Breast Reconstruction Geelong
Breast Reconstruction is an important choice for women who have undergone a mastectomy as part of their treatment for breast cancer. More recently some women may opt to undergo a mastectomy if they have a strong link to the breast cancer gene or a very strong family history of breast cancer.
Dr Rahdon is able reconstruct the breasts using your own tissue (“autologous reconstruction”) or breast implants. Both methods have their place are good choices and each has its own benefits and potential drawbacks.
The decision to have breast reconstruction surgery is very personal. You’ll have to decide if the benefits will achieve your goals and if the risks and potential complications are acceptable. The technique will vary according to the individual but recent advances make it possible in most cases to construct a breast that looks and feels very natural.
Choosing your reconstructive surgeon is important: it will affect the quality of your reconstruction as well as your choices of reconstruction. There are increasing numbers of breast surgeons offering reconstruction in Australia, but as these surgeons are not Plastic Surgeons, they are not trained in microsurgical techniques and can only offer limited reconstructive options. Dr Rahdon trained in General and Breast surgery, then trained in Plastic Surgery and followed on with a microsurgical breast reconstruction fellowship in Oxford, UK. He is highly experienced in complex breast reconstruction.
The first decision to make is when to undergo breast reconstruction surgery, and this decision will need to be made in consultation with Dr Rahdon and the treating breast surgeon. The options are either to go ahead at the same time as the breast cancer surgery (immediate reconstruction) or later (delayed reconstruction).
Immediate reconstruction is possible when there is likely to be no requirement for post-operative chest radiotherapy. A joint plan with the breast surgeon is made. In many cases most of the original skin of the breast is preserved during the mastectomy, which reduces the amount of visible scarring from the reconstruction. In some cases, even the nipple can be preserved.
Delayed reconstruction is performed more commonly. In this case the reconstruction waits for other therapies to be completed, such as radiotherapy and chemotherapy. Many women will have had a mastectomy some years earlier, and then later decide to have a reconstruction. In delayed reconstruction the original breast skin has been removed, so the procedure usually involves bringing in skin with the new breast, most often from the tummy.
Reconstructing with your own tissues is the “gold standard” and these techniques are now very sophisticated. As the reconstructions are from your own tissues, they look, feel and move much more naturally. Your reconstructed breast will gain or lose weight as you do, and will age much more like your other breast. The result is usually much better symmetry. If the tummy tissues are available, Dr Rahdon uses a DIEP (deep inferior epigastric perforator) reconstruction. This involves taking the skin and fat from a tummy tuck with its blood supply, and “re-plumbing” the tissue into a new blood supply from the chest using microsurgery. This operation preserves the abdominal muscles and of course leaves you with the bonus of a tummy tuck. Dr Rahdon uses the most advanced techniques in the world: venous couplers, VCS micro stapling devices and implantable Doppler monitoring devices to make the operation as safe and reliable as possible. He usually performs this very high-tech surgery with another Plastic Surgeon colleague. If the tummy tissues are not available, Dr Rahdon can use other tissue donor sites such as the inner thigh, back or buttock.
Autologous reconstruction may not be appropriate in some patients. Examples may be very slim patients (with no spare donor sites), slimmer patients requiring both breasts to be reconstructed, or those who are not fit for, or do not want to go through the long surgery and recovery associated with autologous reconstructions. In these patients, the reconstruction uses a tissue expander followed by a definitive implant in most cases.
In order to improve symmetry and the final aesthetic outcome, the “good” breast may need a lift or reduction. Dr Rahdon usually performs this at the same time as the main reconstruction, so that all the more major procedures are completed in one surgery. Some months later, there may end to be some minor adjustments with liposuction and/ or fat transfer, and of course nipple reconstruction.
Do I need a referral to see Dr Rahdon for a breast reconstruction?
Yes, you need a referral from your GP or breast surgeon. The consultation provides an expert assessment and all the information required to decide whether or not breast reconstruction is appropriate for you, and which technique would suit you best. During this appointment, Dr Rahdon will discuss the potential risks associated with surgery.
What are the potential risks with breast reconstruction?
The possible risks of breast reconstruction include, but are not limited to, bleeding, infection, poor healing of incisions, and anesthesia risks. You should also know that:
- Flap surgery includes the risk of partial or complete loss of the flap and a loss of sensation at both the donor and reconstruction site.
- The use of implants carry the same risks as breast augmentation.
Is breast reconstruction right for me?
Whether or not to proceed with a breast reconstruction is a highly personal decision and one that should be made after careful consideration.
Breast reconstruction is a good option for you if:
- You are able to cope well with your diagnosis and treatment
- You do not have additional medical conditions or other illnesses that may impair healing
- You have a positive outlook and realistic goals for restoring your breast and body image
Breast reconstruction typically involves several procedures performed in multiple stages. It can:
- Begin at the same time as mastectomy, or
- Be delayed until you heal from mastectomy and recover from any additional cancer treatments
It is important that you feel ready for the emotional adjustment involved in breast reconstruction. It may take some time to accept the results of breast reconstruction. Breast reconstruction can be a physically and emotionally challenging procedure for a woman who has lost a breast due to cancer or other condition although the results are very rewarding.
The creation of a new breast can dramatically improve your self-image, self-confidence and quality of life. Although surgery can give you a relatively natural-looking breast, a reconstructed breast will never look or feel exactly the same as the breast that was removed.
What is involved?
Dr Rahdon performs breast reconstruction surgery at St John of God Hospital or at Barwon Health under general anaesthetic. The operation is usually performed by two plastic surgeons and the length of the procedure is determined by what procedure is being done and whether the reconstruction is unilateral or bilateral. It can take from 6-10 hours and patients will usually remain in hospital for several days afterwards.
After the surgery you will need to wear a compression garment for your tummy and a surgical bra to help with your recovery and reduce any swelling. This garment is to be worn for six weeks, after which time you may wear whatever you choose. Several weeks off work for autologous reconstructions is recommended. Usually pain can be well managed with either endone or regular paracetamol tablets. Vigorous exercise should be avoided for the first six weeks.
Will I be able to have more than one procedure performed on the same day as my breast reconstruction?
Despite the complexity and length of the breast reconstruction surgery, Dr Rahdon will usually perform any required surgery on the “good” breast to improve the final result, ie breast lift or reduction.
What about the scars?
The location of the scars will depend on the method of breast reconstruction chosen. As part of the surgical package with Dr Rahdon we offer complimentary laser scar revision at Body Recon Cosmetic Clinic to assist with healing and improve the appearance of scars.
What happens on the day of my surgery?
You will be advised by your anaesthetist as to fasting times. On arrival at hospital you will be required to fill out some paperwork. From there you will be taken to your own private room and given a gown to change into. Your anaesthetist and Dr Rahdon will meet with you before your surgery and the nursing staff will dress you in your lovely hospital gown. Then it’s to the a aesthetic room and asleep. You will wake in the recovery ward comfortable- any discomfort will be taken care of. The first 24 hours requires close monitoring, but after that you will catch up with you rest. After a DIEP reconstruction, you will go home after 3-6 nights in hospital (1-2 nights for implant reconstructions).
As the anaesthetic wears off you may be nauseated and start to experience some discomfort. You will be given medication to take home with you and instructions on how to use it. One of our cosmetic nurse specialists will call you within 24 hours to check on you following your surgery. You
How long will my recovery be?
It depends on your operation. Implanted reconstruction patients will need a week off work, but autologous reconstruction patients usually need at least three weeks off work. It is usually two months before you can get back into vigorous exercise.
What if I don’t live in Geelong?
We have a large number of patients who travel to Geelong in order to have their surgery performed by Dr Rahdon. Following breast reconstruction you will be required to stay in hospital for a few days. Dr Rahdon will usually see you each day while you are on the ward to monitor your progress until you return home. Dr Rahdon usually likes to see patients for review appointments at two weeks, six weeks and three months. An alternative follow-up plan may be arranged depending on where you are travelling from. Of course you are welcome to contact us at any time or to make an extra appointment if you have any concerns.
How much is a consultation?
A consultation with Dr Rahdon is $170.00.The first consultation for breast reconstruction generally lasts about 1 hour. Dr Rahdon will often order special investigations such as a CT angiogram and blood tests. He will see you at least one more time prior to your reconstruction.
Will I need revision surgery?
The reality is that there are some patients that never require revision surgery and will enjoy the results from their reconstruction for decades to come. However some women’s bodies will change after having a breast reconstruction- pregnancy/breast feeding, weight fluctuations, personal preferences can all change how your breast and body looks therefore you may require revision from a preference point of view rather than a necessity.
What are the costs?
With all surgical procedures there are three costs that need to be considered. These are the surgical fee, the anaesthetic fee and the hospital fee. Some procedures are subsidised by your health fund, reducing the overall costs. The anaesthetic fee and hospital fee are dependent on the duration of the operation. Following your initial consultation you will be provided with a written estimate of the fees involved with the procedure.
When do I need to pay these fees?
Your surgical and anaesthetic fees are payable two weeks prior to your surgery. The hospital fee and any medications you are sent home with will be paid at the hospital on the day of your surgery.
Why Should I choose Dr Rahdon to perform my Breast Augmentation?
Dr Rahdon is a highly skilled, fully qualified Plastic Surgeon who specialises in and performs many breast reconstruction surgeries per year.
We are able to offer you the best facilities – St John of God Hospital Geelong has been awarded one of the best surgery centres in Australia and Body Recon Cosmetic Clinic won runner-up best MediSpa in Australia in 2012.
We are able to offer you the best post-operative care with on-call cosmetic nurse specialists and regular review appointments with Dr Rahdon to ensure you are 100% happy with your new breasts. In Geelong there is 24 hour plastic surgeon cover for emergencies.
Complimentary laser scar revision at the Body Recon Cosmetic Clinic.
Dr Rahdon uses the most up-to-date equipment and techniques in order to provide the best results possible.
What’s a breast reconstruction?
Breast reconstruction is the rebuilding of a breast. This is usually required following mastectomy for breast cancer, but it may follow prophylactic mastectomy i.e. mastectomy to prevent the development of breast cancer in women who have a high risk of developing cancer. Reconstruction may even be appropriate in women who have had breast conserving surgery (“lumpectomy” and radiotherapy) but who are left with a deformed, unattractive breast.
Breast reconstruction involves using your own tissue or implants to construct a natural-looking breast. Often this includes the reformation of a natural-looking nipple and areola. This procedure involves the use of relocated flaps of the patient’s own tissue followed by cosmetic tattooing.
As a fully trained plastic surgeon Richard Rahdon can offer you the full range of options. Almost certainly the best results are obtained from using your own tissue, using microsurgical techniques. Most breast surgeons (as opposed to plastic surgeons) who offer reconstruction will not offer this option as they are not trained in microsurgery techniques.
Richard Rahdon offers the absolute state-of-the-art in breast reconstruction techniques. He uses pre- operative CT angiogram imaging to obtain exact anatomy of the blood vessels to aid in operative planning, and he uses a DIEP flap wherever possible thus interfering less with the abdominal muscles. He uses reliable, modern microsurgery techniques and uses implantable Doppler probes for the most accurate post operative monitoring available in the world.
Immediate or delayed?
There is ongoing debate about the timing of breast reconstruction. The very best results are achieved with an immediate reconstruction (ie at the time of or soon after the mastectomy) but there are often a number of factors that make it unfeasible to perform an immediate reconstruction, such as the need for post- operative radiotherapy. Having said that, each situation is individual and the various factors need to be considered on a case by case basis.
What are the different techniques?
In increasing order of complexity:
- Implant only reconstruction
- Latisimus dorsi muscle flap and implant
- Pedicled TRAM flap
- Free tissue transfer (usually DIEP- skin and fat from the lower abdomen) where the tissue is detached from the body and reattached to its new place and joined to new blood vessels with microsurgery.
The advantages of using your own tissue are that the reconstruction feels and looks more natural and requires no further surgery once the reconstruction is complete. Using the tummy tissue means the added bonus of a tummy tuck as part of the procedure.
The DIEP reconstructions are complex and take 6-8 hours of surgery and usually about a week in hospital. The full recovery is around 6 weeks. There is usually the need for a further operation after 3-6 months to improve the symmetry of the breasts (eg to perform a lift on the other breast) and to perform the nipple and areola reconstruction, but this is minor surgery in comparison and is usually performed as a day case.
The success rate of free tissue transfer reconstructions is very high- well over 95%.
Can I still have the operation if I have had abdominal surgery before?
Most often the answer is yes. Even if you have had a caesarian section or midline scar, it is usually possible to use thre free tissue transfer technique from the abdomen. If this isn’t possible, there are other potential donor sites than can be used, such as the inner thigh or buttock.
Sometimes the free tissue transfer technique might not be appropriate- eg if you are very slim or are not well enough to undergo longer surgery. In this case Dr. Rahdon will be happy to discuss the alternatives, which will most likely be an implant based reconstruction with or with out the use of the latisimus dorsi muscle.
Am I suitable for a breast reconstruction?
Not everyone is suitable for a breast reconstruction. Suitability is a matter for you and Dr. Rahdon to discuss, following a thorough analysis of your medical history and a thorough clinical consultation. In general you will have to be in good health and be in a healthy weight range.
What are the benefits of a breast reconstruction?
The operation is very successful at increasing patient confidence and improving self esteem. Patients who have had a breast reconstruction enjoy participating in sport and being able to wear clothes and swimwear that they would have previously been too embarrassed to wear.
Where are the scars?
It depends on the technique. If you have an immediate reconstruction and have small breasts, the scar will be limited to around your nipple only, but if you have had a mastectomy there will be a visible scar over the top of your reconstructed breast. All scars are designed to be hidden under the average bra or bikini top. The scars from the donor site depend on the location, but those from the tummy (the most common donor site) are similar to that for a tummy tuck. During your consultation, Dr. Rahdon will discuss the scars in your particular case.
Is the procedure painful?
The operation is usually not very painful. While in hospital strong painkillers can be given to keep you comfortable. We will give you tablets to take when you go home to keep you comfortable.
How long does it take to recover from surgery?
Following surgery, you should wear a soft bra for six weeks. Depending on your job you can usually return to work for light duties after four weeks. By six weeks you should be able to return to full activities including sport.
Will I be told the risks and complications?
Major complications are not common after breast reconstruction surgery. During your initial consultation Dr. Rahdon will have a full discussion with you about the risks and complications of surgery. You will be given an information leaflet about breast reconstruction surgery which includes complications and if you decide to go ahead with surgery, these risks will again be discussed as part of the consenting process. Fortunately, with correct patient selection and appropriate procedure selection, the risks are kept to an absolute minimum. It is important that you should be reassured that Dr. Rahdon will not agree to perform any procedure on you unless he feels the benefits significantly outweigh the risks.