FOR many years, society has held the notion that people who choose to have breast reconstruction do it solely for vanity. Though improving one's appearance is certainly an added benefit, many individuals do undergo breast reconstruction procedures to improve various aspects of their overall health.
The commonest indication for breast reconstruction is to recreate a breast mound after the native breast tissue is removed for breast cancer treatment (mastectomy).
Other candidates who are suitable for breast reconstruction include patients who have developmental problems where their breasts did not develop or are unequal or asymmetrical in size, those who suffered burn trauma to their breast or those who lost their breast to severe infections.
Sunway Medical Centre consultant plastic and reconstructive surgeon, Dr Jeffrey Chan Chee Yean says patients usually express hesitancy to undergo plastic surgery, especially pertaining to areas that may be seen as vanity points.
In many cases, plastic surgery can help alleviate pain, improve mobility and boost overall self-esteem, he explains.
"Patients who have had breast reconstruction are happier because they can get on with their day to day activity such as going to the gym or swimming or attend functions wearing their favourite dress," he says.
Dr Chan says there are a few misconceptions regarding breast reconstruction:
Myth: Breast implants are the only reconstruction option
There are many effective breast reconstruction techniques. They can be broadly divided into two major categories: implant-based reconstruction or tissue-based reconstruction using the patient's own tissue.
The surgeon can take advantage of the patient's extra tissue from other body areas, such as on the abdomen, thighs or buttocks, by transferring tissue from one body area (such as excess skin and fat from the abdomen or the thigh) to the chest area to build a breast mound. Using the patient's own tissue gives a more natural feel and look.
"Tissue-based reconstruction is expected to last for the patient's lifetime and does not require revision once completed. In contrast, patients with implant-based reconstruction frequently require further revisional surgeries in later life for long term problems," shares Dr Chan.
"You should be given a range of suitable options for breast reconstruction by your plastic surgeon. To a certain degree, it depends on your body type, medical history, and previous surgeries.
Your surgeon will discuss the advantages and disadvantages of each reconstruction method and reach a decision on the best approach that is ideal for you," he adds.
Myth: My breasts will not be equal after the reconstruction
A woman's own natural breasts are never equal between the two sides. Therefore, it can be challenging to match a reconstructed breast to a natural breast. The patient's own tissue or implant utilised for breast reconstruction is going to feel and look different from the other breast.
Using the patient's own tissue (skin and fat from another body area) typically gives a more natural feel and look. When an implant is used, the difference between the two sides is more apparent. One of the top priorities of plastic surgeons is to ensure that your reconstructed breast is as close to the other as possible after the procedure.
Myth: I don't have enough tissue to spare, how can I undergo breast reconstruction?
There are many options available to the patient. For tissue-based breast reconstruction, if there is insufficient tissue available at one site (such as the abdomen), tissue from the thigh or buttock can be considered.
Frequently, if the patient is slim, their natural breast is also smaller, therefore, only a small volume of tissue is required from the donor sites (such as abdomen, thigh, buttock). Additionally, two donor sites (for example abdomen and thigh) can be combined to make a breast mound if necessary although it will be a longer surgery, or it can be combined with an implant, explains Dr Chan.
Myth: It will look unnatural
Although a reconstructed breast does not contain breast tissue, it would have the adequate volume and shape to fit into a regular bra. It can be impossible to tell the difference under clothes. The objective of breast reconstruction surgery is to give a natural looking breast mound.
An experienced reconstructive plastic surgeon will shape the transferred tissue to look like a breast and make it to be as symmetrical as possible. Occasionally, a symmetrising procedure needs to be performed on the opposite breast to balance any mismatch in volume or shape.
The timing of breast reconstruction surgery can influence the final cosmetic result. Immediate breast reconstruction (done at the same time as the mastectomy operation) is frequently associated with the best cosmetic outcomes. This is not to say that patients who have delayed reconstruction (done at a different time to the mastectomy) have poorer outcomes.