Breast reconstruction is a common procedure in Singapore because breast cancer is a relatively common cancer in Singapore. In fact, it is the commonest female cancer in Singapore with an incidence of about 1 in 11 women. The annual number of new breast cancer cases in Singapore is more than 1000, and the number of yearly deaths from breast cancer is more than 400. Patients who require breast reconstruction are those who have undergone a mastectomy for breast cancer. A mastectomy is an operation where the breast containing the cancerous growth is surgically removed. In the old days, the nipple, areola, a substantial amount of skin, and sometimes even the underlying pectoralis major muscle were removed as well. Fortunately, with advances in breast health screening, and early breast cancer detection and diagnosis, such radical and mutilating operations are now rarely required. When breast cancer is picked up early and the tumor is small, it can be surgically removed without removing the entire breast. This is known as a lumpectomy. If it turns out that the entire breast needs to be removed, most cancerous tumors can still be removed using mastectomy techniques that preserve the skin of the breast, the nipple areolar complex, or both. This allows the breast surgeon performing the mastectomy to minimize disfigurement to the breast and chest, and simplifies the task of breast reconstruction by the plastic surgeon. The two modern and common techniques of mastectomy are the skin sparing mastectomy and the nipple sparing mastectomy. The skin sparing mastectomy involves removing the breast and the nipple areolar complex, but preserves all the skin. The nipple sparing mastectomy, also known as a subcutaneous mastectomy, involves removal of the breast tissue only, while sparing the nipple areolar complex and all the skin. The choice between these types of mastectomy will depend on a number of factors such as the size of the tumor, its location, and whether the milk ducts close to the nipple are involved. Upon completion of the mastectomy by the breast surgeon, the plastic surgeon then becomes involved, and his job is to reconstruct the breast to make it look as natural as possible and as symmetric as possible with the opposite breast. The breast can be reconstructed using a breast implant, the patient’s own tissues harvested from another part of the body, or both. Each reconstructive option has its pros and cons, and this will be discussed in detail beforehand so that the patient can make a fully informed choice. If the plan was to reconstruct the breast with an implant but a significant amount of skin had to be removed (which is uncommon nowadays), it may be necessary to first expand the skin gradually with a tissue expander over a period of 8 to 10 weeks before replacing the expander with an implant. This is to compensate for the loss of skin by slowly stretching the remaining skin so that it can subsequently accommodate the breast implant. If no skin was removed, i.e. either a skin sparing or nipple sparing mastectomy had been performed, it should be possible to perform an immediate direct to implant reconstruction without the need for an initial period of tissue expansion. If the choice was to reconstruct the breast with the patient’s own tissues, this is often harvested from the back (the latissimus dorsi muscle flap, with or without an overlying piece of skin), or from the patient’s abdomen (the TRAM flap). In certain cases, the reconstruction may be consisted of a combination of implant and the patient’s own tissues. Again, these reconstructions are usually performed immediately after the mastectomy and during the same operation. Whether the reconstruction is implant based or soft tissue based, fat grafting can be useful ancillary tool to fine tune and enhance the result of the reconstruction. Fat grafting involves removing fat cells from other parts of the body using gentle, non-traumatic liposuction technique, purifying the fat, then injecting the purified fat cells carefully and meticulously in small parcels into the areas that need it. Thus, fat grafting allows the plastic surgeon to add volume and tissue thickness to areas that need it in order to optimize breast size and breast shape and make the result look as natural as possible. It can be considered as an “icing on the cake” procedure that provides enhancement and refinement to the overall result. Regardless of the method of reconstruction, with current advanced techniques and the availability of high quality breast implants such as the Motiva Ergonomix implant, it is often possible to fully reconstruct a breast following mastectomy and produce a new and natural looking breast. Apart from restoring volume and shape in the reconstructed breast, we should also pay attention to the issue of symmetry with the opposite breast. If the opposite breast is significantly different from the reconstructed breast in terms of size or shape, it may be necessary to modify the opposite breast accordingly by performing a breast reduction (if the opposite breast is larger), a breast augmentation (if the opposite breast is smaller), or a breast lift (if the opposite breast is sagging). To find out more about breast augmentation services, visit us at mhplasticsurgery.com.sg
March 12 2021
You have figured out how you spent your quarantine days. While eating cake for breakfast or local gyms are close so no exercise at all. Have have heard about the "freshman 15" ?? the "quarantine 15" is the same idea.
Physicians in across the country say quarantine may have changes the dietary and exercise habits and are causing people to gain weight. If you are doing the same or now facing with the same problem. there's still plenty of time to get in shape in 2021, and some Body Contouring/Bodysculpting options of MHplasticsurgery can help you feel your best in what we all hope is a more joyous and satisfying.
Liposuction is a body contouring procedure that targets pockets of stubborn fat that refuse to drop no matter how many crunches you do. While lipo is not designed for weight loss, it is an ideal body contouring procedure for someone close to their ideal body weight and looking to remove unwanted fat. Liposuction is not limited to the abdominal area and can target fat in the thighs, hips and buttocks, upper arms, back, inner knees, chest, calves and ankles.
Pain after surgery is mild and well controlled with oral pain medication. Moderate swelling and bruising are common side effects. The bruising normally takes two to three weeks to subside. About half the swelling will usually have subsided by two weeks, and about seventy percent by one month. Downtime ranges from a few days to about one week, depending on the amount of work done. Stitches are removed after one week.
Compression garments are worn over the treated body parts for a total of six weeks, initially all the time for the first two weeks, then about half the time for the next two weeks, followed by nightly for the last two weeks.
Exercise can be resumed at one month after surgery. By three months, about ninety percent of the final result can usually be seen, with the final result being attained at about six months postoperatively.
The results are normally long lasting as long as body weight is maintained.
Risks associated with liposuction include blood loss, infection, uneven contours, and skin burns. Blood loss is carefully managed by technical measures that minimize bleeding during the procedure. If large volumes of fat are to be removed, a planned blood transfusion using the patient’s own blood previously donated to the blood bank specifically for this purpose is carried out. This is known as autologous blood transfusion, and the blood is transfused immediately after the surgery. Another useful blood preservation technique that is used for large volume liposuction is hemodilution. In this technique, one or two units of blood are drawn out by the anesthetist at the start of the operation, and transfused back into the patient at the end of the surgery. These types of proactive management of blood loss ensure that the patient does not lose excessive amounts blood from the procedure, and maintains the safety of the procedure.
Infection is rare, and is prevented by attention to sterility during the procedure and prophylactic antibiotics.
The problem of uneven contours caused by uneven fat removal is minimized by the liquefying effect of the ultrasound energy on the solid fat.
The ultrasound energy of Vaser translates into heat energy. This is what produces the skin tightening effect. However, excessive heat energy applied to the skin can cause burns. Therefore, several technical precautions are observed in using this technology that ensure that the risk of this complication is low.
A tummy tuck, or abdominoplasty, is a surgical procedure that addresses sagging skin, weak muscles and pockets of fat in the abdominal area. With traditional tummy tucks, you leave the hospital with a drain in place to remove excess fluids that build up. A drainless tummy tuck avoids your body's lymphatic system, enabling you to naturally drain this fluid after your tummy tuck. In many cases, a drainless tummy tuck will also include liposuction.
With a tummy tuck, you can expect to take at least 2 weeks off from school or work for your recovery, but if you are working from home during quarantine, this is the perfect time. Once your swelling and tightness subside, you will see a flatter and firmer waistline and the body contours you were looking for. Just keep eating healthy and following a regular exercise routine and you can enjoy that slimmer waistline for years to come.
The surgical Mommy Makeover comprises breast augmentation to restore breast volume and shape (with a breast lift if sagging is present), and either RFAL or abdominoplasty to address the tummy issues. Please see the sections on Breast Augmentation, Radio Frequency Assisted Liposculpture (RFAL), and Abdominoplasty for detailed information.
RFAL is the procedure of choice when excess fat with mild to moderate skin laxity are the main problems. On the other hand, if muscle laxity or separation and severe skin laxity are present, then abdominoplasty is the appropriate option. Dr Huang will discuss the different options with you and advise you on which option is suitable for your condition after analyzing it.
To Know More About our Plastic Surgery Services visit our website MHplasticsurgeryor schedule appointment to get consultation.
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