introduce in general terms the breast reconstruction process in Singapore. However, the best way to learn how to achieve your goals and satisfy your desires is to consult with SGH breast surgeon.

What is breast reconstruction?

Breast reconstruction is the restoration of the appearance of the breast after the removal of a whole breast which is called mastectomy or part of the breast. The procedure aims to recreate, replace volume, and to achieve symmetry to the other breast. Reconstruction can be done when only one breast has been removed. In this case, additional procedures such as lifting, reducing, or enlarging the breasts are recommended to improve the symmetry between the two breasts (size and position).

surgeonsp erforming breast reconstruction surgery on a patient

In case you are considering breast reconstruction, finding a good doctor in Singapore is the first step in the process. It is important to know that although reconstruction allows for effective recovery of a woman’s breast, the results can vary greatly. The reconstructed breast will not have the same sensitivity and will be different in sensation compared to the natural breast. The incisions, whether it is from the reconstruction or from breast removal can be noticeable. Flap method also leaves incision lines at the donor sites, but they are generally localized in less exposed areas of the body such as the abdomen, buttocks, or back.

The outcome goals of breast reconstruction are improving shape, symmetry, size, softness, sensuality, and natural feel of the breast.

Types of breast reconstruction

Breast reconstruction is accomplished through several reconstructive techniques that optimally restore the shape, appearance, and size of the breast. These include:

  • Reconstruction by using implants – formation of a new bust through breast prosthesis;
  • Autologous breast reconstruction, which uses your own skin, fat, and muscles to create a chest mound or to cover the breast;
  • Fat Grafting and other specific techniques for creating nipple and areola. Fat grafting uses fat from the body as a way to naturally shape the breast.

Autologous breast reconstruction can be performed using tissue from different parts of the body:

  • abdominal tissue (DIEP Flap);
  • buttocks tissue (SGAP flap);
  • back tissue ( Latissimus Dorsi flap or TDAP flap);
  • inner tight tissue (TUG flap);
  • The Latissimus Dorsi or TDAP flap is often a combination of both Autologous breast reconstruction and an implant for increased projection.

Your surgeon will help you decide the best possible choice for you.

Options for breast reconstructive surgery in Singapore

Staged reconstruction is when breast surgery is done in phases over a period of time. This breast reconstruction is rare in Singapore.

Immediate breast reconstruction means that breast removal and reconstruction are done at the same time. This is a more common choice of plastic surgeons. The nice thing about immediate breast reconstruction is that after a mastectomy you comes out and you will have some sort of form, you will have not the same as you did before surgery but you will at least have something that makes you feel a little bit better than losing a completely flat chest with a large scar.

Delayed reconstruction is when the reconstruction happens several months or years later in a separate surgery, after radiation therapy and chemotherapy. The advantage of late reconstruction compared to immediate breast reconstruction is that it allows you to focus first on your recovery from cancer and to regain your strength. Delayed reconstruction also gives you more time to consider alternatives and make a well-informed decision about breast reconstruction.

There are different ways to reconstruct your breasts. The method you and your doctor will choose will be based on several factors, such as:

  • Your health and lifestyle;
  • Your body type;
  • The size of your breasts;
  • Your personal choice;
  • The amount of skin and tissue.

Who is a good candidate for breast reconstruction?

Good candidates for breast reconstruction in Singapore are patients that have either an abnormality to the breast or absence of the breast due to cancer surgery. You are suitable for this procedure if:

  • you accept the diagnosis and treatment;
  • you don’t have other diseases that could reduce the effect of reconstruction;
  • you are non-smoker;
  • you have realistic expectations and a positive attitude regarding the recovery of the breast and the figure as a whole.

Any patient who wants breast reconstruction and is healthy enough to undergo surgery is normally a good candidate.

Breast reconstruction flap vs Implant

Woman planning to have a breast implant

Breast reconstruction with implants is one of the most common choices for breast augmentation among women. About 80 % of ladies choosing to have it and many of them choosing to have it at the same time as their mastectomy for their cancer surgery. Implant reconstruction can recreate the volume and also give a nice shape of the breast. When you look at all the different reconstruction strategies, an implant strategy is the least complex with the least time in there with many ladies going home the next day or even the same day after this surgery. Recovery may take about six weeks but many ladies back to their normal activities within about four weeks. The major disadvantages of implant reconstruction are:

  • the lifespan of the implant;
  • rupture, in rare cases the implant should be removed because of infection;
  • risk of capsular contraction.

Flap reconstruction surgery is a procedure that uses your own tissue to reconstruct the breast, replace the volume, and give a breast symmetry. This procedure can be performed at the same time as your cancer surgery or after that. It is considered using your own tissue can make a breast more natural compared to the reconstruction with implants. However, not many women in Singapore undergo flap reconstruction. And the reason is probably that it is a complex procedure and it often takes longer to heal. Breast reconstruction flap surgery recovery time is within six to eight weeks. The benefit of using the flap method is that it may naturally change as your normal breast skin and tissue would change. The other advantage is that it gives stable and long term results, whereas with the reconstruction by using implants you may get complications over time.

What to expect during the consultation?

Consultation with a plastic surgeon in Singapore is the first step you need to take to understand how the breast reconstruction procedure will achieve optimal recovery of the injured breast. During the consultation, you should be informed about all the possibilities concerning your specific case. The consultation normally includes:

  • discussing your goals and assessing your health;
  • expected results and risks;
  • detailed information about the treatment process recommended by your surgeon, as well as additional procedures if needed;
  • Your surgeon will answer all your questions.

General health and appearance can significantly affect the outcome of the procedure. During the consultation, they will be carefully assessed and taken into account by your surgeon.

For having the best results and achieving your goals, you must:

  • Share your expectations;
  • give details about your health, medications, and vitamins you take, herbal substitutes, cigarettes, drugs, and alcohol;
  • exactly follow your surgeon’s instructions.

By deciding to consult a plastic surgeon and follow his advice and recommendations, you are actually ensuring your own safety and the success of the procedure.

Your doctor will carefully explain to you the forthcoming procedure. Before undergoing surgery in Singapore, you will get specific instructions for breast reconstruction, which will include: preoperative guidelines, diagnostic tests, and medications, instructions, and medications for the day of the operation, and other specific information related to the surgery.

The main factor for an excellent result in breast reconstruction and in any type of aesthetic or reconstructive surgery is the qualification of the surgeon, his experience, and his specializations in the country or abroad.

Possible risks and side effects

Possible risks with this procedure are infection, bleeding, and poor healing. By using the flap method, there is also a risk of significant tissue loss and loss of sensitivity, both at the donor site and at the reconstructed site. When using implants there is a risk of capsular contracture and rupture of the implant. Each operation carries risks associated with anaesthesia. These and other possible side effects should be discussed with you before the operation.

Although breast reconstruction leads to remarkable results, every qualified and respected surgeon in Singapore will tell you that reconstructed breasts cannot completely replace natural breasts. Even after corrections of the other breast, the symmetry between the two breasts will not be complete. However, when you are wearing clothes or swimsuits, your breasts will look natural and shaped.

Anxiety before breast reconstruction surgery is completely natural and justified. Share your emotions with all the questions you are interested in with your surgeon.

The type of anaesthesia that will be used depends on the surgeon’s recommendations, your preferences, and of course the specifics of the procedure. Your surgeon and medical staff will take full care of your stay and safety.

Recovery time

Recovery from breast reconstruction requires a short stay in the hospital. In Singapore, the initial reconstruction procedures are most often performed under general anaesthesia. Some secondary procedures are lighter and do not require staying in the hospital. In these cases, local anaesthesia is sufficient.

When breast reconstruction surgery is completed, the incisions will be bandaged. An elastic bandage or support bra will minimize swelling and tighten the breasts. Before you are discharged from the hospital, you will be given specific instructions that are important to follow carefully. You may go home with one or more drains in place. This is a small tube that’s put in the wound to remove extra fluid from the surgery site while it heals. When the drain is placed, the bandage should be changed the next day. The doctor will decide when the drain can be safely removed. This normally depends on how much fluid is collecting each day. The doctor probably will prescribe you some medications and painkillers.

Do not expose the scar to the sun or solarium until the 6th month of the operation. Manipulations for removing the scars can begin after 1 month. Avoid lifting heavy things. It may take around 6-8 weeks to get back to normal activities. If you have any questions about your breast reconstruction, contact your surgeon. During the recovery process, it is recommended to wear a supportive bra. It is important to clean the operated area and apply the prescribed medicated creams.

Recovery after surgical reconstruction of the breast lasts several weeks. During this time the swelling disappears and the shape and position of the breast are refined. Continue to follow your surgeon’s instructions and get checked your breast periodically.

What do you need to know?

Breast reconstruction is a highly individualized procedure. Different breast reconstruction methods offer different benefits. Your anatomy and preferences, and the surgeon’s recommendations are taken into account when choosing the appropriate course of treatment.

Flap techniques lead to a more natural feeling of the breast. These are performed when the tissue and muscle remaining after the mastectomy is insignificant. The incision lines are noticeable both on the reconstructed breast and on the donor sites. Recovery is longer. There is also a possibility of partial or complete loss of the flap due to poor healing.

Sometimes a mastectomy leaves enough tissue from the chest wall to cover the implant. Implant placement almost always requires flap techniques or tissue expansion. In tissue expansion reconstruction, recovery is easier, but the reconstruction process is longer.

Breast reconstruction ends with a reconstruction of the nipple and areola.

Reconstruction can be done once or in several stages depending on the techniques used for breast reconstruction, the treatment, and the time frame in which you want to achieve the desired results. Complete reconstruction is usually achieved through multiple procedures over several months.

The final results

The final results of breast reconstruction after a mastectomy due to cancer or other illness or accident can help you feel satisfied both physically and emotionally. Over time, some of the breast’s sensitivity returns, and the scars fade. Efforts and compromises are needed, but for most women, they are insignificant compared to a better quality of life and the capability to look and feel full again. Careful monitoring of the condition of the breast through various diagnostic techniques is really important for your health in the long run.

Remember to do regular check-ups after surgery to maintain the good results of breast reconstruction.