Procedure guide · Plastic and reconstructive surgery
Breast reconstruction rebuilds the shape of the breast after a mastectomy. MedlinePlus describes two main approaches: implants or tissue taken from elsewhere in your body. It can be done at the same time as the mastectomy or later. Some women choose not to have reconstruction. You and your surgeons decide together.
What is breast reconstruction?
With implants, MedlinePlus explains that reconstruction usually happens in two stages. First a tissue expander is placed under the chest muscle and gradually filled with saline at clinic visits. Later it is replaced with a permanent saline or silicone implant. A smaller procedure can later rebuild the nipple and areola.
With natural tissue, skin, fat and sometimes muscle are moved from the belly, back, buttocks or thigh. These are called flaps, such as TRAM, DIEP or latissimus flaps. MedlinePlus says the result can look softer and more natural. But surgery and home recovery are longer than with implants.
Who may be suitable?
The choice depends on your cancer treatment, your body and your wishes. MedlinePlus says the decision is made by the patient and surgeon together. It also notes that reconstruction does not make it harder to find a tumour if cancer returns. Your breast surgeon, oncologist and plastic surgeon should agree the timing.
MedlinePlus lists risks. With implants they include leaks, hard scar tissue around the implant, infection and shifting. With flaps they include loss of the flap from poor blood supply and weakness where tissue was taken. Reconstruction does not restore normal feeling in the breast.
Coordinate with cancer care
If you are still having chemotherapy or radiotherapy, the timing of reconstruction must fit your cancer plan. Share your full oncology records so all specialists can plan together.
Which reports does a surgeon usually ask for?
Send your cancer diagnosis and pathology report, the mastectomy operation note if surgery has happened, and details of chemotherapy or radiotherapy. Include recent breast imaging. MedlinePlus suggests asking whether a screening mammogram is needed early enough to avoid delay. Send a list of medicines and say whether you smoke. Mention diabetes or heart disease.
How do you plan the trip?
Implant reconstruction often means more than one visit, because the expander is filled over time before the final implant. Ask whether expansion can be done near home. Flap surgery means a longer hospital stay and a longer recovery before flying. MedlinePlus notes that drains may still be in place at discharge. Plan who removes them. Bring an attendant who can help with drains and daily tasks. Ask for written records of any implant used. Your surgeon decides when it is safe to fly.
What should you ask the surgeon?
- Is implant or own-tissue reconstruction more suitable for me, and why?
- Should reconstruction be immediate or delayed, given my cancer treatment?
- How many trips will the full reconstruction need?
- Can tissue expansion or drain removal be done in my country?
- What imaging will I need in future to check the implant?
- How will you coordinate with my oncologist?
Questions people ask
Does breast reconstruction affect cancer follow-up?
MedlinePlus states that having breast reconstruction does not make it harder to find a tumour if breast cancer comes back. You will still need the follow-up your oncologist advises. Implants also need periodic imaging.
Will the reconstructed breast have normal feeling?
MedlinePlus says reconstruction will not restore normal sensation to the new breast or nipple. Discuss what to expect with your surgeon before deciding. Ask how flap or implant choices affect feeling in your case, and whether nipple reconstruction is planned.
Do I have to have breast reconstruction?
No. MedlinePlus notes that some women choose not to have reconstruction. Some wear a prosthesis inside the bra and others choose nothing at all. It is your decision, made with your surgeons.
Sources
General information, not medical or legal advice. Rules change: confirm with the official source. Your treating specialist decides on suitability, treatment and length of stay. How we write and check.