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Dr.Priti Shukla - Cosmetic SurgeonMaking New Breasts with Plastic Surgery - Article
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Making New Breasts with Plastic Surgery - Article


Breast cancer is one of the most common cancer affecting women. Early detection of cancer and intensive treatment with surgery, radiotherapy and chemotherapy has increased the survival rate and a lot of patients are living long life even after breast cancer. That raises the question of quality of life of cancer survivors. Breasts are an integral part of woman's body and her self image. Without breasts women feel incomplete and studies have demonstrated that they suffer from lack of self confidence and depression. Relationships also may suffer. Lack of breast is a constant reminder of the disease that they have left behind. Plastic surgery reconstruction of new breasts after mastectomy can help women overcome the sense of loss and give them a normal body.

When the cancer is detected very early by mammography or during routine breast self examination, and its size is smaller than 2 cms and it has not spread outside the breasts, total breast need not be removed. That is why early detection is very important. Unfortunately many times cancer lump is larger or has spread to lymph nodes by the time it is detected. In this scenario complete removal of breast becomes mandatory. New breast can be made immediately at the same time of mastectomy (breast removal) or can be made at any later date. Immediate reconstruction is popular in western world, and it is also covered by insurance there (but not in India) as breast reconstruction is considered an integral part of breast cancer treatment in west. There is hardly any woman who does not get her breasts reconstructed after breast cancer. At times in advanced cases reconstruction is done as a delayed procedure, after completing chemo and radiotherapy, to make sure that the cancer will not come back.

There are many ways a new breast can be made. The most popular procedure worldwide is TRAM flap. In this procedure new breast is made by taking skin and fatty tissue from the lower abdomen below the belly button. Areola and nipple is made in second stage and a very natural looking and soft breast can be created.

Breast can also be made by taking skin and muscle from the back. This tissue is called LD( latissimus dorsi) flap. Usually a breast implant is placed under the flap to give it good size.

Breast can also be made by first stretching the skin on the flat chest with a balloon like tissue expander and then placing an implant in the stretched skin envelope after removal of tissue expander. This surgery requires two stages. Breast implants are made of high quality silicone gel and they are available in different sizes and shapes to match the normal breast.

Sometimes the normal breast is sagging or too big. In that case to achieve perfect symmetry, normal breast also can be lifted or modified in size to match the reconstructed breasts. The end result is usually pleasing and natural looking.

Breast reconstruction is a major surgical procedure. Ideally even before the cancer surgery is undertaken a plastic surgeon should be consulted to plan immediate reconstruction if possible. Close coordination between cancer surgeon and reconstructive surgeon is a must. Reconstruction surgery takes 3-4 hours to perform under general anaesthesia and 3-5 days of hospital stay is required. Complete recovery may take more than a month’s time. Areola and nipple are made usually under local anaesthesia in another stage after 3-6 months. Chemotherapy if needed can be given after or before breast reconstruction. The reconstructed breast does not interfere with follow up of cancer for recurrence.

Breast reconstruction is a popular procedure worldwide. In our country due to lack of awareness it was not so common until recently. But now more and more women are seeking this procedure to improve their quality of life for years to come.