Breast reconstruction in London

Who breast reconstruction is for

Breast reconstruction may be considered:

• at the same time as a mastectomy (immediate reconstruction)

• months or years after a mastectomy (delayed reconstruction)

• after risk-reducing mastectomy, for example with a BRCA gene change

• to revise or improve a previous reconstruction

Reconstruction is a choice, not a requirement. Some women choose not to have it, and that decision is respected.

Reconstruction using your own tissue

Autologous reconstruction uses skin and fat moved from another part of the body to rebuild the breast. When the tissue is moved as a free flap, its blood vessels are reconnected under the microscope (microsurgery).

• DIEP flap: tissue from the lower abdomen. The abdominal muscle is preserved. It is the most commonly used free flap.

• TUG and PAP/LAP flaps: tissue from the inner or upper thigh, or from the lower back and hip area. These are options when abdominal tissue is not suitable or available.

• SGAP and IGAP flaps: tissue from the buttock.

• Pedicled and local flaps (LD, TDAP, ICAP, LICAP): tissue from the back or the side of the chest, moved while still attached to its own blood supply.

After autologous reconstruction, a small drain is usually placed at the reconstructed breast for a short time. Drains are not normally needed at the abdominal donor site.

Mr Oezdogan will explain which options suit your body, your treatment and your preferences.

Implant-based reconstruction

Reconstruction can also use a breast implant, sometimes after a tissue expander and sometimes combined with a flap. Mr Oezdogan also revises previous implant-based reconstructions, including implant replacement and correction of shape or position.

Nipple reconstruction and lipofilling

Nipple reconstruction is usually the final stage of reconstruction. Lipofilling (fat grafting) uses your own fat to refine the shape or contour of a reconstructed breast. It may be done in more than one session.

Surgery on the other breast, such as a reduction or uplift, may be offered to improve symmetry.

Your consultation

At your consultation Mr Oezdogan will:

• discuss your diagnosis, treatment plan and preferences

• examine you and explain which reconstruction options are suitable

• explain the benefits, risks, recovery and possible need for further procedures

• give you time to consider your decision

Reconstruction is planned together with your breast surgeon and oncology team.

Risks and recovery

Every operation carries risks. These are discussed in detail at your consultation and in writing before you decide. They include:

• bleeding, infection and wound-healing problems

• for flap reconstruction: partial or complete flap failure, firmness from fat necrosis, and changes at the donor site

• for implant reconstruction: capsular contracture, implant rupture and, rarely, breast implant-associated anaplastic large cell lymphoma (BIA-ALCL)

• asymmetry, and the possible need for further surgery

Flap reconstruction usually involves a hospital stay of 3–5 days and a recovery of 4–6 weeks. Implant reconstruction usually involves a shorter stay. Your own timeline will be discussed with you.

Surgery aims to restore the shape of the breast, but individual results vary and no particular outcome can be guaranteed.

Where surgery takes place

Consultations and body contouring surgery take place at Highgate Hospital (Nuffield Health) and The London Welbeck Hospital. Day-case procedures take place at Chase Lodge Hospital, Mill Hill.

Frequently asked questions

Can reconstruction be done at the same time as my mastectomy?

Often, yes. Whether immediate reconstruction is suitable depends on your cancer treatment, including any planned radiotherapy. This is decided with your breast and oncology team.

Am I suitable for a DIEP flap?

Suitability depends on the amount of abdominal tissue, previous surgery, general health and smoking status. Mr Oezdogan will assess this at your consultation and discuss alternatives if a DIEP flap is not suitable.

Is breast reconstruction covered by insurance?

Reconstruction after breast cancer is often covered by private medical insurance, subject to your policy and authorisation. It is also available on the NHS. Please check with your insurer before booking.

How do I arrange a consultation?

Send an enquiry through the Contact page.

To discuss breast reconstruction, book a consultation with Mr Oezdogan.

Discuss your options