Are You Looking for Breast Reconstruction in Leeds?

Breast cancer is a challenging journey, and for many women, the prospect of breast reconstruction after a mastectomy can be both empowering and daunting.

Leeds-based specialist Mr. Philip Turton offers some immediate breast reconstruction options at the time of mastectomy to help restore confidence and provide support during this critical phase of treatment.

Understanding your choices and the procedures available can help you make informed decisions about your body and recovery.

Why Consider Breast Reconstruction?

Approximately 1 in 8 women will face breast cancer in their lifetime. While breast-conserving surgery works for many, a mastectomy may be necessary or preferred in certain cases. The breast multidisciplinary team will often make recommendations here.

After a mastectomy, you have three main choices:

  1. Remain flat and use an external prosthesis. This is actually a common choice.
  2. Opt for an immediate breast reconstruction performed during the mastectomy procedure.This cannot always be recommended as some other treatments like radiotherapy may be needed.
  3. Choose a delayed breast reconstruction, allowing time for recovery or additional treatments like radiotherapy before reconstruction.

Each option is deeply personal and should align with your medical needs, lifestyle, and preferences.

What Is Involved in Breast Reconstruction?

Breast reconstruction is a major surgical procedure often requiring a series of operations to achieve optimal results. There is an inherent risk of reconstruction failure and of complications. It is therefore not a choice that everyone takes.

It is not always advised that the breast is reconstructed at the same time as a mastectomy for invasive breast cancer, especially if there is a chance that radiotherapy treatment will be required after surgery.

This is because radiotherapy can affect the breast reconstruction permanently. If we know in advance that radiotherapy is unlikely to be required, then an immediate reconstruction can be considered.

This means the breast is removed (the mastectomy) and under the same anaesthetic the surgeon (or tema of surgeons) will perform the breast reconstruction. It is usually the case that a number of operations are required to complete the reconstruction, and this should therefore be regarded as a series of operations to complete the job.
Some of these operations are done months later, and may involve procedures with implants, with fat transfer, further reshaping, the nipple reconstruction, tattooing for the areola, and surgery to the other breast is quite common to try to improve the match to the reconstructed side.

Your own medical situation and factors assessed at examination must be taken into account

breast reconstruction

When radiotherapy isn’t required, an immediate reconstruction might be an option, offering a seamless transition during a single operation.

The complete process might involve multiple stages, such as:

  • Implant placement or tissue flap surgery.
  • Fat transfer or reshaping.
  • Nipple reconstruction and areola tattooing.
  • Balancing surgery on the opposite breast for symmetry.

Decisions regarding surgery are tailored to your unique situation. Factors such as your overall health, available body tissue, hobbies, and tolerance for recovery and further procedures are all considered during consultations with Mr. Turton.

What Are the Breast Reconstruction Options?

Mr. Turton specializes in several approaches to breast reconstruction, ensuring patients in Leeds have access to modern and reliable techniques. However, he does not perform free-flap surgery which is a specialised technique performed by microvascular plastic surgeons. If Mr Turton feels you should consider that approach he will advise you see a surgeon who is specialised in that technique. Not all patients have suitable body tissue donor sites for free flap breast surgery. For example if you previously had a tummy tuck, or have a thin abdominal fat pad without loose skin. Free flap surgery generally produces the best long term results though so it should be a consideration if you are suitable. .

Mr Turton can off these options:

1. Implant-ADM Breast Reconstruction

This is the most common method in the UK. It usually involves placing a silicone breast implant behind the pectoral muscle (pre-pectoral techniques in front of the muscle may be considered). Behind the breast is a muscle called the Pectoralis Major. By lifting this muscle from its attachments to your ribs a space can be created behind the muscle where the silicone breast implant can be positioned.

The muscle is not long enough to cover the whole implant. However, it will cover the top half of the implant when it is pulled down, giving a nice smooth transition from the upper chest skin to the thin breast skin covering the muscle and implant.

However, to cover the lower half of the implant too, an artificial product called an ADM is stitched to the muscle to lengthen it. ADM is a sterile, collagen-based material derived from pig or cow skin, integrated over time into the body. Mr Turton has been using this for over 15 years. The ADM is pre-treated in a special way that removes the animal cells and leaves just the collagen material.

It is a thin product that is white in colour and packaged in ultra-sterile packaging ready for use. The surgeon cuts it to the correct shape for your implant during the operation. Once the Implant and ADM are in place, the skin of the breast is closed over the top.

Usually there is some gradual ingrowth of your body’s own tissue into the ADM in the months that follow surgery so that it becomes incorporated as part of you. The early failure rate is about 2%. Usually due to infection. Implants require long term maintenance and do not last forever.

With time some patients get capsular contraction which is the scar tightening around the implant. Around 10% of implants rupture within the first 10-years, but are often not detected (silent).

A small number of patients get other problems that are not well defined but might be attributed to the implants.

There is a rare risk of lymphoma occurring in the scar tissue around the implants (breast implant associated lymphoma) although it is usually treatable if caught early, but you should ask your surgeon about this. Additional information is available fron the MHRA website and should be reviewed by patients for updates.

Key points about this method:

  • Initial failure rate from infection (~2%).
  • Long-term maintenance is required as implants may rupture or develop complications over time (over 10%).
  • Some risks, such as capsular contraction exist but are manageable
  • Rare cases of rare implant cancers like implant-associated lymphoma.

2. Latissimus Dorsi Flap (LD Flap)

For patients needing additional soft tissue coverage, this method uses a long incision on the back to harvest muscle and skin from the back to reconstruct the breast. The latissimus dorsi muscle is repositioned on the chest while keeping its blood supply intact. An implant is commonly required behind the muscle to increase the shape and volume.

Although implants can sometimes be used on their own, there are occasions where additional skin and soft tissue cover is required over them.

This might be a deliberate choice i.e. the patient deliberately selects this technique for personal preference, or it might be recommended by your surgeon as the preferable approach.

It can sometimes be used where one technique using just implants has failed and so the LD flap becomes the backup procedure. The technique is a major operation and much more so than the Implant-ADM method, as it involves harvesting some of your own muscle and the skin of your back, which is dissected from its attachments. It takes many hours.

We then create a space under the skin of the armpit and move the latissimus dorsi muscle (completely separated now from your back and only attached to your body by its main blood supply high in the armpit which has not been cut.

These vessels enter the flap as major branches from big vessels in the armpit. These vessels run with the tendon of this muscle into the body of the muscle, and therefore keep it and the attached fat and skin alive.

The flap is therefore taken around to the front of the chest wall with its segment of overlying skin. Often patients are too slim for the LATISSIMUS DORSI flap to provide enough bulk to fully substitute your breast and therefore a breast implant is also placed underneath it.

Healing takes a little longer and although the back feels numb and tight, most patients eventually find there are minimal overall functional problems. But you would always have weakness that was measurable. You could not rock climb for example.

There are smaller muscles around the shoulder that provide a similar role to this muscle but are weaker. The overall failure rate is about 0.3%. Sometimes some of the fat goes hard (fat necrosis).

Often combined with an implant, this method:

  • Provides a natural-looking reconstruction.
  • Has a low failure rate (~0.3%).
  • May result in mild back tightness and discomfort but usually no serious disabling long-term functional issues.

3. DIEP or TRAM Flap

If you have sufficient abdominal fat, a DIEP (Deep Inferior Epigastric Perforator) flap offers a highly natural breast reconstruction option.

This is a very clever type of reconstruction performed by microvascular plastic surgeons. A flap of fatty tissue and skin is removed from the lower tummy and the blood vessels are cut. The flap is lifted out of the body and placed on the chest wall and the blood vessels are joined again to vessels under the breast bone by removing a piece of rib cartilage to gain access. The joint is called anastomosis. It tends to produce the most natural feel to a breast reconstruction and usually requires little modification as you get older. There is a failure rate of about 1-2%. Sometimes some of the fat goes hard (fat necrosis). This technique can also be very suitable to build up a breast for delayed reconstruction.

This involves transferring fat and skin from the lower tummy to the chest, reconnecting blood vessels through microsurgery. The TRAM flap is a similar procedure but uses part of the abdominal muscle.

Benefits include:

  • A natural look and feel with minimal long-term maintenance.
  • Suitability for both immediate and delayed reconstruction.

While Mr. Turton does not perform the DIEP flap himself, he collaborates with skilled colleagues in Leeds who specialize in this advanced technique. Some of these surgeons also perform TUG flaps which are taken from the upper inner thigh.

Choosing the Right Option for You

Selecting a breast reconstruction method depends on several factors:

  • Are you reconstructing one or both breasts?
  • How much body tissue is available for use in reconstruction?
  • What are your activity levels and lifestyle preferences?
  • Are you prepared for multiple surgeries and follow-up appointments?
  • Where is the surgery best conducted? Sometimes the NHS is our preferred location depending on the operation involved. Please be aware Mr Turton does not work in the NHS now and since 2025 is a full time private surgeon.

Mr. Turton offers individualized consultations to guide you through these considerations, ensuring your chosen method aligns with your health and aesthetic goals.

Why Choose Philip Turton?

With over 20-years years of expertise in breast reconstruction surgery, Mr. Philip Turton is a trusted name in Leeds. He combines advanced surgical techniques with compassionate care, working closely with his patients to achieve results that restore confidence and promote well-being. Whether you are wanting to choose an implant-based procedure, a flap method, or need referrals for specialized options, Mr. Turton provides guidance every step of the way.

Take the Next Step

Breast reconstruction is sometimes bewildering but can be a journey of healing and empowerment.
Whilst it is not for everyone, having a discussion is useful to weigh up your options.
Contact Mr. Philip Turton in Leeds today to discuss your options and take the first step towards restoring your confidence and reclaiming your body.

FAQs

Skin sparing mastectomy what is it?

If an immediate breast reconstruction is suitable, the breast tissue with or without the nipple is removed preserving the overlying breast skin. The aim of the mastectomy is to delicately remove the breast tissue from inside the breast skin envelope and only remove any involved skin.  In the majority of cases the breast skin is perfectly healthy and can be preserved to retain the original breast shape.

Reduction pattern skin sparing mastectomy

The skin envelope is reduced or make into a more ideal shape or size. Usually involves a vertical scar down the front of the breast (the nipple is removed) and a long scar across the crease. It creates a smaller breast without sag.

Nipple preserving, skin sparing mastectomy

In certain circumstances a patient may be able to retain their nipple. The incision is usually under the areola and then across to the side of the breast. If you have had radiotherapy before to the breast this would not be recommended.

Nipple sacrificing, skin sparing mastectomy

Where the nipple needs to be removed at the time of mastectomy. The nipple might be reconstructed later, or a tattoo done if the skin is too thin- this would be done  in the future once the breast reconstruction has fully healed. The scar for this approach usually goes horizontally across the front of the breast and the breast looks smaller, and often more rounded than the other side. Surgery is therefore often done to adjust the other side at a later date (mastopexy/uplift procedure).

What is acellular dermal matrix (ADM)?

ADM is a biological mesh derived from animal skin that has been processed making it completely safe to use in humans. The animal cells are removed leaving just a sheet of collagen. ADM acts like a scaffolding framework for your own blood vessels and tissue to infiltrate. The implant will be covered by your own muscle at the top and by the matrix at the bottom giving a more natural breast shape. Some other types of matrix are available that are synthetic and not derived from animals.

Who is suitable for this type of surgery?

It is most suited to those with small to moderate breasts where there is minimal breast droop (ptosis) or where a bigger breast is deliberately reduced in size as part of the reconstruction. A breast reducing (and uplifting) technique is something that large breasted women often request. This method of reconstruction allows a quicker recovery time than reconstruction involving tissue transfer from other parts of the body (flap based reconstruction).

Some patients may not be suitable for an immediate  breast reconstruction, this may be due to the type of cancer, need for further treatments, underlying  medical problems or risks .  Also this type of reconstruction may not be suitable for smokers, diabetics and those with increased body mass index as serious complications are more frequent.

What will happen to me?

The surgery and possible risks will be discussed by your breast surgeon and consent will be obtained. You will also spend time with your breast care nurse who will support you throughout the process and she will also carry out pre-operative investigations including blood tests.

The majority of patients spend one to two nights in hospital however you will be assessed to ensure you can manage safely on discharge.

Pain will be managed by local anaesthetic which is put into the breast wound at the time of surgery which should last around 4-6 hours. Oral pain killers will be encouraged once you are managing oral fluids. You will be given tablets to take home; it is recommended that you take these for at least a week. Please remember all pain relief can lead to constipation a mild laxative may be required.

Your surgeon will insert wound drains in your breast to drain away blood and tissue fluid. This is produced as a result of your surgery. These are likely to remain in place for two weeks, and as a consequence of these you will be required to take oral antibiotics for two weeks also. The breast care nurses will advise you in managing your drains.

The stitches used are dissolvable and under the skin surface. At the end of surgery steristrips are used to cover the scar lines. Dressings are used to cover your wound. These must be left in place until you see your surgeon in outpatients. Dressings need to be kept dry; however you may have a very shallow bath if you can keep the water completely away from dressings.

The physiotherapist may visit you on the ward and give you written information with regard to arm movement. However, this should be avoided for the first two weeks whilst the drains are in place and Mr Turton will advise you in out patients himself. These can be performed once you have been reviewed and assessed as ok to start doing them.

Initially you will wear a tubigrip to support your breasts and following removal of your drains a soft medium support bra may be worn. Clothing with front fastening is always easier to apply and comfortable to wear.

Are there any specific risks from this type of operation?

Partial or full skin flap loss (necrosis )

This is a rare but serious complication which may result in the implant and the affected skin having to be removed. If the circulation to the skin over the reconstruction is compromised, then some or all of the skin may not be healthy enough to survive. In some cases with appropriate dressings healing may occur but in more serious cases the skin and reconstruction cannot be saved.

Infection

If the implant becomes infected it is not usually possible to save it with antibiotics and it will need to be removed. On average in the UK this is seen to occur in 5-10% of patients within the first 6-weeks after surgery. Mr Turton’s techniques have reduced the rates of this occurring to his own patients to under 5%.

Seroma

This is a collection of plasma like fluid under the skin or around the implant. If the seroma persists for a number of weeks post drain removal it may be necessary for the fluid to be drained but this will be at the discretion of your surgeon. Too much movent too early will encourage seroma. Seroma can increase the risk of infection and losing your implant due to complications.

Red breast syndrome

Occasionally there is a transient immune reaction to the acellular dermal matrix causing the skin to become red, whilst this is not an infection it is best treated as such in order to reduce the risk of implant loss- It is not initially obvious if infection is causing the redness or a reaction.

Numbness

The tiny nerves and nerve endings, which supply the skin’s sensation are divided or disturbed by surgery when the breast tissue is removed. It is therefore common to experience numbness, which is often permanent, though usually lessens over the first few years.

Nipple complications

If your nipple has been preserved it will be numb and unable to become erect when cold or touched.

If your nipple has been preserved there is sometimes a partial loss of colour and it often becomes flatter.

The majority of nipples survive well but in the early post-operative weeks the nipple tip and areola have the potential to develop some scabbing or discolouration.  Surgical intervention is not usually required and will settle within a month. If the nipple or areola does not survive it may be possible to perform a nipple construction or tattoo at a later date.  Where the nipple does not survive it may need to be removed to prevent it from becoming infected and then deeper infection spreading to the implant and the ADM.

Implant complications

No breast reconstruction can replace the breast you have lost in terms of feeling and movement and on touching the breast you may be able to feel the implant edges under the skin and muscle. The implant will move a little when the chest wall muscles are tensed and return to its normal position when relaxed again. Because the chest wall muscle is just under the skin this looks odd as it happens. Subtle rippling of the implant surface may also be noticeable with softer implants and in general a firmer gel implant that has an tear drop shape is used to minimise this. The temperature of the breast often feels cooler.

Implant Rotation and malposition

Sometimes an implant will move out of its best position. A tear drop implant can sometimes rotate. It is better not to sleep on your front if you have an implant. If malposition occurs you may need further surgery.

 Capsular contracture

A contracture is a tight fibrous capsule that the body forms around the implant causing the breast to look less natural and feel hard. This is one of the more frequent problems in the long term and affects around 1-2% of patients per year. Smoking and radiotherapy and any deep infections  are known to increase the risks greatly. If it becomes severe, salvage with a tissue flap based reconstruction or removal of the reconstruction altogether might be required.

Need for further surgery

It is not possible to predict how your breasts will change; over time the shape and volume of your natural breast may be affected by weight loss and gain and the natural ageing process.

There is a significant chance that you will need some further aesthetic surgery at some stage-  this may be adjustment to the reconstruction or implant replacement as time progresses. Surgery may be required to the contralateral breast to improve symmetry. It is not always possible to obtain good symmetry due to the limitations of this type of surgery.

Implant rupture

Modern generation silicone breast implants have a well established safety record.  However they are not devices that will last for the rest of your life. The rupture rate is thought to be between 5 and 10% within the first 10 years after surgery. It is generally advisable to consider implant exchange after 10 years in any event.

Other Rare Implant Systemic Symptoms

It is possible in a small number of individuals that there can be unexpected systemic symptoms. The research in this area has usually discounted any association with systemic symptoms such as tiredness, dry eyes, muscle or joint aches, or automimmune disorders. Some of these problems may happen in association but purely by chance (as they would occur in women with out implants) and therefore not be related to the implants. But there have not been large enough volume, or high enough quality research studies to prove or disprove any link conclusively, and although previous studies have stated there are no links, it is fair to say there is still the possibility of a link that can affect a small percentage of susceptible people, but it has not yet been proven.

 

Implant related cancer (Anaplastic large cell lymphoma – BIA-ALCL)

There is a rare implant-associated cancer of the tissue-based white blood cells found in the capsule or fluid around the implant that is very occasionally seen years after reconstruction. A sudden effusion around the implant like a bag of fluid would always need to be assessed just in case it was caused by this rare condition. However, there are many totally innocent causes of fluid to form around an implant such as trauma, or infection, or implant rupture. However, to check for BIA-ALCL you should been seen and assessed by your specialist if it did occur. The occurrence of ALCL is difficult to quantify and some estimates put it as rare as 1 in 100,000, but in some countries such as Australia it has been estimated to affect around 1 in 3800 with some implant types. If it occurs it can usually be successfully treated by removing the implant and the capsule fully.