Alternatives to lipomodelling reconstruction

There is a lot of information available to those of you who want non-lipo reconstruction. Many books have been written on the subject and I have reviewed some of them for Macmillan as a Cancer Voice.

Your options include:-
Implants of a ‘foreign’ nature, such as silicon or saline-filled implants
Autologous ‘implants’ using tissue from other parts of your body, such as LD flaps or TRAM flaps
Everybody who has a reconstruction will probably have a different experience, as each persons body, cancer and treatment preferences will be different.
I do know from what I read that not every person will have the same options available to them. You only need to consider the variety of situations to realise this, for example:-
1) Bi-lateral mastectomy with immediate reconstruction
2) Bi-lateral mastectomy with delayed reconstruction
3) Single (left or right) mastectomy with immediate reconstruction
4) Single (left or right) mastectomy with delayed reconstruction
5) Lumpectomy with delayed reconstruction (usually following radiotherapy)
5a) I don’t actually know if immediate reconstructions ever done after a lumpectomy due to the effects radiotherapy can have on implants

Much expert advice and information is available and this is continually being updated. You may find it useful to find out from your surgeon what the options are for you and then read up o it. I on the other hand went about it the other way and read about all the options available and ruled out the procedures that I did not even want to consider (which was most of them in the end). My summary is never going to give you the fullest of information so please do your own careful research.

Foreign implants:
Usually silicon and can be inserted under the skin or behind the muscle on the chest wall, depending on individual circumstances. It may be necessary to use an inflatable implant first to ensure that the breast area will accommodate the final implant. All man-made implants will eventually need replacing (as at the time of writing).

Autologous ‘implants’:
Most commonly from the back or the abdomen. The donor material is removed (usually) with blood vessels still connected. This is then tunnelled under the skin to its new site in the breast. The attached blood vessels keep the relocated tissue alive and increase the chances of a successful reconstruction. I understand that sensations from the relocated tissue are felt in the source site and that muscle movement in the breast may occur when flexing muscles in the donor area.

With man-made implants the surgical site is constrained to just the chest area (and when I say just the chest I do realise that this can be a large proportion of the chest, i.e. From breast bone to beneath the armpit).
Whereas with the autologous implant there will be additional surgery at, and from, the donor site as well.
It is well to remember that all surgical sites will need to be cared for during the healing process to avoid infection setting in and potentially prolonging the time it takes to heal.

Again, I repeat what I said earlier… The information input here is information I discovered when I was researching my own reconstruction. It is not necessarily the most up to date and it is most definitely worth your while investing some of your own time in finding out what is available and also what is most appropriate for your own circumstances. Bear in mind that research into breast cancer is a very active field and developments are leaping forward all the time. You may even get to be a pioneer!



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