Cosmetic Surgery | Breast | Breast Reconstruction Surgery

Cosmetic Surgery

Breast Reconstruction Surgery

Breast reconstruction may be undertaken at the same time as breast cancer surgery   (‘immediate’ reconstruction) or at a later date (‘delayed’ reconstruction).

Miles Banwell recognises that breast reconstruction surgey is ultimately about enhancing quality of life, and that although important,  it is a secondary priority relative to the life-preserving oncological treatments and surgery that patients must endure. In this regard he works closely with patients’ oncologists, breast cancer surgeons and breast care nursing teams in  determining when will be the the optimal time to consider reconstructive breast surgery.

Miles has a subspecialty interest in breast reconstruction following cancer treatment, and has particular expertise in microsurgical breast reconstruction. In this case, a woman’s own tissue from elsewhere is used to reconstruct breast volume, instead of  using implants. For example, a  DIEP breast reconstruction uses excess abdominal skin and fat; similar tissue to that removed in a tummy tuck. Alternatively, a TUG breast reconstruction makes use of excess skin and fat on the inside of the upper thigh; similar tissue to that removed in a thigh lift procedure.

He also employs microsurgical techniques in performing local ‘perforator flap’ reconstructions of partial breast defects; these may present aesthetic problems following  breast conserving cancer surgery (e.g. wide local excisions). For example, a thoracodorsal artery perforator flap (TDAP) flap uses back tissue with a concealed scar (horizontal bra strap) to reconstruct lost volume in the lower or outer part of the breast.

Miles uses implant-based breast reconstructions when appropriate, and to improve implant aesthetics may recommend combining an implant with a layer of acellular dermis (e.g. Strattice®). However, he will caution patients that in the medium to long term, most implant-based breast reconstructions will need implant maintenance surgery.

Irrespective of the technique used for reconstruction, small additional procedures are usually required to complete the reconstruction. Miles will undertake these at a later date – they may include fat grafting of any small remaining contour irregularities, nipple reconstruction or minor scar revisions.  Balancing mastopexy (lifting) surgery to the unaffected breast is sometimes necessary to achieve optimal breast symmetry.