The Australian Society of Plastic Surgeons (ASPS) launched Breast Reconstruction Awareness (BRA) Day Australia in 2013 to raise awareness about breast reconstruction so all women, no matter where they live, have the same access to information.

In the spirit of BRA Day, this blog is about educating and building awareness around post-mastectomy breast reconstructions. A breast reconstruction is just one of many ways for women to restore confidence after breast cancer.

Did you know only around 10% of Australian women who have had a mastectomy go on to have a reconstruction?

While there is research showing there can be physical and emotional benefits for women who have a reconstruction, we believe not enough women are aware of all their options, or perhaps their options are not fully explained to them.

A mastectomy can be a very traumatic and personal experience for some women, and this can impact decision making when considering further surgery.

What some women don’t know is that in some cases, a breast reconstruction can be performed at the same time as mastectomy. Undergoing a breast reconstruction at the same time as mastectomy will give the best aesthetic results as there will be numerous highly skilled specialists working collaboratively on your procedure.

Some of the benefi­ts of an immediate reconstruction are:

  • The cosmetic results are usually better
  • More of the skin of your breast may be preserved
  • The scarring on the breast itself is usually less
  • You will only need one major anaesthetic and recovery period
  • It will involve only one stay in hospital, avoiding the stress and anxiety around returning to the hospital for a second major operation
  • You will not have to spend any time without a breast

However, before you decide on breast reconstruction, there are some important issues you should keep in mind:

  • Breast reconstruction usually requires more than one operation
  • In the right circumstances, your breast reconstruction can be performed at the same time as your mastectomy
  • Breast reconstruction may be a good option for you if you do not have additional medical conditions or other illness that may impair healing.
  • In some instances, cancer treatments may be delayed post reconstruction

Breast reconstruction is a highly individual procedure and may not be suitable for everyone, however Dr Lee and his team are always more than happy to talk about your options.

Dr Lee has significant breast reconstructive surgery experience and has previously developed innovative, minimally invasive techniques for the procedure.

BRA Day is not about trying to talk people into having a reconstruction; but simply to ensure all women and their doctors to have a conversation about breast reconstruction so women undergoing a mastectomy are aware of their options.

Dr Lee provides you with thorough instructions on post-operative care, which is critical to ensure your overall wellness and optimise the outcomes of your procedure.

Tips for self-monitoring

Get to know the normal look and feel of your breasts and self-examine your breasts and surrounding area, including the armpits up to the collarbone, regularly. A good time to self-examine is when you are in the bath or shower. Things to look for:
• Swelling
• Fluid build-up
• Lumps
• Pain
• Changes in breast shape
If you believe there are any changes, or if you have any concerns, see your GP.

We won’t forget you once you’re fully recovered!

Ensuring your ongoing care is very important to Dr Lee and his team, and our care certainly doesn’t stop once you have fully healed. We are here for the long-haul and will always be here to answer any questions you have throughout the lifetime of your implants.

Ongoing check-ups

As breast implants are not lifetime device, they generally need to be replaced or removed after 10 to 15 years, but we understand circumstances change and sometimes complications can arise that may mean you need to act sooner than anticipated. We also know the risk of serious complications, such as breast implant illness and breast implant associated anaplastic large cell lymphoma (BIA-ALCL), increases with how long a patient has had an implant.

You can book a check-up with our team throughout the duration of your breast implant lifetime. At your check-up we will also let you know any new information on your implants and answer any questions you may have.

Contact our friendly team today to learn more.

Further reading

Therapeutic Goods Administration breast implant hub

Dr Mark Lee and the team always ensure patients, past, present and prospective, are empowered to make informed choices about their healthcare and understand the risks and benefits of their preferred procedure.

Read on to find out more about the proposed regulatory action from the Therapeutic Goods Administration (TGA) for breast implants and what it means for you.

Why is there a proposed cancellation or suspension?

The TGA is currently monitoring the association between breast implants and anaplastic large cell lymphoma (ALCL), a rare cancer of the immune system. This cancer is often called BIA-ALCL, or breast implant associated anaplastic large cell lymphoma. While the factors that cause the cancer are not confirmed, there are certain risk factors that increase the likelihood of BIA-ALCL including:

  • textured implants
  • bacterial contamination during surgery
  • the patient’s genetic predisposition
  • length of time the patient has had the implant.

The TGA has proposed the cancellation or suspension based on this rare complication and has identified possible implants that need to be further investigated to ensure the utmost safety for patients moving forward.

At this stage, this is just a proposed cancellation and leading implant manufacturers are conducting thorough data reviews and safety checks to establish any patient risks.

Does this affect all types of breast implants?

The TGA has proposed regulatory action in relation to a number of textured implants only. This includes all MENTOR® SILTEX® Microtextured Breast Implants and Expanders, as well as various other providers.

All reported cases of BIA-ALCL in Australia involve patients who have had a textured implant at some point in their life. Experts believe, based on the evidence currently available, breast implant associated cancer is not related to either the contents (saline/silicone) or shape (round/teardrop) of the implant.

What happens from here?

The companies who make the affected implants need to provide additional information including safety research and data to the TGA for assessment along with the results from their own laboratory tests. The outcome of this will determine whether the implants will continue to be used, be suspended for further research or be cancelled. When more information is available, we will make this available on our blog and social media pages.

I already have breast implants, do I need to get them removed?

Generally, if you have implants and you have not noticed any significant changes to your body, it is unlikely there is any reason to worry. Any changes you may notice are unlikely to be BIA-ALCL. Given BIA-ALCL is so rare, experts do not recommend preventative removal of breast implants, unless there are specific concerns or complications with the implant.

Our strongest recommendation is to consistently monitor your breasts and overall health, and always discuss any concerns or changes you have noticed with your GP or surgeon.

I’m looking at getting breast implants, what should I do next?

It’s important you understand any surgical or invasive procedure carries risks, and no medical device is completely without risk.

If you are considering breast implants, we recommend booking an appointment with Dr Lee to discuss your desired outcome, explore the benefits and risks of the different types of implants, and determined the right type of implant for you.

If you would like to learn more about the possibility of breast implant removal surgery, or have any concerns about your current breast implants, Dr Lee and his team are always more than happy to talk about your options.

Useful links

Therapeutic Goods Administration – Breast Implant Hub

TGA’s review of textured breast implants and preliminary outcomes

Dr Mark Lee is proud to be part of a global network of doctors who donates hundreds of thousands of hours toward the care of children around the world each year. An astounding 98 surgeries have been completed as part of his recent Operation Smile Australia mission in Vijayawada, India, this month.

Reconstructive Surgery for child’s Cleft Palate in India

India remains one of the most populous areas of the world with an estimated population of 1.1 billion. This yields an estimated 24.5 million births per year and the prevalence of children born with a cleft palate is somewhere between 27,000 and 33,000 per year.

In many cases, parents cannot afford the surgeries required to live a normal life – with their children facing difficulties with speaking, eating and socialising. Operation Smile Australia believes every child should have access to world-class surgical care – enlisting the support of medical professionals like Dr Lee all across the world.

Over the past 13+ years, Operation Smile medical volunteers have treated more than 22,000 patients in India alone.

Mark has been volunteering with Operation Smile and various other aid missions around the world for nearly 20 years.

Here is Dr Lee with one of his patients in India.

Dr Lee smiling with one of his little patients in India after the cleft palate surgery

Breast augmentation and lifts are two of the most popular cosmetic surgery procedures performed in Western Australia today.

Depending on what your individual body shape is and what you’re hoping to achieve, a breast lift or a breast augmentation (or even both) may be right for you.

How are they different?

Breast augmentation or enlargement is designed to increase breast size, with various options in terms of implant size and shape that we will work through with you in your initial consultation. A breast augmentation will only impact the size of the breast, not the positioning. This is where breast lifts have become increasingly popular. A lift is designed to correct breast ‘drooping’ – commonly occurring with age, weight fluctuations and pregnancy. A lift will raise and firm the breasts by removing excess skin and reshaping the breast tissue to achieve enhanced contours.

Is a breast lift right for me?

If your breasts have lost their shape and volume over time, a lift may be the ideal cosmetic procedure for you. Remember a breast lift will not significantly change the breast size, so if you want your breasts to either look fuller or smaller – an augmentation or reduction may be a better option. Women planning a pregnancy should also be aware that this may impact the results of the lift.

Can I have an augmentation and lift at the same time?

Yes, sometimes a breast lift is performed in conjunction with breast augmentation so the position, shape and volume are enhanced during the one procedure. Depending on what your goals are (ie a change in size, position or both), Dr Lee will advise you if an augmentation and lift is the right fit for you.

What do I do before the procedure?

When you first meet with Dr Lee to discuss your lift, he will request your relevant medical history and undertake a physical exam to ensure this is the best procedure to help you achieve your goals. The consultation before you undergo a breast lift procedure is one of the most important stages of the process. This is the time to ask any questions you have around recovery time, clarify your expectations of the end result and ensure you’re completely comfortable with your decision.

What happens after my breast lift?

After your procedure, you’ll be given a post-surgical bra to promote healing and support your breasts. You’ll have some discomfort for the first few days and likely require some pain medication to keep you comfortable. Some women experience numbness in various places around the breast for up to six weeks, while any form of straining or lifting is strongly discouraged. Stitches (if not dissolvable) will be removed around 1-2 weeks following the lift.

Contact our friendly staff for more information, or to book a consultation.

Although nation-wide plastic surgery statistics are unavailable for Australia, the American Society for Aesthetic Plastic Surgery reports a steady increase in ethnic (non-Caucasian) surgeries each year. In 2017, ethnic minorities accounted for 32.1% of the total cosmetic and reconstructive procedures in the US (up 7.5% from the previous year).

Ethnic plastic surgery also appears to be increasing at a faster rate. The American Society of Plastic Surgeons reports that ethnic procedures doubled between 2005 and 2013, compared with a 35 percent increase in the Caucasian population.

Defining ‘ethnically appropriate’ surgery

Instead of aiming to erase ethnic differences, ‘ethnically appropriate’ surgery is informed by multiculturalism. It identifies differences in the needs and interests of different patients. It also determines variations in ethnic skin types in terms of likely reactions to different procedures. For example, patients with darker skin can be more susceptible to developing post-surgical pigmentation abnormalities and keloid (raised, reddish) scars. In such cases, fillers may be injected deeper into the skin to avoid hyperpigmentation. Dr Lee may also recommend pre-treating darker skin before other treatments are administered.

As a specialist plastic surgeon, Dr Mark Lee has a thorough understanding of different surgical and non-surgical techniques for patients with various skin types. He can manage any possible complications, and will always select techniques that will produce the most natural looking results.

Book an appointment at our Skin Enhance clinic to discuss your skin concerns, or contact Dr Mark Lee’s office to arrange a no-obligation surgical consultation.