October is breast cancer awareness month – and Wednesday 20th is Breast Reconstruction Awareness Day – so let’s create reconstructive pathways for women! Breast cancer effects many Kiwi women, of all ages, and the breast cancer journey is often scary, anxious and filled with unknowns, so it’s important we support beyond diagnosis and treatment. Breast reconstruction can restore what breastcancer takes away – normalcy, body confidence and assurance. However, too few Kiwi breast cancer patients opt for reconstruction following a mastectomy – this is often due to limited knowledge being shared. This is highlighted in a recent NZ study of patients: https://www.nzherald.co.nz/nz/cancer-breast-reconstruction-rates-much-lower-for-maori-and-pacifika-patients/XWOK5KRX2UXVE3MXWZ6ME7BFH4/

Increasing awareness about reconstruction opportunities for breast patients beyond implant speak is all important too,because it there is no one-size-fits-all. It’s a journey that is driven by personal preference, wellness, and short and long-term goals and expectations.

Specialist reconstructive surgeons, like our very own Adam Bialostocki and Brandon Adams, work with patients to achieve long-lasting, natural reconstructive results post-surgery. This can involve using tissue from a women’s own body, such as the abdomen to form a breast, alongside implant use.

So, what are the two main breast reconstructive procedures available to Kiwi women – and how do you know which is best for you?

Breast Flap Reconstruction:

This commonly used technique involves uses flaps of your own tissue – sometimes with the addition of an implant too – to reconstruct your breast/breasts. This includes taking skin, fat and sometimes muscle, from your back, bottom, inner thighs or lower abdomen. The flaps are then reshaped to form a new breast.

When is flap reconstruction most commonly used?

• Typically, it is used in delayed reconstruction – especially if radio therapy has or is being administered. Why not implants? Because radiotherapy may cause the skin around the implants to shrink which can ultimately cause scar tissue and may interfere with healing and potential implant leaks.
• Flap reconstruction is well suited to women with moderate-to-large sized breasts as these have a natural droop.
• For those wanting a good match for their other breast long-term, tissue reconstruction can provide a better partner as this will naturally conform to gravity, weight changes and aging – as opposed to an implant which may end up sitting higher in the chest wall.

Breast Implant Reconstruction:

The procedure involves inserting an implant under the skin and muscle to restore the shape and volume of your breast. It can be less extensive and involved than flap surgery – no additional tissue requirements needed – and it is often recommended for women with smaller breasts. Breast implant reconstruction lends itself to a more natural breast shape, which is firmer – however it may move less naturally than a flap reconstruction and sit higher – as age, gravity and weight loss affect the other natural breast.

Implant considerations to stay abreast of . . .

- As implants have no fixed life span (average lifespan 10years), these will need to be replaced.

- For those opting for delayed breast implant reconstruction, a permanent or temporary tissue expander will be placed behind the chest muscle. Why? This will ensure the implant sits in the right place and will disguise its outline. After several weeks after the expander has been inserted, your surgeon will inject the implant with a saline solution to inflate it.

Additional Considerations. . .

What many of us don’t realise, is that breast reconstructive procedures don’t have to be carried out immediately following a mastectomy – reconstruction can happen months, even years, following breast cancer treatment. No matter the time of surgery, post-breast surgery support and ongoing guidance is as essential to surgeons as it is to patients. With any breast matter, it is essential we arm ourselves with the best advice, guidance and support – always – let’s connect to reconstruct.

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