Breast reconstruction at Leeds Hospital

Your surgeon will use a breast implant or a tissue expander to recreate the shape of your breast. It is possible to reconstruct your breast using your own tissue. Be sure to discuss with your surgeon which procedure is right for you.

What happens during breast reconstruction using an implant or expander?

Breast reconstruction is usually performed under general anaesthesia. Your surgeon will place an implant into a space under your chest muscle. The muscle will support the implant. 

If you have already had a mastectomy, there may not be enough skin to recreate a breast shape. In this case, your surgeon may use an expandable implant (tissue expander) to stretch your skin. The expander will be placed in a pocket under your chest muscle. It will have a valve (port) so salt water (saline) can be injected into its hollow chamber. Over time, the implant will be expanded to stretch your chest tissue. Once your skin and muscle have stretched to the correct size, you will have a second operation to insert a permanent silicone implant.

Be sure to discuss the frequency of your outpatient expander appointments with your surgeon.

What happens during breast reconstruction using the latissimus dorsi muscle?

Breast reconstruction is usually performed under general anaesthesia. During breast reconstruction using a latissimus dorsi flap at Nuffield Health Hospitals, your surgeon will make an elliptical cut in your back along the natural creases of your skin, and a cut in your breast or in the front of your chest. They will move the latissimus dorsi (back) muscle around to the front of your chest and use it to create a breast shape. If you need an implant, your surgeon will create a pocket under the muscle to insert the implant.

After your breast reconstruction surgery

Once your operation is over, you’ll be taken to the recovery room where you will wake from the anaesthetic. Your breasts may be covered by dressings. Your wound may be stitched or closed with steri-strips, and you may have a small tube coming out of your wound to drain away any excess fluid from inside the wound. Please tell a member of our healthcare team if you are experiencing any pain. When you are stable and comfortable, a nurse will take you back to your room.

Back in your room

A physiotherapist will help you with exercises to help you build strength on the operated side. These exercises may be difficult at first. Just keep trying - these exercises are essential to your recovery.

You will probably be in the hospital for one to two days. Everyone heals differently, so be sure to ask your consultant about your length of stay.

Going home after breast reconstruction

You will be given instructions on how to care for your wounds, medications to relieve pain, and when you can bathe or shower, as well as specific things to look out for during your recovery.

For the first few days, you may feel quite tired. It may be a good idea to have someone help you with daily activities for the first week. You can gradually increase your activity after the first week; however, you should not attempt any strenuous activity or heavy lifting until your surgeon has cleared you.

If you have any questions or concerns about your restrictions, please ask a member of the healthcare team or the Physiotherapist.

Be sure to discuss your return to work with your surgeon.

If you have had breast reconstruction with an implant, you will need to return to our Outpatient Clinic every one to two weeks, where they will inject more saline into your implant. After your visits, your breast may ache or feel tight for a few days. Once your breast is the correct size, your surgeon will schedule a second surgery to replace your tissue expander with a permanent implant.

What are the risks of breast reconstruction?

Most people make a good recovery and return to normal activities following breast reconstruction. As with any surgery, there can be complications:

• Pain
• Bleeding
• Infection of the surgical site (incision)
• Scarring
• Blood clots (DVT - deep vein thrombosis)
  

Specific complications of breast reconstruction:

• Bruising and bleeding
• Fluid buildup inside the wound
• Chronic pain
• Numbness
• Wound breakdown
  

Specific complications of implants:

• Fluid buildup inside the implant pocket
• Infection
• Thickening or tightening of the scar tissue
• Kinking or rippling
• Rupture or deflation of the implant
  

The Medicines and Healthcare products regulatory Agency (MHRA) is responsible for ensuring the safety of implantable medical devices, including breast implants.