Reconstruction can be broadly categorized into using your own tissue (autologous) or using a breast implant. There can also be combinations of these approaches. For the purposes of this description, reconstruction of your breast with your own tissue (autologous reconstruction) using excess abdominal tissue to reconstruct one or both breasts will be described.
This technique is known as a DIEP flap surgery. DIEP stands for ‘deep inferior epigastric artery perforator’ flap and describes the blood supply of the abdominal tissue. This is the most advanced technique in breast reconstruction. It offers the advantage of being your own tissue which behaves like normal breast tissue and so therefore is a ‘like for like’ when it comes to tissue replacement.
The surgery requires adequate abdominal tissue to be available as tissue is removed much like a tummy tuck. This is performed through a very low incision that usually runs hip to hip depending on the extent of the laxity of the skin and the excess fat. It also involves cutting around the existing belly button. This results in a low scar from hip to hip and also a scar around the belly button.
This tissue is removed from its blood supply and reconnected to blood supply in the chest and the tissue is shaped to recreate a breast shape.
This is a lengthy, highly technical reconstructive procedure and is performed under a general anaesthetic.
What is the aim of breast reconstructive surgery?
To reconstruct missing breast tissue. This can involve skin, breast gland (volume), areola and nipple tissue on one or both sides.
How long will the results last?
There are changes in the breast tissue with age, weight gain, exercise, weight loss and also pregnancy.
The results of the breast reconstruction will withstand well over time but the above factors will inevitably have effects on the tissues especially untreated breast tissue.
This varies from patient to patient and can be difficult to predict.
It often involves more than one surgery for further adjustments to create symmetry.
What happens on the day of surgery?
Prior to the day of surgery you will be given the following information and it is critical to know these details ahead of time:
On the day of surgery you will be checked in by a nurse and all your details will be confirmed and you will be changed into a surgical gown.
Dr Rory will see you before your surgery to run through all the details of the surgery, the consent forms as well as performing all your surgical markings. Multiple ID checks and procedure confirmation will be performed prior to your operation as safety is a priority.
After your surgery Dr Rory will notify your friends or family to let them know the procedure has finished and put their mind at ease. Depending on the procedure he will see you after the surgery and discuss the procedure.
When you are feeling comfortable, the team will then allow you to be discharged as planned that morning. All medicines and instructions will be given to you on your discharge.
You will be discharged with a binder, which is an adjustable support garment.
How long will the surgery take?
If done in isolation, the surgery takes approximately four to five hours. This is highly variable as other procedures are performed in conjunction with DIEP flap reconstruction.
This does not include anaesthesia time. In total, the whole procedure may last longer.
Will the procedure be painful?
No, one of the primary aims of any procedure performed by Dr Rory is to create a pain free experience.
A long acting local anaesthetic agent is injected at the end of the procedure within the tightened muscle (if performed) and the wound to make you comfortable and a garment will be applied to help minimize swelling and add support.
In terms of recovery, there will be some tenderness in the surgical areas and some discomfort.
As your abdomen has been tightened up you will inevitably be hunched over for the first few days and your back will start to ache. This resolves once you stand up straight. The point at which you can stand straight varies between individuals.
Dr Rory does not used drains which again makes the procedure more comfortable. He use a drainless abdominoplasty/DIEP flap technique with internal stitches.
What is the recovery period?
This is a major procedure and so the recovery is two weeks.
During this time you can fully mobilise and are encouraged to walk around and use your arms and are encourage to do so with care.
The golden rule is no heavy lifting for the first month following the surgery or any abdominal (core) exercises.
What should I consider when recovering from the procedure?
There will be a specialized skin glue placed on the surgical areas of the breast and the abdomen and a splash proof dressing. This will allow you to shower with care. The garment should be removed before showering.
No heavy exertional activity that will cause excessive sweating, heavy lifting or jerking abdominal movements in the four weeks. This is to protect the repair of the abdominal muscles and also avoids tension in the scar.
The specialized skin glue will peel off at week three to four. At this time, a silicone based strip or gel should be applied to the dry healed scar in order to minimize the final appearance of the scar.
The garment should be worn for four to six weeks after your DIEP flap reconstruction.
The final results in terms of resolution of swelling will be at approximately four months and also the new breast shape will develop due to gravity over six to twelve months.
As you attend your wound check appointments you will see the skin glue as purple and very often the skin can appear gathered at the wound edges. This gathering of the skin will flatten over time.
The final appearance of your scars will be at eighteen months.
The scar from a DIEP flap are similar to that of an abdominoplasty scar in that it is like the handle bars of a bicycle and curves down at the edges. This is to ensure your scar is hidden by the bikini line.
What is the cost of the procedure?
The cost of the procedure starts at 125,000 AED (excluding VAT).
The final cost is determined on a case by case basis dependent on complexity and additional procedures. Combination surgeries will lower the price of individual surgeries if done together.
A full surgical no-commitment consultation with Dr Rory will provide all the necessary details for your particular case.
What are the risks of the procedure?
These include some discomfort, infection, risk of bleeding, seroma (collection of fluid), swollen abdomen, degrees of asymmetry, back pain, dog ear (bumps at the ends of wounds), recurrence of the muscle gap due to activity in the healing phase, wound breakdown, delayed wound healing, flap failure and other additional procedures.
Very often you can feel bloated after the surgery and there can be a change in your bowel habit. This varies between patients.
The final results in terms of resolution of swelling will be at approximately four months. This varies between patients.
Smokers face increased risk of flap failure, delayed wound healing and poorer quality scars generally from most surgeries. Dr Rory is therefore very strict when it comes to smoking and DIEP flap surgery surgery. You are advised to stop smoking one month before and after this surgery.
In the event of DIEP flap failure, other techniques using implants and muscle and skin from the back are used.
There is also the risk of stretching of the scar and excessive scarring such as hypetrophic or keloid scarring.
Anything in particularly important I should know about the procedure?
It’s a lengthy and technically demanding procedure requiring a three to five day stay in hospital with very high satisfaction rates if you are willing to accept the scarring which will fade over time.
Its critical not to heavy lift in the first four weeks.
The back pain during recovery is something most people experience due to not being able to stand up stand for the first few days.
Very often you can feel bloated after the surgery and there can be a change in your bowel habit.
The final results in terms of resolution of swelling will be at approximately four months. This varies between patients.
It is most commonly performed in conjunction with other procedures over time.
What is the follow up after the procedure?
Each patient has a follow up schedule that is different.
You will be advised by Dr Rory and his team your particular follow up journey.
Typically it involves seeing the team a week after surgery for a wound check, then protective dressings until the glue falls off.
Thereafter, scar checks are performed at the six week point. This schedule will differ between individuals.
You will have a separate follow up for cancer surveillance.
Who is involved in my care?
Dr Rory is the primary physician in charge of all your care. He performs all procedures himself and is meticulous about every aspect of your care.
Once he has performed a procedure on you he is available for you as your on-call doctor.
He will provide you with contact details and will be available for you. If you have any questions or concerns at any time he is available to support you.
He has trained his team around him to an exceptionally high standard from his aesthetic coordinators to aesthetic nurses.
In some instances, for example, for photography, garment fitting, wound dressings, checks or removal of stitches, his highly trained team will perform the care liasing directly with Dr Rory with real time updates.
Dr. Rory takes plastic surgery to a whole new level. Highly professional, amazing supporting staff and a true gentleman. I had a full tummy tuck done a year ago with beyond amazing results.
Dr Rory is absolutely incredible, made me feel so relaxed about my surgery. His level of care and expertise sets him as one of the best plastic surgeon in the region.
I have never experienced such a professional consultation before the treatment. He is focusing of getting natural look and i really liked that. It wasnt my first time, but im very impressed the way of communication. Not to mention the result. Thank you so much Dr. Rory, I will honestly recommend you to all my friends and definitely will come back!
Dr Rory is an absolute professional. I cannot recommend him highly enough. Always impressed with the personalised services of him and his team.
The facilities at the Lutetia clinic are very hard to beat – the whole experience is very unique.
Dr Rory is an absolute superstar. He is not only outstanding surgeon but his approach to patients is “human”. He listened to my opinion and what I wish to achieve with the treatment I opted for.
His caring but professional approach before, during and after the procedure made the whole journey ja pleasant one. Would highly recommend him to anyone who considering cosmetic procedure in Dubai.
Dr. Rory is an amazing plastic surgeon. Not only he knows the best his job , but also he is very polite and attentive to his patients after treatment too. Highly recommend.
Dr Rory is not only a gentleman but a true professional. His surgical approach and results are of the highest standard. In addition, his bedside manner and dedication to his patients is a welcomed change in an already saturated mediocre market.
I cannot recommend Dr Rory enough and have full confidence in his ability and amazing results. Any client pursuing enhancement at any level will not be disappointed.
After 10 years of contemplating breast augmentation surgery I have finally done it! I’m so glad that I decided to finally have my surgery performed by Dr Rory McGoldrick and his wonderful team. I’m so happy with the results and would highly recommend him if you are looking to have this procedure done.
The most professional service and a level of care which is exceptional. Absolute pleasure. Big thank you to Dr. Rory and his team.
I recently had breast reduction surgery with Dr. Rory. I can honestly say it was the best thing I have ever done, after 4 children and turning 50, I feel like a new person.
Dr. Rory was amazing from the moment I walked into his office, until now with my aftercare 2 months later. If you are thinking of having this or any other type of surgery done, he is your surgeon, genuine, understanding and most important he listens to what you want and gives his best guidance. Thank you Dr. Rory for changing my life.
After meeting a few other surgeons, I was not sure I would proceed with my surgery in Dubai. Then I was referred to Dr. Rory from a friend and this changed my mind after the first consultation.
He is professional, patient, and made me feel comfortable and confident in every decision along the way. I am ecstatic with my results and thankful for the expertise of Dr. Rory!
Does not disappoint. Dr Rory is always so professional and honest. He takes the time to explain everything so you know exactly what you are getting.
I cannot recommend Dr Rory enough. In a location we’re we struggle to find certified, competent and capable surgeons finding Dr Rory has been an absolute god send and he has exceeded all expectations I had.
After loosing a significant amount of weight I was left with many areas of my body that had excess skin and needed fixing and a face that required signigant rejuvenating I now have the body and face I’ve always dreamed of.
If you are looking for great results, realistic opinions and a Dr you can trust he’s your surgeon. Thank you Dr. Rory for everything!
He is professional, highly competent and his relaxed caring bedside manner instills confidence that you have chosen the well. I have recommended family members and friends to him and they have all been very pleased with their results.
I recently had surgery (4weeks ago) with Dr Rory and from the moment I met him I felt in safe hands no question was too silly or too small!! Even on the day of surgery his calm, professional manor put me at ease even though I was very nervous!!
After having a very bad experience before I did lots and lots of research and I would have no doubt recommending Dr Rory to anyone that was looking for an amazing surgeon.
I had been considering Rhinoplasty & Breast Augmentation surgery in Dubai for quite a while, I visited a number of surgeons but the one person that I was eager to meet was Dr Rory, not only had I heard great things about him, I had been left a little dubious about other surgeons I had met here and just never felt comfortable enough to make the decision to book the surgery and go ahead…. I genuinely cannot recommend Dr Rory enough!
I have been a patient of Dr Rory for a couple of years and have been extremely pleased with the results.
He is very professional and caring. He consults with each patient to achieve the desired results for each individual. I would highly recommend Dr Rory for any of your cosmetic needs.
Very happy with my breast augmentation results and so glad i chose Dr.Rory as my surgeon. He’s a professional compassionate and very skilled doctor. He was very attentive before and after my surgery. My breasts look natural and not overdone. It was an easy and stress free experience with great results.
I would never recommend anyone else, his professionalism, knowledge, experience are all spot on and would not trust anyone else in Dubai. He is also a great person and takes the time to listen and adjust his approach based on your needs.
I had some light facial procedures over a 6 month period with Dr Rory and then found the courage to undertake a Mommy makeover with him. It has been the best decision I ever made.
The care I received from him and his team were second to none, he never laughed at my daft questions and really reassured me every step of the way.
The surgery and the aftercare was fantastic. He has done an amazing job and even 10 months on I still look in the mirror completely thrilled. I have absolutely no hesitation in recommending Dr Rory.
He explains everything in detail and will not oversell any procedure for the sake of it. His advice and technique are tailored to each patient and you always feel that he is giving you a service above and beyond the norm. I trust his work implicitly.
The best plastic in Dubai hands down. Such an amazing experience as a patient from start to finish
I am an absolute fan of Dr Rory for his real and matter-of-fact approach to his work and his natural and confident talent at administering it. In a matter of my first visit I knew I was in the hands of a true professional and ever since he has exceeded expectations.
He is a perfectionist and the best plastic surgeon in Dubai! Cannot recommend him enough.
Dr Rory McGoldrick has been my Dr and Surgeon for over a year. I cannot recommend his services enough. He is highly experienced, extremely professional yet empathetic at the same time.
Dr. Rory is not only one of the best doctors I have met but also one of the most genuine people I have ever met. He takes the time to explain and listen to your wants or concerns.
Not only is he THE BEST but his team of nurses and assistants go out of their way to help in any way possible! Thank you Dr. Rory for always looking after me.
I had a reconstructive surgery following mastectomy with Dr Rory and he was beyond amazing. He is extremely professional. He took special care of me considering my situation.
The second I met him I was at an ease. I felt very comfortable discussing all the tiny details with him.
His level of follow up is remarkable. He doesn’t mind contacting him at anytime and responds to all questions patiently. He is a true example of what an outstanding surgeon can be like.
I had my breast augmentation surgery with Dr Rory as have three of my friends. We all had the same experience. Five stars.
An artist! Absolutely hands down would recommend Dr. Rory to everyone looking for an honest, professional and ethical doctor who isn’t afraid to say no to unrealistic requests but yes to enhancing natural beauty.
Very kind, friendly and patient. 10 stars from me!
Super knowledgeable, professional & personable – highly recommended!
Dr Rory is an incredible, professional and ethical plastic surgeon who I would recommend to anyone. His warm and welcoming approach instantly puts you at ease in what is often a daunting process.
He offers honest and professional advise/recommendations that will not go beyond your bodies limits leaving you feeling confident, supported and positive in your decision.
Couldn’t ask for anything more from a doctor. Honest, professional, helpful and the best results you could ask for.
I’ve been seeing Dr Rory for about 3 years now and I wouldn’t go anywhere else in Dubai or London. Couldn’t recommend him highly enough.
Dr Rory is definitely one of a kind. He is not only an expert in his field, he is also a wonderful human being.
Dr Rory made me feel at ease during the consultation as well as treatment and explained every step throughout the procedure.