What is Breast Reconstruction?

Breast reconstruction is a surgical procedure to restore the shape, size, and appearance of one or both breasts after mastectomy, lumpectomy, or trauma, often due to breast cancer or other medical conditions. The goal is to create a natural-looking breast that aligns with the patient’s body and preferences. At Nairobi Sculpt Aesthetic Centre, Dr. Mukami Gathariki specializes in personalized breast reconstruction, offering a range of techniques to help patients regain confidence and femininity while prioritizing emotional and physical well-being.

Dr. Mukami collaborates closely with patients and their oncology teams to ensure a comprehensive, compassionate approach tailored to individual needs.

Key Benefits

• Restored Breast Appearance: Creates a natural-looking breast shape and symmetry, enhancing body image.
• Improved Emotional Well-Being: Helps patients regain confidence and a sense of wholeness after breast loss.
• Customized Results: Offers tailored options to match patient preferences, body type, and lifestyle.
• Clothing and Activity Confidence: Allows for comfortable fitting of clothes and participation in daily activities.
• Long-Lasting Outcomes: Provides durable results with proper care and maintenance.

Ideal Candidate Profile

Ideal candidates for breast reconstruction include individuals who:

• Are in good overall health, with no serious medical conditions that impair healing.
• Have undergone mastectomy, lumpectomy, or experienced breast trauma and desire restoration.
• Have completed or are near completion of cancer treatments (e.g., chemotherapy, radiation), depending on the reconstruction timing.
• Have realistic expectations, understanding that reconstructed breasts may not feel or look identical to natural breasts.
• Are non-smokers or willing to quit before and after surgery to promote healing.
• Are emotionally prepared for the process, with a clear understanding of the procedure and recovery.
• Have discussed their options with Dr. Mukami and their oncology team to align reconstruction with overall treatment plans.

During your consultation, Dr. Mukami will assess your medical history, breast anatomy, and aesthetic goals to recommend the best reconstruction approach.

Technique Variants

Dr. Mukami offers a range of breast reconstruction techniques, customized to each patient’s needs and preferences:

• Implant-Based Reconstruction: Uses saline or silicone implants to create the breast mound, often with tissue expanders to prepare the site. Ideal for patients with limited donor tissue.
• Autologous (Flap) Reconstruction: Uses the patient’s own tissue (e.g., from the abdomen, back, or thighs) to form the breast. Common techniques include:
  • DIEP Flap: Uses abdominal skin and fat without sacrificing muscle.
  • TRAM Flap: Uses abdominal tissue, including muscle, for reconstruction.
  • Latissimus Dorsi Flap: Uses back tissue to create the breast mound.
• Hybrid Reconstruction: Combines implants with flap techniques for enhanced volume and natural texture.
• Nipple and Areola Reconstruction: Performed as a separate procedure using skin grafts, tattooing, or local tissue to recreate the nipple and areola.
• Symmetry Procedures: Adjusts the opposite breast (e.g., lift, reduction, or augmentation) to achieve balance.

Reconstruction can be performed immediately (during mastectomy) or delayed (after cancer treatment), depending on medical and personal factors.

Procedure Overview

Breast reconstruction is performed under general anesthesia and varies based on the chosen technique. The process typically follows these steps:

1. Consultation and Planning: Dr. Mukami collaborates with you and your oncology team to evaluate your health, discuss goals, and select the best technique and timing (immediate or delayed).
2. Anesthesia Administration: General anesthesia is administered for comfort and safety.
3. Surgical Execution:
   • Implant-Based: Tissue expanders may be placed to stretch the skin, followed by implant insertion through incisions (often at the mastectomy site). Permanent implants are placed in a later procedure if expanders are used.
   • Flap-Based: Tissue is harvested from the donor site (e.g., abdomen, back), shaped into a breast mound, and microsurgically connected to chest blood vessels. The donor site is closed with sutures.
   • Hybrid: Combines flap tissue with an implant for optimal shape and volume.
   • Symmetry and Nipple Reconstruction: Additional procedures may adjust the opposite breast or recreate the nipple/areola for a complete result.
   • Closure: Incisions are closed with sutures, and drains may be placed to prevent fluid buildup. Compression garments or bandages support healing.
4. Recovery Initiation: Patients are monitored post-surgery in a recovery area before discharge.

The procedure takes 2–8 hours, depending on the technique, whether it’s unilateral or bilateral, and if it’s combined with mastectomy. Dr. Mukami’s expertise ensures natural-looking results with minimal scarring.

Recovery & Aftercare

Recovery from breast reconstruction varies based on the technique and timing, with the following timeline:

• First Week: Expect swelling, bruising, and discomfort, managed with prescribed pain medications. Drains and bandages may be used, and light walking is encouraged to promote circulation.
• Weeks 2–4: Swelling subsides, and drains are typically removed. Patients can return to non-strenuous work, avoiding heavy lifting or arm-intensive activities.
• Months 1–3: Initial results become visible as swelling decreases. Light exercise may resume, but strenuous activities are restricted.
• Months 6–12: Full results emerge as tissues settle and scars fade. Patients can resume all activities, including vigorous exercise, with clearance from Dr. Mukami.
• Long-Term: Regular follow-ups monitor healing and breast health. Scars continue to soften over 12–18 months.

Aftercare instructions include:

• Wearing a surgical bra or compression garment for 4–6 weeks to support healing and reduce swelling.
• Keeping incision sites clean and dry to prevent infection.
• Avoiding heavy lifting, pushing, or overhead arm movements for 6–8 weeks.
• Monitoring for signs of complications (e.g., unusual swelling, redness, or pain) and reporting them promptly.
• Attending follow-up appointments to assess healing and discuss additional procedures (e.g., nipple reconstruction).

Combining with Other Procedures

Breast reconstruction can be combined with other procedures to enhance overall results or address additional concerns, such as:

• Symmetry Procedures: Breast lift, reduction, or augmentation on the opposite breast for balanced proportions.
• Scar Revision: Improves the appearance of mastectomy or reconstruction scars for a smoother look.
• Liposuction: Contours areas like the abdomen or flanks, especially if donor tissue is harvested for flap reconstruction.
• Non-Surgical Treatments: Botox, fillers, or chemical peels to rejuvenate the face and complement the overall transformation.
• Body Contouring: Procedures like tummy tuck or body lift for patients seeking comprehensive aesthetic restoration.

Dr. Mukami will discuss combination options during your consultation to create a comprehensive treatment plan tailored to your needs.

Frequently Asked Questions

• Will breast reconstruction leave visible scars? Scars are inevitable, but Dr. Mukami places them discreetly (e.g., along mastectomy lines or donor sites) to minimize visibility, and they fade over time.
• How long do results last? Results are long-lasting, though implants may require replacement after 10–20 years, and natural aging can affect tissue-based reconstructions.
• Is the procedure painful? Mild to moderate discomfort is common, managed with pain medications, typically subsiding within 1–2 weeks.
• Can reconstruction be done immediately after mastectomy? Immediate reconstruction is possible for many patients, but delayed reconstruction may be recommended based on cancer treatment needs.
• Will reconstructed breasts feel natural? Reconstructed breasts may not have the same sensation or feel as natural breasts, but flap-based techniques often provide a more natural texture.