Women who undergo a mastectomy, an operation to remove the breast that is affected by cancer, are advised two options for breast reconstruction - artificial implants or autogenous reconstruction in which tissue from other parts of the body is used to create a breast.
Speaking to Gulf News, breast reconstruction specialists said that the reconstruction of both types can be carried at the time of the mastectomy or at a later stage depending on the stage of cancer, need for radiation and patient preference.
“There are two main types of reconstruction – prosthetic, in which artificial implants [silicone outer cover with either silicone gel or saline inside] are used, and autogenous, in which tissue from the body – back, buttocks or abdomen, is used to create a breast. In some cases, a combination of the two is carried out,” said Dr Zahrah Rafaei, plastic surgeon specialising in oncoplastic surgery for breast reconstruction, Rashid Hospital, Dubai.
Dr. Buthaina Al Shunnar, consultant plastic and reconstruction surgeon, Al Shunnar Plastic Surgery, Dubai, said that a breast reconstruction is a three-step process – creating a new breast to match the existing breast, nipple reconstruction and nipple tattoo.
Of artificial implants, she explained that it involves two stages. “First a tissue expander [a temporary implant] is placed to gently stretch the skin. After three to four months, this temporary implant is replaced with a permanent implant. In general, when an implant is used one could expect a second surgery within 10-20 years. Artificial implants work well for patients who need to reconstruct both breasts.”
An autogenous reconstruction is done in one stage involving either tummy fat and muscle or the back muscle, she said. “If using tummy fat, a simultaneous tummy tuck is performed, and the fat removed is used for the breast and shaped to match the other side. In all types of reconstruction, the nipple is reconstructed once the breast tissue has healed and the patient has completed treatment. First, the nipple shape is created and then it is tattooed. It is an office procedure performed under local anaesthesia.”