Breast Conservation via “Spare Skin Surgery “

Breast reconstruction via spare part surgery is a procedure available to certain patients. Your breast surgeon will inform you if you are a candidate for this type of surgery.

Certain prerequisites need to be met in order to be a candidate for this procedure. Some of those are the size of your breasts, the size and location of the tumour and your ability to receive radiation should that be required.

During this procedure the breast cancer surgeon removes the tumour and breast tissue. Our unit pathologist assesses the excised breast tissue to make sure that the tumour has been completely excised .The remaining breast tissue is  rearranged in such a way as to reconstruct the breast mound via breast reduction techniques. Some of the anterior and lateral abdominal wall skin may be mobilized and used in the reconstruction. It is important to realize that the entire inside of the breast tissue is removed and the remainder of the skin is arranged in such a way as to reconstruct a breast mound/round shape.

Breast surgery is done via incisions that surround the nipple and areola, a vertical component with or without a horizontal component the so called inverted T incisions. The incisions facilitates the movement of the nipple and areola into a new position and removing breast tissue. Once the breast tissue have been excised the surrounding breast skin flaps are arranged so as to give a cosmetically pleasing shape. Thus the breast size is reduced to accommodate the removal of the cancer and breast tissue.

It is important to realize that the entire inside of the breast is removed and it is merely the breast envelope that remains. It is impossible to predict the amount of tissue that will be available after the removal to reconstruct the breast. In addition there is a great possibility that some of the skin flaps and the nipples may not be able to stay alive once the inside of the breast tissue have been removed. This will require additional surgery to remove the necrotic or dead tissue.

The advantage of this procedure is:

1.) No additional cuts on the body besides the breast as no other donor tissue is used.

2.) Ability to receive radiation

3.) No need for prosthetic material

4.) Possibility to achieve breast reconstruction in a single stage although this may not always be possible.

5.) Reduction in the size of the breast

Disadvantages:

1.) Return to theatre

2.) Loss of skin and nipple

3.) Inability to predict the final size of the breast

Breast reconstruction via spare part surgery is a safe procedure, nevertheless as with any surgery there is always a possibility of complications. These include bleeding, infections and anesthetic related complications. The procedure leaves noticeable permanent scars and some patients have poor healing around the nipples and at the inverted T junctions, worsened by smoking.

The following pictures illustrate the reconstructive procedure