What breast reconstruction is
After a mastectomy, reconstruction aims to rebuild a breast whose shape, volume and feel are as close as possible to a natural breast and as symmetrical as possible with the other side. For many women, reconstruction is an important part of recovery after cancer treatment.
Planning is done together with the oncologist and the surgeon performing the mastectomy, because the timing depends on the treatments needed (for example radiotherapy).
Timing
- Immediate reconstruction, in the same operation as the mastectomy.
- Delayed reconstruction, months or years after the mastectomy, once treatment is complete.
Methods
- With an implant, sometimes after a tissue expander stage: a temporary implant gradually filled with saline that stretches the skin to the desired volume, then replaced with the permanent implant.
- With your own tissue (a flap): skin, fat and sometimes muscle moved from the back or abdomen to form a new breast. This suits women who have had radiotherapy in particular.
- Combined, a flap with an implant.
- Fat transfer, for contour corrections and to improve tissue quality.
Nipple and areola reconstruction is usually done as a separate stage. For symmetry, surgery on the other breast (lift, reduction or augmentation) is sometimes recommended.
The consultation
At the consultation we discuss your cancer history, the treatments you have had or will have, the quality of the tissue and your preferences. The doctor explains the benefits and limits of each method, the number of stages and the overall timeline.
Recovery
Recovery depends on the method: from a few weeks for implant reconstruction to 6–8 weeks for flap reconstruction, which also involves a donor area.
Risks and things to know
- healing problems, especially after radiotherapy;
- capsular contracture or other implant complications;
- partial flap loss, which is rare;
- asymmetry, which may need later correction;
- scars on the breast and at the donor site.
Results vary from one patient to another.
