Breast Reconstruction Surgery | Plastic Surgery Thailand | Medical Tourism

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Breast Reconstruction Surgery
Duration	2 - 3 Hours
Surgery type	Inpatient Surgery
Anesthetic	General Anesthesia
Hospital Stay	1 - 5 Nights
Days Required in Bangkok	15- 20 Days
Plastic Surgeon	Dr. Preecha Tiewtranon
	Dr. Saran Wannachamras
Average Cost	From US$ 4800 [see note ]

Breast Reconstruction Surgery - Introduction

Breast reconstruction surgery restores breast appearance for women who have had their breast(s) removed to treat breast cancer. A plastic surgeon rebuilds the breast so it is about the same size and shape as it was before the mastectomy. The nipple and the darker area surrounding the nipple (the areola) can also be surgically reconstructed.

Some women will have breast reconstruction done at the same time as the mastectomy, while others may wait a requisite period of time.

With immediate breast reconstruction, the chest tissue is undamaged by radiation therapy or scarring. Also, immediate reconstruction means one less surgery.

Delayed breast reconstruction may be advised if radiation to the chest area is needed after the mastectomy. Radiation therapy that follows breast reconstruction can increase complications after surgery.

The reconstruction process may require one or more operations. The final surgery is typically the nipple and areola reconstruction.

Breast Reconstruction Surgery - Procedure

Plastic surgeons can perform several types of breast reconstruction surgery. Options include a newly shaped breast with the use of a breast implant, your own tissue flap, or a combination of the two. A tissue flap is a section of your own skin, fat and muscle that is moved from your stomach, back or other area of your body to the chest area.

Breast reconstruction with breast implants The most common implant is a saline-filled implant. These implants have an external silicone shell and are filled with salt water. Silicone gel-filled implants are another option for breast reconstruction. Due to the more natural feel and texture of silicone implants, many breast cancer survivors who undergo breast reconstruction choose these over saline implants.

Current breast reconstruction clinical trials are looking at new types of implants that may be beneficial for breast reconstruction.

Whatever implant you and your surgeon decide on, it is placed between layers of chest muscle, under breast skin that will be saved during the mastectomy.

Some women can have the implant placed immediately if they have relaxed muscle tone and stretchy skin and your cancer surgeon is able to do a skin- and tissue-sparing mastectomy. Women with tight chest skin and muscles, however, may need an expandable implant or a tissue expander, which is followed by a permanent implant in a two-stage operation.

Breast reconstruction with tissue flap. Tissue flap procedures use tissue from your stomach, back, thighs or buttocks to reconstruct the breast. The two most common types of tissue flap surgeries are the TRAM flap (transverse rectus abdominis muscle flap), which uses tissue from the stomach, and the latissimus dorsi flap, which uses tissue from the upper back.

The TRAM flap procedure can be done in one of two ways. The pedicle flap involves leaving the flap attached to its original blood supply and tunneling it under the skin to the breast area. In contrast, a free flap means that the surgeon cuts the flap of skin, fat, blood vessels and muscle free from its original location and then attaches the flap to blood vessels in the chest area.

The latissimus dorsi muscle flap procedure removes a large muscle in the back, along with skin and underlying fatty tissue. The surgeon uses these tissues to reconstruct the breast. Including fatty tissue helps create a more natural-looking breast, but the flap itself is usually only about one inch thick, so an implant is also required.

These tissue flap operations require two surgical sites and thus scars where the tissue was taken and on the reconstructed breast. Tissue flap breast reconstruction procedures usually cannot be offered to women with diabetes, connective tissue disease or vascular disease, or to smokers, because blood vessels are involved, and these can all damage blood vessels.

A newer type of flap procedure, the deep inferior epigastric artery perforator (DIEP) flap, uses fat and skin from the same area as the TRAM flap, but does not use the muscle to form the breast mound. This procedure results in a tightening of the lower abdomen, essentially a "tummy tuck." The procedure is done as a "free" flap, which means the donor tissue is completely removed and then reattached.

Another newer type of tissue flap surgery is called the gluteal free flap. This surgery uses tissue from the buttocks to create the breast shape. It is an option for women who cannot use the stomach sites because they are too thin.

Nipple and Areola Reconstruction

Nipple and areola reconstructions are the final phase of breast reconstruction. This separate surgery is done to make the reconstructed breast resemble the original breast more closely. It can be done on an outpatient basis with local anesthesia. It is usually done after the new breast has had time to heal, which may be three or four months after surgery. Occasionally, however, nipple reconstruction can be done at the time of the flap surgery.

The tissue used to rebuild the nipple and areola is taken from your own body, such as from the newly created breast, opposite nipple, ear, eyelid, groin, upper inner thigh or buttocks. Tattooing may be done to match the color of the nipple of the other breast and to create the areola.

What To Expect After The Surgery
May take about 6 weeks to recover from a combined mastectomy and reconstruction or from a flap reconstruction alone. Most scars fade over time, but may take a few years to lighten.

Risks

Bleeding, fluid collection, excessive scar tissue, infection, and problems with anesthesia. The implant can shift or leak, requiring its removal. Using an implant carries a remote risk of infection or capsular contraction, a condition that makes the scar, implant, and breast feel hard. Capsular contracture may be treated with additional surgery to remove the scar tissue. With any flap procedure, there is risk that it may not reattach well to blood vessels, block blood flow and reject the flap.

Recovery

You may feel tired and sore for a week or two after implant reconstruction and longer after flap procedures. Medications can control most of your discomfort. Most people can go home from the hospital in one to six days. You may be discharged with a surgical drain to help remove excess fluids from the site while it heals.

You should be up and around in six to eight weeks. If implants are used without flaps, recovery time may be shorter. Your plastic surgeon will give you more specific details about your recovery from breast reconstruction.

Pre-Surgery Medical checkup
Blood pressure, BUN, CBC, prothrombin & partial thromboplastin times, EKG & HIV tests prior to the surgery.

Cost

Average cost of Breast Reconstruction Surgery in Thailand is US$ 4,000 . But this cost may vary individually depending on the patients medical history and the surgeon and facility you chose to get the surgery done. Please mention about your insurance coverage if you may have when you request for this procedure, as health insurance policies typically cover most or all of the cost of reconstruction after a mastectomy.

"You are required to send a Photograph of your chest area frontal , sideways to the surgeon for the initial consideration and approval. Without the photographs Surgeons will not approve and schedule the consultation appointment."

All the costs quoted by the Hospital / Surgeon includes the following

Pre-Surgery Consultation
Doctors Fee
Surgery fee
Hospital room charges
Nursing fee
All medications required
Post-Operative Follow Up

In addition to the cost of the surgery, you will need to be prepared for the following additional costs.

Stay
For this procedure you are required to stay in Bangkok for at least 8 days of which you will be spending the first night at the hospital, and then you can choose whether to stay in the serviced apartment at the hospital or a hotel outside until the post surgery follow up appointment 7 days after the surgery. Surgeon will allow you to fly only after the follow up appointment, and therefore you need to plan accordingly.

Serviced apartment at the Hospital : Piyavate hospital provides a serviced apartment manned 24/7 by registered Nurses within the hospital complex, with prices ranging from US$ 45 - US$ 195 / night depending on the type of room you choose.

Hotel: If you wish to stay in a Hotel outside the hospital it could cost you anywhere between US$ 40 - 300 / night depending on the hotel you choose. There are many Quality / Clean entry level hotels that offer rooms for as little as US$ 40 in the near vicinity of the hospital and the Up market hotels near the Sukhumvit (10 mins in taxi) or Silom (25 mins in taxi) Shopping districts, the rate could go as high as USD 300 / night.

BMT Concierge Service : If you wish to have us arrange you received at the airport and arrange the round trip airport transfer, and Transfer to all of your appointments and the surgery by one of our patient co-coordinators, there will be an additional Fee of US$ 169 which is to be paid after you confirm the surgery plan. This fees only applies if you choose our Concierge service. There are no additional fee if you choose only the Surgery planning service.

All the fees due for the surgery has to be paid directly to the surgeon or the hospital before undergoing the procedure. There are no fees to be paid to us apart from the fee for the Concierge service if you wish to have us arrange all of your transportation.
If you are HIV+ve, there will be an additional 60% fee will be levied to cover the cost of additional equipment and personnel expenses.

Hospital
This Surgery will be performed at the Plastic Surgery center at Piyavate International Hospital. piyavate Hospital is ISO 9001 certified and HA accredited International Hospital in Bangkok, Thailand.
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FACIAL PLASTIC SURGERY

	FACE LIFT SURGERY Improves sagging facial skin and loose neck skin.
	EYELID SURGERY Corrects sagging or drooping eyelids, as well as bags below the eyes.
	EAR PINNING SURGERY Reduces the size of large ears or sets ears back closer to the head.
	NOSE SURGERY Reshapes the nose by reducing or increasing size.
	CHIN AUGMENTATION Reshapes the chin by inserting an implant shaving the bone.
	CHEEK AUGMENTATION Restore the fullness to your cheeks if it has been lost with aging.
	FOREHEAD LIFT Forehead lift is often performed to treat conditions associated with aging.

BREAST PLASTIC SURGERY

	BREAST AUGMENTATION Procedure to surgically enhance breast size with breast implants.
	BREAST LIFT SURGERY Breast enhancement procedure that raises and reshapes sagging breasts.
	BREAST REDUCTION SURGERY Performed to create a more proportional chest curvature with your overall body.
	BREAST RECONSTRUCTION Restores breast appearance for women who have had their breast(s) removed.
	MALE BREAST REDUCTION Reduces abnormally-enlarged, female-like breasts in men.

BODY PLASTIC SURGERY

	LIPOSUCTION Surgical procedure that vacuums fat deposits from under the skin.
	ABDOMINOPLASTY Flatten the abdomen by removing excess skin and fat.
	CALF IMPLANTS Performed to enlarge the calves, resulting in a more defined appearance.
	BUTTOCKS AUGMENTATION Procedure to surgically enhance buttocks size with implants.
	ARM LIFT Reduces or removes loose, sagging skin from the upper arm.
	BODY LIFT Body lift aims to improve the shape and tone of the underlying tissue that supports fat and skin.

OTHER PLASTIC SURGERY

	BOTOX INJECTION A toxin designed to help eliminate or improve persistent facial wrinkles.
	INJECTABLE FILLERS Used to fill in fine lines and provide more contour and definition.
	MICRODERMABRASION Used to remove superficial layers of the skin using vacuum & sand like crystals.
	SPIDER VEIN TREATMENT Removes superficial dilated veins that lie just beneath the skin..
	HAIR TRANSPLANTATION Transplantation of Grafts containing hair follicles to bald scalp
	SEX CHANGE SURGERY Reassignment of gender using a number of surgical methods.

WEIGHT LOSS SURGERY

	GASTRIC BYPASS SURGERY Gastric Bypass, Roux en-Y (Proximal) is the most commonly employed gastric bypass technique.
	ADJUSTABLE GASTRIC BANDING b Johnson, generally known as Swedish Bandy Realize Adjustable Gastric Band from Johnson & or SAG-BAND Surgery

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