Breast Cancer Reconstruction Surgery

Breast Cancer Reconstruction Surgery


I have written articles for a number of medical and specialist journals, both online and in print, about how to choose the right Plastic Surgeon for you and one of the main points I talk about when choosing your Surgeon is to check that their Consultant role in the NHS matches the type of work that they do in the private sector so that all their skills are honed, up to date and they are using the latest surgical techniques.


You can do your research by first looking at the hospital website which will list the surgeon, their specialist, their training background and how long they have been practising, along with their GMC number which is the General Medical Council’s register of doctors who are qualified to practice in the United Kingdom. This will include a link to their private practice website so that you can peruse their site and see a number of Before and After pictures, along with some further information and any frequently asked questions as your second port of call, in my case I own Reflect Clinic Ltd which is full of patient information in general or on specific procedures and has a contact page if you would like to ask any specific questions before you go ahead with your private surgery.


In my NHS role, I am currently working for the world renowned Christie Hospital, in Didsbury, South Manchester, where I have led the Breast Reconstruction Unit there since 2012. I’d like to tell you a little bit more about my NHS role as it is very humbling and rewarding to treat my female patients.


I take immense satisfaction from reconstructing a woman after she has had breast cancer. When I see a lady in my clinic, they have been through a really difficult time. they have had the shock of a diagnosis of breast cancer and then breast surgery, usually mastectomy if they are seeing me, and then they have had months of treatment with chemotherapy and radiotherapy. I am fortunate in that I provide a service which is the happy side of their journey and I can then physically put the patient “back together” after what is a truly arduous journey.


Types of Breast Reconstruction


Plastic Surgeons who are fully trained can perform all methods of breast reconstruction but we are the only surgeons who are skilled in reconstructing with a patient’s own tissue (known as autologous reconstruction). This involves using skin and fat from a woman’s tummy below the umbilicus (belly button) to make them a breast that feels and acts just like their natural breast. This is a long and technically challenging surgery and involves years of training in microsurgery. I typically perform 2 of these cases per month. This type of work involves a team approach and I have excellent support from a nurse in my team who specialises in Breast Reconstruction. She is able to spend lots of time talking patients through the reconstructive journey and supporting her on the emotional side of the journey.


It is an honour to be closely involved with patients at a time in their life when they are recovering from treatment and are taking positive steps to put their own life back together. I was uncertain of just how valuable breast reconstruction was when I was a trainee but now that I see first hand the huge difference it can make to a woman’s confidence and sense of self I fully understand it’s importance.


Microsurgical breast reconstruction is not the only method though, and I also perform all other methods of breast reconstruction too. Breast implant based methods of reconstruction form a large part of my work and some of this is revisional surgery which can be very challenging. I frequently see patients for a second opinion after they have had surgery elsewhere and this can then involve using the whole range of breast surgery techniques like exchanging the breast implant plus fat grafting and then perhaps a breast uplift (mastopexy) on the other side in order to achieve harmony and balance between the two breasts.


Risk reducing surgery 


I also see patients who have been identified as having a high lifetime risk of breast cancer through the Manchester Family History Clinic. These patients have either a very strong family history of breast cancer or they have been identified as having the BRCA gene which is the same diagnosis that Angelina Jolie had. The patients go through a long counselling process and they have a psychologist and a team of geneticists as well as surgeons who look after them. Once a patient has been identified and counselled, they then see a surgeon to discuss the process of risk reducing mastectomy and reconstruction.


Patients are given the chance to hear about all the options including using breast implants and their own tissue as well as other options like using the LD muscle from the back (known as the latissimus dorsi muscle, whose name means “broadest muscle of the back,” also known as the “lat”).  


All patients are different and so not all options are available to everyone. The patients are followed up for a long time and so over this lifetime they may have or may not have children, they will age and all of this can lead to changes in the breasts and the possible need for revision surgery.


Sometimes it is necessary to perform an exchange of old or oversized implants, or removal of the breast implants followed by fat grafting. Occasionally for different reasons patients want to change their implant based breast reconstruction for an autologous reconstruction using their own tummy tissue.


Up to the minute skills


Due to the high demands from this work in terms of skill required to fix many challenging problems, I ensure that I am also able to meet all of the challenges in my cosmetic practice. I regularly read medical and surgical journals to keep up to date of the latest medical innovations and breakthroughs and I meet regularly with other breast surgeons to discuss difficult cases and their management together. 


You can be sure that I will always have the latest and safest techniques to look after you and to solve any difficult problems that are referred to me from patients who have had problems with their results and which I am used to correcting on a regular basis from other surgeons both in the UK and frequently from abroad.