Breast reconstruction after cancer

After a mastectomy, a significant minority of women, especially younger women choose to have breast reconstruction surgery. This helps them live the full and fulfilled life they want within a reconstructed, full body. Such requirements to regain the shape and look of your breast/breasts is entirely natural. 

Breast reconstruction can measurably improve self-confidence and body image. 

Let’s explore some aspects of “breast reconstruction surgery”, how to choose the best option for you and what to expect after your surgery. 


What is breast reconstruction surgery?


A breast reconstruction surgery’s goal is to restore one or both breasts after a mastectomy or lumpectomy and make it/them of similar size, shape and appearance to your original breast. 



When to have breast reconstruction surgery? 

First, you’ll need to find a plastic surgeon with expertise in breast surgery - he/she will help you decide which option is best for you. Your doctor will consider the type and stage of your cancer, the treatments you might need, but also your feelings and expectations from this reconstructive surgery.  


Breast reconstruction can be done:

  • at the same time as the cancer surgery (immediate reconstruction)

  • after your cancer surgery (delayed reconstruction) 


Immediate breast reconstruction has the advantage that you will have your new reconstructed breast after you wake up from your mastectomy - this means fewer operations, so fewer anaesthetics and maybe less down-time. Some women prefer this option because they feel they would cope better with the loss. Delayed breast reconstruction has the advantage that you’ll have more time to decide on what type of reconstruction you want and your breast appearance will be stable since surgery will be performed after any additional adjuvant treatments for example, radiotherapy treatment.



What type of Breast Reconstruction Surgery to have? 

Breast reconstruction generally falls into two categories: implant-based reconstruction or flap reconstruction (autologous tissue), but you should discuss your options with your surgeon, as they may not all be suitable for you. 



Some factors to consider when choosing the best kind of breast reconstruction include:

  • your body type

  • overall health

  • the type and size of your breast cancer

  • Your breast size

  • Cancer treatments

  • Lifestyle

  • Family commitments 

  • Personal preference






Types of Breast Reconstruction

  • Implants reconstruction

The use of implant-based reconstruction (IBR) accounts for 37% of immediate

reconstructions following mastectomy in the UK. 

This option means your plastic surgeon will insert implants made out of silicone or saline-filled expander underneath the skin or chest muscle, similar to the process of aesthetic breast augmentation. 




  • ADM - Acellular Dermal Matrix

The use of ADMs in breast reconstructive surgery is a great innovation. ADMs used in the UK are bovine-, or porcine-derived biotechnologically engineered tissue scaffolds that have become a cornerstone of implant-based breast reconstruction over the last 2 decades. 

The collagen matrix provides surgeons with additional means of obtaining pliable, vascularized soft tissue to cover the implant, thereby avoiding expanders, reducing some tissue healing and Infection complications and encouraging tissue regeneration.

The main benefits of the acellular dermal mesh are related to aesthetic outcome (keeps the implant in place and creates a natural droop, so a more natural look is obtained), a shorter recovery period and reduced cost to the patient.

  • Fat transfer

Fat transfer (or lipofilling) in breast reconstruction can be used in many ways:

  • In conjunction with implant-based breast reconstruction

  • Fat transfer alone to reconstruct one or both breasts (only works if you have enough adipose tissue)

  • Fat transfer to improve breast tissue quality after radiotherapy



You can read more about fat transfer on my blog:

Everything you need to know about Fat Transfer

What is lipofilling? Uses and advantages



  • Flaps or autologous reconstruction 

Flap (or autologous) reconstruction uses the patient's own tissue from another part of their body (such as the abdomen (TRAM, DIEP), thighs (TUG) or buttocks (I-GAP, S-GAP) ) to form a new breast. 


This kind of surgery requires a meticulous highly skilled surgeon who specializes in microsurgery. 


Sometimes both procedures are used in combination to reconstruct a breast. Finally, you can also choose to reconstruct your nipple or have a nipple ‘share and consider areola tattooing. Et voila!


Recovery from breast reconstruction

Reconstructive microsurgery is a meticulous and often long procedure but entails minimal disruption to the muscles. So although there may be a protracted recovery time, the end function should be full. 

Recovery will be in the order of weeks (as your surgery will likely require significant dissection - to remove the breast, reconstruction, movement of tissues and drainage tubes). As with any breast surgery, you may experience swelling and soreness of the breasts, reduced movement and mobility and generally require to take it easy and recover. By 3 months you should be back to full activity and sports.