The ideal bosom after Breast Cancer: Does it exsist?

The ideal breast reconstruction combines the following elements for most patients:

1. A long term naturally youthful appearance: filling in the cleavage and upper pole and absence of drooping) 2. Flexibility in choice of size, position and shape. 3. Symmetry in both breasts. 4. A soft natural feel 5. Compatibility with chemo- and radiotherapy 6. No lasting discomfort nor pain. 7. A minimum of cosmetically acceptable scarring, in hidden places if at all possible. 8. Low donor side morbidity 9. A low or negligible complication rate. 10. Absence of the danger of hospital infections. 11. No deep general anaesthetic. No muscle relaxants. 12. Quick recovery 13. Short down time 14. A minimal amount of short surgical stages 15. Hassle-free planning and follow-up 16. Safety, also in compromised patients. 17. A cosmetic result that is in line with expectations. 18. Cost efficiency

The HOFF method.

We specialize in cosmetic breast reconstruction under tumescent infiltration and light intravenous sedation on an outpatient basis. We aim for a permanently youthful appearance of a breast up to size DD. This long-term solution appears to be the treatment of choice in most well informed mastectomy patients. Both for surgical and practical reasons, we perform the surgery (excluding the nipple reconstruction) as a delayed reconstruction in two stages only.

Stage 1: Preparation for implantation (both sides). Latissimus Dorsi reconstruction always involves muscle and fat and, depending on the need, a variable quantity of skin. Usually, the other breast is matched at the level of skin envelope and residual breast tissue. This may be a breast lifting (traditional or BodyTIte) or a formal breast reduction with nipple repositioning.

Stage 2: Final MPS implantation. After three months, we insert the MPS implants, carefully matched for ultimate symmetry. Any asymmetries are surgically corrected if at all possible. This usually involves the final skin and scar shaping. The Nipple-areola complex (NAC): A nipple reconstruction is optional. We can offer tissue transplants or refer you for cosmetic tattooing after the implants have fully settled (6 months)

Before Surgery: We may want to ascertain the viability of the main supplying vessels with computerized angiography, when there has been surgery and or radiation performed in the armpit. We carefully plan both the donor site operation as well as the surgery to the other breast, which is usually required.

Aftercare: The immediate aftercare is done in Belgium. Most people stay 1 night in our special care hotel, together with an accompanying adult. We may remove a drain the next day, or organize removal after 5 days. Stitches are removed on day 10. There will be a careful breast measurement after a minimum settling period of two months, and no later than 1 week before the second stage, as the implant sizes and shapes have to be custom ordered. There is a 24/7 helpline available for advice.

What is a HOFF Breast Reconstruction exactly?

The following are the 7 essential elements to a HOFF breast reconstruction:

1. Aim for a long lasting youthful appearance of both breasts. It routinely involves surgery to the healthy breast.

2. Aim for detailed symmetry in 2 stages only.

3. Flexibility in size, position and shape (size B-DD).

4. Micro-textured Polyurethane Surfaced implants (MPS)

5. Latissimus Dorsi flap cover of the implant (no micro-surgery).

6. Local anaesthesia with light sedation.

7. Outpatient surgery at both stages (no hospital stay).