Primary Endocrine Therapy for Breast Cancer: A Treatment for Patients Unable to Undergo Curative Surgery

This can be a difficult question to answer. In the cosmetic setting your surgeon will listen to you about what you wish to achieve focusing on shape and volume. They will then examine and assess your chest frame to determine what range of implants are suitable for you to compliment your body shape without risk of long term poor cosmetic results.

Implants vary by brand, surface texture, volume and projection. The choices available within each of these categories can be extensive. The right implant for you will be based on a collaborative discussion between you and your surgeon to select the right implant, volume, shape and projection to be the best fit to meet your cosmetic needs.

Same day cosmetic surgery is generally very safe. Your surgeon will discuss with you specific risks which will be related to the surgery that is to be undertaken and the individual risks that may be more specific to you. This can often be related to any other medical conditions you have or if you are a smoker.

Following surgery you are observed for 2-4 hours afterwards to ensure you have recovered from the anaesthetic and there are no immediate post operative complications. If you are then deemed fit to be discharged you will be able to leave with further post operative instructions to guide you at home and also contact details should you experience any problems at home and need further medical advice. You will be required to have a responsible adult stay with you for the first night after surgery to be eligible to be discharged on the same day of your surgery.

The purpose of cosmetic and reconstructive surgery is different. Cosmetic surgery has a goal of improving the cosmetic appearance by complimenting and modifying the shape and/or size of your natural breasts. Reconstructive surgery is primarily considered for patients who may require or have a mastectomy(removal of all breast tissue). This can be for a number of reasons but primarily is for the treatment of breast cancer or risk reduction if patients have a gene defect making them much more at risk of developing breast cancer. Reconstructive surgery involves the recreating of a breast mound and shape. The cosmetic goals in reconstructive surgery can be quite different to cosmetic breast surgery due to the effects of cancer treatments and the loss of all breast tissue often preventing an optimal natural appearance to be achieved.

Both types of surgery can use implants and fat grafting but reconstructive surgery can also be undertaken by moving your own tissue from another area to recreate the breast.

If you are experiencing a breast symptom such as a new lump, skin or nipple change, nipple discharge, breast shape change, armpit lumps or breast/chest swelling in men then this clinic appointment will aim to address these and other breast symptoms. I will undertake a detailed assessment of the symptoms, screen for the need for genetic risk assessment and examine you. Based on this I will give you a clear explanation of that assessment.

I will inform you as to any diagnosis reached or the need for any imaging, which could be a breast ultrasound or mammogram to help reach that diagnosis. This may also be complimented by a tissue biopsy to confirm any diagnosis. Following any diagnosis I will discuss with you a plan of treatment or reassurance as necessary.

Breast symptoms are extremely common and can range from noticing a difference in the appearance or texture of your breasts to new lumps, nipple changes and breast pain. All breast symptoms should be reviewed by either your GP or a breast surgeon. However this does not mean to say that your symptom is likely to represent a worrying change such as cancer.

MOST breast symptoms are either the result of a normal variation in the tissues that comprise your breast or to a family of conditions that are collectively called benign breast disease. In my breast reassurance clinic I will be able to assess you and provide a diagnosis and explanation for your symptoms or if necessary, further assess the symptoms if a cancer is suspected. It is much more likely your breast symptoms are not due to breast cancer but please do be assessed for any new symptoms.

Choosing to have breast augmentation is a very personal decision. Your surgeon should guide you through this process. By doing this they should help you to decide firstly whether it is right for you and then guide you through your vision for the final look and how to achieve it. I always aim to really understand what the final desired appearance is wanted right up to the smallest detail. We discuss this based on the shape including cleavage, appearance in and out of clothes and then also volume. Following this discussion to achieve your look we may also discuss performing a small uplift as well as the use of implants.

I will always be honest about what can be expected and whether your vision of the final look is possible and responsible to achieve whilst respecting your body shape and frame. A library of my work will also be available for you to view. Beyond this it is also crucial that your surgeon discusses with you the potential risks of the surgery which should include short term and what may happen in the long term. With this entire discussion you will develop a rapport and relationship with your surgeon. You can then decide if that surgeon is the right one for you or not.

Breast augmentation surgery can be undertaken as a day case procedure. Hence you can go home the same day once you have had a period of observation after surgery. You will be fitted with a surgical bra and a binder which can be purchased by yourself or provided at the hospital. The binder provides gentle pressure from above the implants ensuring they remain in the optimal position whilst healing occurs. Please aim for about 4-6 weeks of recovery before getting back to anything strenuous such as the gym or long runs. If returning to work this can be done after 1-2 weeks but ensure you only undertake light manual labour activities.

I will ask you to wear the surgical bra as much each day and night as possible for 6 weeks to provide the best cosmetic result. Upon review during your recovery I will inform you as to when to remove the binder.