ACSS - Auckland City Surgical Services

Breast Surgery

Breast Surgery
This may be:

• Simple or Total: all breast tissue, skin and the nipple are surgically removed but the muscles lying under the breast and the lymph nodes are left in place.

• Modified Radical: all breast tissue, skin and the nipple as well as some lymph tissue are surgically removed.

• Partial: the breast lump and a portion of other breast tissue (up to one quarter of the breast) as well as lymph tissue are surgically removed.

• Lumpectomy: the breast lump and surrounding tissue, as well as some lymph tissue, are surgically removed. When combined with radiation treatment, this is known as breast-conserving surgery.

Breast Reconstruction
When a breast has been removed (mastectomy) because of cancer or other disease, it is possible in most cases to reconstruct a breast similar to a natural breast. A breast reconstruction can be performed as part of the breast removal operation or can be performed months or years later.

There are two methods of breast reconstruction: one involves using an implant; the other uses tissue taken from another part of your body. There may be medical reasons why one of these methods is more suitable for you or, in other cases, you may be given a choice.

Implants

A silicone sack filled with either silicone gel or saline (salt water) is inserted underneath the chest muscle and skin. Before being inserted, the skin will sometimes need to be stretched to the required breast size. This is done by placing an empty bag where the implant will finally go, and gradually filling it with saline over weeks or months. The bag is then replaced by the implant in an operation that will probably take 2-3 hours under general anaesthesia (you will sleep through it). You will probably stay in hospital for 2-5 days.

Flap Reconstruction

A skin flap taken from another part of the body such as your back, stomach or buttocks, is used to reconstruct the breast. This is a more complicated operation than having an implant and may last up to 6 hours and require a 5- to 7-day stay in hospital.

Breast Enlargement (Breast Augmentation)
Surgery to increase breast size involves inserting silicone sacks (implants) filled with silicone gel or salt water (saline) under the chest muscle and skin.

The procedure involves making a cut (incision) in the armpit, under the breast or around the areola (the dark area around the nipple) from where the implant is inserted. The surgery is usually performed under general anaesthesia (you will sleep through it) and it will probably take 1–2 hours. You will probably be able to go home the day of the operation, but you will need to arrange for someone else to drive you.

You may need to take some medication for pain relief for 2-3 days and you should rest for a few days after the surgery. You will probably be able to return to work after 7-10 days. It will take several months for the scars to fade.

Breast Lift
This is an operation that can lift and reshape sagging breasts.

The procedure usually involves removing skin from an area below the nipple and reshaping the breast. The surgery is performed under general anaesthesia (you will sleep through it) and will take about 2 hours. You will probably stay in hospital overnight and will need to arrange for someone else to drive you home the next day.

Your breasts will be bruised and swollen for several days and you may need to take some medication for pain relief. You will need to wear a special support bra continuously for 3-4 weeks after surgery. You will probably be able to return to work after about 1 week. It will take several months for the scars to fade.

Breast Reduction
Surgery to reduce breast size involves making a cut (incision) around the areola (the dark area around the nipple) straight downwards and along the crease beneath the breast. Glandular tissue, fat and skin are removed and the breast reshaped. The surgery is performed under general anaesthesia (you will sleep through it) and will take 2-4 hours. You will probably stay in hospital 1-2 nights and will need to arrange for someone else to drive you home.

You may need to take some medication for pain relief for several days and you must wear a special support bra continuously for 2 weeks after surgery. You will probably be able to return to work after about 2 weeks. It will take several months for the scars to fade.

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