Breast reconstruction is not just a tool for the vain

While society perceives that individuals who choose breast reconstruction do so out of vanity alone, many times it is borne out of necessity.

Due to this widespread misconception, some individuals may be discouraged from undergoing what could be a very beneficial surgical procedure, said Dr Jeffrey Chan Chee Yean, consultant plastic and reconstructive surgeon.

While improving one’s appearance is unquestionably a plus point, many individuals undergo breast reconstruction procedures to enhance various aspects of their health. The most common reason for breast reconstruction is to recreate a breast mound after a mastectomy. Patients with developmental problems in which their breasts did not develop or are unequal or asymmetrical in size, those who suffered burn trauma to the breast, and those who lost a breast due to severe infections are also candidates for breast reconstruction.

Chan said: “Patients usually express their hesitancy to undergo plastic surgery, especially pertaining to areas that can be seen as vanity points. In many cases, plastic surgery can help alleviate pain, improve mobility, and boost overall self-esteem. Patients who had breast reconstruction are happier because they can get on with their day-to-day activity such as going to the gym or swimming or attending functions wearing their favourite dress.”

Chan lists and debunks a few common misconceptions about breast reconstruction.

Misconception 1: Breast implants are the only reconstruction option

Reality: There are numerous effective breast reconstruction techniques. These are broadly divided into two major categories: implant-based reconstruction and tissue-based reconstruction using the patient’s own tissues. In the latter, surgeons can transfer the patient’s excess tissues from other body areas, such as the abdomen, thighs, or buttocks, to the chest area to build a breast mound. Utilizing the patient’s own tissues results in a more natural feel and appearance.

Misconception 2: Breasts will not be equal in size after reconstruction surgery
Reality: Naturally, a woman’s breasts are never identical on both sides. Therefore, matching a reconstructed breast to a natural breast can be difficult. For breast reconstruction, the patient's own tissue or implant will feel and appear differently than the other breast.

Typically, using the patient’s own tissue results in a more natural feel and appearance. When an implant is utilized, the distinction between the two sides becomes more pronounced. One of the top priorities of plastic surgeons is to ensure that the reconstructed breast is as similar as possible to the other breast following surgery.

Misconception 3: Sometimes there is insufficient tissue left over from a mastectomy for reconstruction surgery:

Reality: As stated previously, the patient has numerous treatment options. If there is insufficient tissue available at one site, such as the abdomen, for tissue-based breast reconstruction, the thigh or buttock tissues can be considered. Frequently, if the patient is thin, their natural breast is also smaller, so only a small amount of tissue is required from the donor sites. Additionally, if necessary, two donor sites (such as the abdomen and thigh) can be combined to create a breast mound, although the surgery will take longer, or it can be combined with an implant.

Misconception 4: Reconstructed breasts will look unnatural

Reality: Even though a reconstructed breast lacks breast tissue, it would be of sufficient size and shape to fit into a standard bra. Under clothing, it may be impossible to tell the difference. The purpose of breast reconstruction surgery is to create breasts that appear natural. The transferred tissue will be shaped and made as symmetrical as possible by an experienced reconstructive plastic surgeon to resemble a breast. Occasionally, a symmetrizing procedure must be performed on the opposite breast to compensate for volume or shape discrepancies.

Additionally, the timing of breast reconstruction surgery can have an effect on the aesthetic outcome. Immediate breast reconstruction ie, performed at the same time as the mastectomy, is often associated with the best results. However, this does not imply that patients whose reconstruction is delayed have worse outcomes. Under clothing, delayed reconstruction can also be indistinguishable from natural, non-operated breasts.


Misconception 5: Breast reconstruction surgery does not last
Reality: Tissue-based reconstruction is expected to last for the patient’s lifetime and does not require revision once completed. In contrast, patients with implant-based reconstruction frequently require further revisional surgeries in later life for long term problems. Patients should be given a range of suitable options for breast reconstruction by their plastic surgeon. Factors that influence a patient’s choice include their body type, medical history, and previous surgeries. Discussing the advantages and disadvantages of each reconstruction methods helps the surgeon reach a decision on the best approach that is ideal for the patient.