Mastectomy & Breast Reconstruction

Mastectomy — surgical removal of one or both breasts — is performed for breast cancer treatment or risk reduction in high-risk individuals carrying BRCA1/2 or other pathogenic variants. At SilverOak Health, mastectomy is always discussed alongside immediate or delayed breast reconstruction, as reconstructive surgery has been shown to significantly improve psychological wellbeing, body image, and quality of life after mastectomy. Our surgical oncology and plastic surgery teams collaborate in joint breast clinics and operate together to deliver seamless oncological and reconstructive care.

Skin-sparing and nipple-sparing mastectomy techniques, where oncologically safe, preserve the breast skin envelope and nipple-areolar complex, significantly improving reconstructive outcomes. Sentinel lymph node biopsy — performed through a separate small axillary incision — minimises the risk of lymphoedema by avoiding full axillary clearance in patients with clinically node-negative disease. Axillary lymph node dissection is reserved for patients with sentinel node involvement meeting specific criteria.

Reconstruction options include implant-based reconstruction using tissue expanders and definitive implants, with or without acellular dermal matrix support; autologous reconstruction using the patient's own tissue — most commonly the deep inferior epigastric perforator (DIEP) flap from the abdomen; and hybrid approaches combining implants with local or remote flaps. Our reconstructive surgeons perform free flap microsurgery to the highest standards, with flap success rates exceeding 99%. The oncoplastic approach to partial mastectomy — reshaping the remaining breast tissue and balancing the opposite breast — allows larger tumour excisions while achieving excellent cosmetic outcomes, expanding the proportion of patients eligible for breast conservation.