Welcome to my February Newsletter!

This month, I want to talk about breast reconstruction. With today’s surgical advances, women who need to have a mastectomy now have more reconstructive options available to them. Up to date medical techniques are used to create a breast that is similar in appearance and form to the natural breast.

Post mastectomy most women are candidates for breast reconstruction. There are a variety of reconstructive options but you may not be a candidate for all types. This month I will discuss the different options, what they entail and who they would most benefit.

Each option will have its own pros and cons; each with options to consider. It is important to fully understand the risks and rewards of undergoing one of these options.

I hope you enjoy this newsletter and remember to visit my website and my Facebook page for more info on all the procedures I perform.


Breast Reconstruction: The Basics

Breast reconstruction refers to several techniques which can be used to reconstruct the breast following removal due to mastectomy. It is often possible to start the reconstructive process at the same time as the mastectomy

However, some women prefer to postpone reconstruction until months or even years after their mastectomy. In some cases, it is recommended to wait and do a delayed reconstruction.

Breast reconstruction involves several techniques which are often performed in stages, first to create the breast mound and later to address elevation of the nipple areola complex as well as balancing of the other breast.

Some techniques may be performed under general anaesthesia and others under local anaesthesia. These techniques may include skin expansion with the insertion of an implant and flap reconstruction.

I will discuss all of the options available to you during consultation at my Pretoria office and help you to decide on the best approach for your individual needs.



It’s up to you!

Several important choices accompany every mastectomy procedure. The first, most basic decision is whether to have breast reconstruction in the first place. In my Pretoria practice, we have found that many women who undergo mastectomy choose breast reconstruction.

If you choose to undergo breast reconstruction, you also need to decide when the reconstruction will be performed, either at the time of the mastectomy (immediate reconstruction) or sometime afterwards (delayed reconstruction).

The advantages of immediate reconstruction include:

  • A subsequent surgery and recovery period are avoided.
  • Scar tissue has not formed from the mastectomy.
  • Remaining breast skin is still stretched to the size and shape of the original breast.
  • The patient does not have to see herself without any breast at all.
  • Postoperative chemotherapy or radiation therapy does not usually need to be delayed.


All the options that are available to your particular situation will be discussed with you at your consultation. The consultation usually lasts 45 minutes to an hour.


Reconstruction Options

Once you have chosen to have breast reconstruction, I will ask you to decide whether you want your breast to be replaced with an implant or autologous tissue flaps (your own body tissue) or a combination of both.

Uses breast implants filled with either saline or silicone. In cases where there is not enough skin and muscle to cover the implant, existing tissue can be stretched over time with a tissue expander or remaining muscle can be expanded immediately.

Patients choose implants because of their aesthetic appearance and minimal surgery time.

The disadvantages of breast implants include scar tissue build up, possible rejection, and the need for a second surgery to replace the tissue expander with the implant. This is the most popular option chosen in my practice.

Autologous tissue flap reconstruction rebuilds the breast by transplanting live skin, fat, andmuscle from another part of the body, usually the abdomen, buttock, back, thigh, or hip area.

The advantages of flap reconstruction are that the reconstructed breast remains live tissue, the body does not reject the tissue, and the rebuilt breast lasts for the patient’s lifetime.

The disadvantages are that the surgery is longer and more complex, there are additional scars from the donor site, and recovery time is increased.



Dr Vivien Jandera

Plastic and Reconstructive Surgeon

MBChB (UCT) FCS (SA) Plast



Pretoria East Hospital

Medical Suite M5

Tel: 012 993 0566

Fax: 012 993 0826

E-mail: drjandera@lantic.co.za




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