Breast Surgery

What is breast surgery?

Breast surgery can involve a variety of procedures. Some of these procedures performed by a general surgeon can include:

● Breast reduction or enlargement
● Lumpectomy (removal of a lump in the breast tissue)
● Mastectomy (removal of the entire breast)
● Reconstruction – this can be immediately after a mastectomy or at a later date

Breast surgery can also include procedures such as removal or drainage of abscesses, as well as breast biopsy to diagnose various conditions.

One of the most common medical conditions associated with breast surgery is cancer. Surgery is often performed to remove tumours, as well as breast tissue, which is done to avoid the spread of the cancer. In some cases the lymph nodes in the armpits may also be removed during breast surgery.

Breast reconstruction forms an important part of the treatment of breast cancer – usually where a full mastectomy has taken place. Breast reconstruction is often completed in stages, and can be done at the same time as the mastectomy (immediate reconstruction) or at a later date (delayed reconstruction).

There are two main types of reconstruction. These are implant reconstruction and flap reconstruction.

Implant reconstruction involves inserting a temporary expander to allow the skin to stretch over time. The expander is inflated over a number of sessions until eventually a permanent implant is inserted. Sometimes a permanent implant can be used from the beginning, but your surgeon will advise you on the best way forward. This procedure may require further surgery at a later date to maintain appearance.

Flap reconstruction involves transferring tissue from your back, thighs, abdomen, or buttocks to the breast area. This tissue is then shaped under the skin to create a new breast. The tissue allows a more natural feel and appearance. Flap reconstruction is more complicated than implant reconstruction and you will likely be in recovery longer.

Some women may require a combination of both procedures to create a breast large enough.

As part of the reconstruction of your breast(s), you may be offered the option to have your nipple reconstructed. This can be done by transferring the nipple from the removed breast and placing it on the new one. Nipple tattooing may also be an option.

Why should I consider getting breast surgery?

Your breast surgeon will advise whether surgery may be required for your condition. If you have been diagnosed with breast cancer, and need the tumour removed, surgery may be the only option.

You may also be at high risk of developing breast cancer due to family history and/or a specific gene mutation that you have. If this is the case, your breast surgeon may suggest removing your breast(s) as a preventative measure. This can be a traumatic and difficult period for any woman, so it is important to get the right information from your healthcare professionals before proceeding.

Enquire with our general surgeons.]

Did you know?

Breast cancer is the most common form of cancer in women in Singapore, accounting for nearly 30% of of all female cancers. Breast screening programs are therefore vital to survival rates across Singapore.¹

What are the risks of breast surgery?

If you have been advised to have breast surgery, it is important to understand the potential risks involved. These problems can include:

● Infection
● Excessive bleeding during or after surgery – this is rare
● Pain or numbness in the area
● Haematoma – a buildup of blood under the skin
● Seroma – a buildup of fluid under the skin
● Complications or reactions to the anaesthesia
● Leaking or rupture of the implants

Many of these complications are temporary, and will go away on their own. In some cases, more surgery may be required to fix complications.

How do I prepare for breast surgery?

Prior to your surgery, you will be given specific instructions from your surgical team on how to prepare. These instructions will most likely include information on when to stop taking any medication, instructions on eating and drinking before surgery, and help with smoking.

You may also have a number of additional checks such as an electrocardiogram (ECG), blood tests, and a chest X-ray.

It is also good to have some help in place ready for when you get home. This is because there will always be some lifting restrictions for a period of time following reconstruction surgery.

What can I expect during breast surgery?

Depending on the type of breast surgery, you will either receive a general or local anaesthetic. If your surgery involves a mastectomy or a reconstruction, it is likely you will receive a general anaesthetic.

Your anaesthesiologist will get you comfortable and administer the anaesthetic. Once you are asleep, your surgeon will then complete the planned procedure. The time it takes will depend on many factors, but reconstruction procedures can take up to 3 hours.

What happens after my breast surgery?

You are likely to wake up from your surgery with some pain and swelling. This should only last a week or two. Bruising may also be temporarily present. Your breast surgeon may prescribe pain medication for you to take home.

Scars will fade over time, but will not disappear completely. Wearing a compression bandage or a sports bra may help with extra support following your surgery.

Your breast surgeon and nurses will give you specific instructions on when you will be able to return to normal activities following your surgery.

It is important to keep a lookout for any redness around the breast area, as well as unusual swelling and pain. If you do notice any of these symptoms after your surgery, contact your breast surgeon as soon as you can.

[1] Jara-Lazaro, A., Thilagaratnam, S. and Tan, P. (2009). Breast cancer in Singapore: some perspectives. Breast Cancer, 17(1), pp.23-28.