At Avenue Plastic Surgery we offer an individualised approach to breast reconstruction.
Have you been told that you are at high risk of developing breast cancer?
If you are at high risk of breast cancer (e.g. if you have a strong family history or have tested positive for one of the BRACA genes), then our aim is to provide you with both peace of mind and an excellent aesthetic result.
What operation is best for you?
Women who face a high risk of developing breast cancer may consider having a prophylactic mastectomy, which is a preventative surgery that removes one or both breasts to reduce the risk of developing breast cancer.
Although we are aware that many surgeons are currently performing “nipple sparing mastectomy” for women at high risk of breast cancer, we have personal experience of DCIS (pre invasive cancer) being found in the actual nipple when this was removed as part of a risk reducing mastectomy.
What is the safest option for risk reducing mastectomy?
We have developed a procedure that we believe is the safest option for a risk reducing mastectomy. We perform a total glandular mastectomy with nipple removal but fat preservation. Our MRI studies have revealed that, in women with larger breasts, there is a significant amount of fat quite separate from the mammary gland. Using MRI guidance, we are able to perform a total glandular mastectomy (including the nipple) while preserving the fat and then using this fat to reconstruct the breast. This can be performed as a double, or bilateral prophylactic mastectomy, whereby both breasts are removed.
Can the nipple be reconstructed?
Yes, excellent techniques are now available for nipple reconstruction, which can be performed once the reconstructed breast has healed. A nipple reconstruction involves a small incision being made at the site of the nipple, with the skin then being raised into a nipple shape to create the appearance of a natural nipple. The areola is then recreated by tattooing. The final result mimics the appearance of a natural nipple and areola.
How is this similar to a breast reduction?
In a breast reduction we retain the central glandular part of the breast (including the nipple) and remove all the excess fatty tissue. In a total glandular mastectomy with fat preservation we remove the entire central glandular part of the breast and use the surrounding fat to reconstruct the breast. So the operation becomes much like a breast reduction except that the entire breast gland has been removed. In most cases, the appearance of the breast is actually improved following this procedure.
Can it be done as a Day Case?
What if I have a small breast?
For women with smaller breasts requiring risk reducing mastectomy we are able to use our highly successful fat grafting procedure (with or without an implant) in order to produce a natural looking breast.
What if I have already had a mastectomy?
Fat grafting, with or without an implant, is also performed for women who have already had a mastectomy.
What is the benefit of this type of surgery?
Using these procedures, we are able to avoid the far riskier TRAM flap and DIEP flap operations for breast reconstruction. In many cases, this procedure also results in a more aesthetically pleasing breast than the original.