Currently there are three types of reconstruction that is available to the patients.

The first type of reconstruction is the one where we use an implant to fill the space. The implant is placed behind the pectoralis muscle and nowadays we commonly use a mesh or ADM to support the implant. This kind of reconstruction is easy to perform , and the recovery is very quick. It has a low rate of complication and gives an acceptable cosmetic result. The patient must accept the following if she goes for any kind of reconstruction 1) that the breast will look like a normal breast inside a Bra,It will look between 80—90 % like a normal breast when the bra is taken off,( if we are able to provide a better reslt then it is a bonus) but it will not feel like a normal breast. The breast will look uplifted initially but will drop down at a later stage. We can do fat grafting ( suck fat as in liposuction and transfer it over the reconstructed breasts at a later stage to improve the feel of the breasts and correct any defects.)

The immediate complications that may be possible are rejection of the implant or rejection of the mesh or ADM. In the long term complication there is always a possibility of development of capsular contracture and rupture of implants.
You must accept that there will be a possible change of implants once every 10-15 years. This has become a very common procedure as many surgeons can perform it and has very low morbidity and complications.

The second type of reconstruction that can be offered is what we call LD flap or Lattisimus dorsi flap with or without an addition of an implant.
In this operation the muscle from the back is swung in the front and used to construct the breast, one may use an additional implant to increase the volume.

It is a procedure with low complication rate in terms of flap failure and it has got a good cosmetic outcome however the drawback is that one has a long scar in the back .In the long term there may be difficulty in playing sport or rock climbing or swimming.(This procedure is being used much less nowadays)

The last type of reconstruction is the use of own body tissue using the fat and skin from the abdomen or buttocks or thigh. This autologous tissue(patient’s own tissue) or fat that is removed from the abdomen is then attached inside the breast envelope using a microvascular anastomosis that is done to provide the blood supply to the area
Cosmetically they have an excellent outcome and they feel like normal breasts including temperature and there is no risk that is associated with the use of an implant. Please note there will also be an associated scar at the donor site.

For some people who have a large abdominal fat this procedure may mimic a tummy tuck so the fat from the abdomen is reduced.
The drawbacks of this procedure is that it is a long procedure between 6-9 hours surgery. Patient stays in hospital for a week if everything goes right.

The recovery is about 2 to 4 weeks and if they develop complications there is long periods of dressings Depending upon the centre where it is done there is a complication rate that includes failure of the flap between 2-20 %.However in high volume centres who do this regularly this is a common procedure with excellent long term results and very low complication rates.

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