For the month of April I want to revisit Breast Reconstruction but with a focus on Autologous Tissue Reconstruction.
Avoiding using an implant in breast reconstruction eliminates many possible extra complications associated with foreign bodies. Autologous reconstruction suits specific patients and is used specifically in certain circumstances e.g: radiation
“To undergo Breast Reconstruction is entirely your choice”
This newsletter will hopefully give you some insight into your options, what you can expect and also how to hasten your recovery.
I hope you enjoy.
What is the process when undergoing breast reconstruction surgery?
If you choose to undergo Breast Reconstruction, we will discuss your individual case in detail to decide what is the best option for you.
In some cases autologous breast reconstruction is recommended. This allows further treatment post reconstruction and reduces risks associated with implants. The surgery is unfortunately long and can last anyting between 3 and 5 hours under general anaestethic.
The recovery time is also long due to the donor site sensitivity and breast sensitivity. Once recovered at approximately 6 months we will bring you back into theatre to reconstruct the nipple area too.
What donor sites can be used for autologous breast reconstruction?
There are traditionally three donor site options:
Each has it pro’s and con’s but each will have specific reference to your case and reconstruction.
- DIEP Flap – abdominal tissue is used in the reconstruction. This process is however complicated due to the necessity to perform a free tissue transplant (free flap). This means microsurgery is involved and there is risk that the flap will not survive.
- TRAM Flap – this is similar to the DIEP Flap but this time a small portion of the abdominal muscle is also used. There are free flap options but surgeons using this technique will nearly always attempt to use a pedicle (maintain permanent blood flow to the tissue) This method allows a very natural looking and feeling breast but again there is a significant risk of flap morbidity.
- LATISSIMUS Flap – probably the most popular autologous reconstruction option. This method uses your Latisimus muscle in your back for reconstruction. This is quick surgery with good cosmetic outcome. The additional benefit is that there is permanent blood flow and flap survival rates are extremely high. The Latissimus is considered world choice of breast reconstruction.
Definition of Autologous Breast Reconstruction:
Autologous reconstruction refers to plastic surgery that uses your own tissue to replace tissue that was lost to an injury or surgery. You are both the donor and the recipient of relocated tissue during autologous reconstruction. In breast reconstruction this means using your own tissue to reconstruct your breasts following mastectomy.
Post reconstruction recovery
You will be required to remain in hospital for a number of days post surgery. You will have drains inserted and the fluid drainage will need to be monitored closely. Pain can also be dealt with immediately during your hospital stay.
You will be required to take it easy for 3 or 4 weeks – this means no work, and no heavy lifting. Someone should also help you with your driving during this time.
Remember that no bathing is allowed until the drains are removed. Showering is ok, but bathing can lead to infection complications.
It is also very important to keep your follow up appointments – these are to change dressings, remove drains and generally follow up on your recovery.
Plastic & Reconstructive Surgeon
MBBCH (Wits), FCS Plast. Surg (CMSA)
PR. N0. 0304131
Life Fourways Hospital
Cedar Road & Cedar Avenue West
TEL: 011 875 1630
FAX: 011 875 1631