Breast Reconstruction Surgery
Breast reconstruction is at the heart of Miss Hunter's expertise. She offers reconstruction after cancer surgery using a patient's own tissue (autologous reconstruction), together with nipple reconstruction, symmetrisation of the other breast and 3D nipple-areola tattooing.
Reconstruction can be carried out at the time of cancer surgery or later, and is highly individual. Miss Hunter explains the options clearly and helps you decide what is right for your situation, body and treatment plan.
Options Miss Hunter offers
- Autologous (own-tissue) reconstruction with DIEP and TUG flaps.
- A latissimus dorsi (LD) flap, using tissue from the back. This is offered occasionally, where the abdomen or inner thigh is not suitable.
- Nipple reconstruction and 3D nipple-areola complex tattooing.
- Symmetrisation surgery to match the other breast, for example fat transfer, an uplift or reduction.
- Immediate lymphatic reconstruction (the LYMPHA procedure), a preventative lymphaticovenous anastomosis offered only when axillary lymph-node dissection is being performed, to reduce the risk of arm lymphoedema.
Advanced reconstruction at Imperial
Miss Hunter chairs a weekly oncoplastic breast MDT for the North West London sector and is part of a team that continues to pioneer reconstructive techniques. These now include sensory flaps, drainless abdominal closure and immediate lymphatic reconstruction (the LYMPHA procedure). LYMPHA is offered only as a preventative lymphaticovenous anastomosis when axillary lymph-node dissection is being performed, to reduce the risk of arm lymphoedema. It is not offered by Miss Hunter as a separate treatment for established lymphoedema. She trained in LYMPHA in Genoa and has been instrumental in introducing the procedure within the department.
She has also established an NHS spoke clinic at Northwick Park Hospital. The clinic strengthens her links with the breast surgeons there and reflects how closely she works with referring teams across North West London.
In her reconstructive microsurgery practice, the flap failure rate is less than 1%, and patients are typically discharged home within three to five days. Miss Hunter's NHS base within Imperial College Healthcare at Charing Cross Hospital is one of the highest-volume centres for free-flap breast reconstruction in the UK. Many reconstructive patients are referred by breast surgeons and oncology teams in North West London, or are signposted through their insurer.
The breast reconstruction seminar
Miss Hunter co-created a breast reconstruction seminar that runs weekly for NHS patients at the Maggie's Centre on the Charing Cross Hospital site. For private patients, she goes through the same seminar material during consultation, so you have the time and information to make a considered decision.
3D nipple-areola tattooing
3D nipple-areola complex tattooing uses semi-permanent micropigmentation techniques to recreate the colour and appearance of the nipple and areola. Miss Hunter is trained to perform this treatment, which usually takes place in the treatment room at Charing Cross Hospital.
Tattooing may be carried out as the final stage after a nipple has been reconstructed, once the breast has healed and its shape has settled. It can also be used instead of formal nipple reconstruction. This creates the visual appearance of a nipple without adding projection, known as a trompe-l’oeil effect.
The procedure takes less than one hour and is performed as a day case. Local anaesthetic may be used, although in some circumstances no anaesthetic is required.
After treatment, a dressing is applied and should be kept dry for three days. You can then remove the dressing, shower and dry the area as usual. An antimicrobial, moisturising ointment will be provided and should be applied twice daily until the tube is finished.
A small amount of bleeding can be expected. Other risks include infection, asymmetry, fading of the colour and, unusually, flattening of a reconstructed nipple. It is quite common to require a top-up procedure as the colour settles or fades.
From a reconstruction patient
“Thank you for the good work you have done on my breast. It is a brilliant job. I was never confused or worried; it could not have gone better, thanks to you and your skill.”