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Comparing different types of breast reconstruction

Things to think about when comparing different types of breast reconstruction include:

View a comparison of the pros and cons of different types of breast reconstruction.

Look, feel and movement of reconstructed breast(s)

In general, breast reconstruction techniques using tissue flaps create a more natural look, feel and movement than those involving implants. The look, feel and movement of the LD flap is more natural compared with breast implants alone. TRAM flaps and DIEP flaps result in the most ‘natural’ look, feel and movement (because the LD flap usually also has an implant).

Breast reconstructions that use a tissue flap ‘age’ with the body, like any other tissue. They also change in size if you gain or lose weight. Ageing and weight changes will be more natural with TRAM and DIEP flaps, compared with a LD flap that uses a breast implant.

Breast implants look, feel and move less naturally than breast reconstructions that use tissue flaps. Implants create firm reconstructed breast(s) that sit higher on the chest and do not change position when sitting or lying down. They also do not change position or shape with age, or with changes in body weight. They might move slightly lower over time if the chest muscle becomes weaker.

Recovery times

Breast reconstructions using a tissue flap involve longer surgery and recovery times compared with breast reconstruction using implants. Tissue flap procedures also result in more scars – on the breast and on the part of the body from which the tissue flap is taken.

"I mean I was running a business. I didn't have time to be messing around with long recovery periods and things."

Possible side effects and complications of breast reconstruction

A side effect is a result of surgery which is inevitable, is part of the surgical process that occurs in virtually all patients, but is not necessarily harmful. For example, most surgical procedures produce some kind of skin scar. Whilst scars are not desirable, they are inevitable and necessary in order for the surgery to be performed.

A complication refers to an undesired effect of breast reconstruction surgery that is not expected, occurs only in some patients, and sometimes requires medical or surgical intervention. Complications of breast reconstruction can occur soon after surgery or develop months or even years later, and may be present for an extended period of weeks or months.

Examples of possible side effects of all types of breast reconstruction surgery include:

  • All breast reconstruction surgeries involve some scarring. With breast reconstructions using implants, scars will only be on the breast. With tissue flap reconstructions, there will also be scarring on the part of the body from which the tissue has been taken.  Scars may appear thickened and reddened initially, but they usually begin to fade after about six months. The scars will never fade completely. By about 18 months after surgery, the scars will have faded as much as they ever will. Skin quality and how quickly your wound heals will affect how the scars fade. Moisturisers and massage may help. It is usually possible to hide the scars under clothing – sometimes even under swimsuits and underwear. Further surgery to improve the appearance of the scars may be an option later down the track.
  • Change in feeling or sensation in the reconstructed breast.
  • Firmness in a breast reconstructed with an implant.
  • Generalised swelling in the area/s that has been operated on.

Examples of complications of all types of breast reconstruction surgeries include:

  • Keloid scarring: These are firm, raised, reddened scars that are more common in people with darker skin tones. If you have keloid scarring, treatments are available to help.
  • Wound infection: Nursing and medical staff will look after the surgical wounds and will provide advice about how to care for the wound at home. If a mild infection develops, a course of antibiotics should clear it up. In the very unlikely event of a severe infection, surgery may be needed to clean the area and remove bacteria causing the infection.
  • Seroma: A seroma is a collection of fluid, which may develop near the surgery wounds on the breast. This fluid may reabsorb into the body over time. If not, the fluid can be drained with a needle and syringe.
  • Haematoma: A haematoma is a collection of blood, which may develop in an area of the reconstructed breast. A swollen area may be obvious and may feel uncomfortable.  Smaller haematomas will absorb into the body over time. Surgery may be needed for larger haematomas.

You should discuss with your breast reconstruction surgeon any other possible side effects and complications related to specific breast reconstruction procedures.

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