breast solutions
by Jenny Bryan
breast reconstruction
While breast reduction rarely takes priority on the waiting list for surgery, recent government initiatives mean that breast cancer operations should always be carried out urgently. Surgeons try to remove as little tissue as possible, but each year about 14,000 mastectomy operations are performed. This means removing the whole breast.
When Paula had her left breast removed at the age of 42 because of breast cancer she dreaded showing her husband:
'I was afraid he wouldn't be able to help himself going "ughhh". But he was brilliant. We talked about it and he said, if anything, he loved me more and he fancied me as much as ever,' she explains.
Just the same, Paula decided to have further surgery to reconstruct her breast so she would feel like her old self.
Wanting breast reconstruction doesn't mean you're vain. It's perfectly natural to want to look and feel yourself. Partners, friends and family may not think of you as any different, but if you are unhappy with your appearance it's quite reasonable to want to do something about it.
Ideally, you should talk about reconstructive surgery with your surgeon before your mastectomy as it may affect the way the operation is carried out, and some surgeons prefer to carry out both operations at the same time.
If you have naturally small breasts and the tumour can be removed without taking away the skin and nipple, a small implant can be inserted beneath the skin and all you'll see is a thin scar running horizontally across the breast or in the crease underneath.
If a sub-cutaneous operation isn't possible, the implant can be put deeper under the pectoral muscle on top of the chest wall. If there isn't enough tissue left on the chest to take an implant, it may be possible to stretch the skin so that an implant can be inserted. This can be done by putting an inflatable bag under the chest muscle, gradually expanding it with weekly injections of sterile solution and then replacing it with a permanent implant.
Alternatively, an inflatable implant can be inserted from the start and gradually increased in size.
nipple reconstruction
When Paula had her breast cancer surgery it wasn't possible to save her nipple. So, once her breast had been reconstructed, she decided to have a new nipple created. Her surgeon marked out a daisy shape at the centre of her new breast and cut carefully around the 'petals'. He then pulled the flaps inwards to create the shape of a nipple and stitched them in place. Three months later another doctor tattooed the finishing touches to the new nipple. Under local anaesthetic she stretched the skin and tattooed the delicate markings of the areola. Paula was thrilled.
'It's 12 months since it all started and I feel like they've cured me, given me my life back and rebuilt me. I feel great, fabulous.'
(July 2004, resources updated January 2005)
