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Reconstructive Breast Surgery

For many years plastic surgeons have focused on reconstruction of the breast following cancer surgery, when patients have undergone lumpectomy or formal mastectomy. The principal goal of breast cancer surgery is cure of the disease, and plastic surgery must always take a second place to this ultimate aim. However there are numerous techniques which allow plastic surgery to facilitate breast cancer treatment, to allow adjuvant therapies to take place, to reduce breast cancer risk, and to reconstruct and replace the breast following mastectomy and tumour resection. Each and every patient present a different profile of breast cancer diagnosis, body size and shape. All the issues of breast cancer care roll into a multidisciplinary approach to breast cancer management, with surgical oncologists, chemotherapy and radiotherapy physicians, and plastic surgeons utilising a multidisciplinary framework as a means of optimising a combination of treatments to suit each patient's needs.

Reconstructive surgery can range from simple implant placement, through to expander and tissue transplantation techniques. Modern microsurgery has allowed the importation of tissue from the abdomen, thigh or buttock as a means of replacing breast tissue resected in cancer treatment. Such tissue or autologous reconstruction techniques are increasing their role in cancer management and provide non-implant reconstructions, potentially producing long-lasting results without the need for implant replacement in the years that follow cure.

Reconstructions may be undertaken at the time of mastectomy or lumpectomy, and would be termed immediate, or can be performed months or years later, the delayed techniques. Careful preoperative analysis and team discussion will guide patients towards an appropriate technique to maximise disease control and facilitate optimal reconstruction. Some patients seek to avoid reconstruction altogether, and this route can often be supported, leaving options open for later reconstruction, months or years after primary treatment.

The diagnosis of breast cancer is a huge shock to the patient, their family, and friends. Plastic surgery can provide one pillar of support at a most difficult time. Mr Searle has significant experience in breast reconstruction in a wide range of circumstances over many years. These will be discussed at initial and subsequent consultations as plans are laid for appropriate plastic surgery input.