Before: Pre-reconstruction Mastopexy or Reduction

In some patients, especially those with larger or drooping breasts, I may recommend a breast lift or reduction before mastectomy. This helps to reposition the nipple and reshape the skin envelope first, so that reconstruction later can be performed more safely and accurately. Trying to correct both problems at once - during or after mastectomy often causes further injury to tissues which can result in skin and nipple loss. A recent study in PRS Global Open supports this staged approach, showing that primary nipple repositioning before mastectomy lowers complication rates and improves reconstructive outcomes.

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After: Restoring Volume, Shape and Symmetry

For patients who have completed chemotherapy, radiotherapy and/or hormonal therapy, reconstruction is usually delayed until tissues have recovered. This typically involves replacing tissue expanders with breast implants (for volume) and using fat grafting to soften and smoothen contours (for shape), especially in areas affected by radiation. Nipple reconstruction is typically performed as the final stage, once everything has settled - to restore a natural sense of wholeness (see my hand drawn picture of this procedure below).

Recovery & Expectations

Each stage of reconstruction has its own recovery timeline.

• After implant exchange and fat grafting, most patients return to light activity in one to two weeks.

• Swelling and bruising usually settle within a few weeks.

• Nanofat and nipple reconstruction are gentler stages, with minimal downtime.

Follow-up visits are essential throughout this process to ensure healing, symmetry, and comfort at every step.

Post-operative care extends beyond routine reviews - it is an integral part of Dr Ng’s surgical philosophy. Through Doctor Stitch, an aftercare service founded to ensure seamless continuity and comfort, every patient is followed up personally by Dr Ng. Whether at home or in clinic, he provides attentive, discreet, and consistent care throughout the recovery journey.