Breast Reconstruction Surgery
Breast reconstruction surgery restores the shape and size of one or both breasts after a lumpectomy or mastectomy. In most cases, breast reconstruction is done by a plastic surgeon. Making the choice to have breast reconstruction is a very personal decision, so take the time you need to figure out the best options for you and your unique situation. Reconstruction can be done months or years after breast cancer surgery.
Quick facts about breast reconstruction surgery:
Breast reconstruction can be done during or after both mastectomy and lumpectomy.
You also can have the surgeon recreate a nipple and areola on the reconstructed breast, if these were removed during surgery.
Although breast reconstruction recreates the breast, it doesn’t restore sensation to the breast or nipple, though some types of breast reconstruction may be combined with procedures that can help restore sensation.
In some cases, breast reconstruction surgery includes surgery on the other, unaffected breast, so the two breasts match in size and shape.
Is breast reconstruction right for you?
If you’re thinking about having breast reconstruction or aren’t sure, it’s a good idea to talk to your breast cancer surgeon and a plastic surgeon who is experienced in breast reconstruction before you have mastectomy or lumpectomy surgery. You can talk to your doctors about the pros and cons of reconstruction, and your doctors can recommend the best options for you.
Here are some things you may want to consider when deciding whether breast reconstruction is right for you:
Breast reconstruction isn’t right for everyone. After mastectomy, you may prefer to leave one or both sides of your chest flat rather than have the breast or breasts recreated – this is called “going flat.” You always have the option to wear a breast form (prosthesis) — an insert that you put in your bra or bathing suit. If you desire a permanent breast shape, whether you’re wearing clothes or not, reconstruction may be best for you.
After a mastectomy or lumpectomy on one breast, some people want their breasts to have a balanced, symmetrical appearance. Although you may be able to see some differences between a reconstructed breast and your other breast when you’re naked, your breasts look similar when you’re wearing clothes.
If you decide to have breast reconstruction surgery, most techniques involve more than one procedure to complete the reconstruction. The first reconstructive procedure may be done during breast cancer surgery. Then a second reconstructive surgery may be scheduled a few months later. It’s also possible that you need several surgeries throughout your lifetime to adjust the reconstructed breast. For example, changes in weight may affect the balance between a reconstructed breast and the opposite unaffected breast, or you may need to replace your breast implant or readjust its position. A plastic surgeon can outline the steps of any breast reconstruction so you know exactly what to expect.
Women who don’t have reconstruction are able to resume their daily activities much sooner than women who have reconstruction; different types of reconstruction have different effects on how soon you can return to your regular routine.
If so, full range of motion in both of your shoulders may be important to you. Some women find that implants, which are placed under or over the chest muscle, can limit their range of motion or be uncomfortable when reaching full range of motion. Certain flap reconstruction procedures cut through muscle in the back or lower abdomen, which can cause weakness or loss of function. A plastic surgeon can help you weigh the physical advantages and disadvantages of each type of reconstruction.
If you have diabetes, circulatory problems, or a bleeding disorder, it may take you longer to heal from reconstruction surgery than someone who doesn’t have these conditions. Heavy smoking and drinking also can affect your ability to heal. All surgery leaves some scars, but the skin cells along your incision may die (a condition called necrosis) if your ability to heal is reduced. If you smoke, you may be required to quit smoking for a period of time before reconstruction surgery so your body is better able to heal.
When is breast reconstruction surgery done?
You can have breast reconstruction surgery at the same time as mastectomy or lumpectomy, which is called immediate reconstruction. (When reconstruction surgery is done at the same time as lumpectomy, it may be called oncoplastic lumpectomy.)
Breast reconstruction can also take place months or years after mastectomy or lumpectomy — this is often called delayed breast reconstruction.
The timing of breast reconstruction depends on a number of factors, including whether radiation therapy after breast cancer surgery is recommended for you.
Types of breast reconstruction procedures
There are two main types of procedures for reconstructing a breast if you’re having mastectomy: flap reconstruction, which uses tissue and fat from another part of your body to recreate the breast, and implant reconstruction, which recreates the breast with a silicone shell that’s filled with silicone gel or salt water.
Another option is a Goldilocks procedure (also sometimes called the SWIM procedure), which is done at the same time as the mastectomy and uses remaining fatty tissue and skin to form a small breast mound. No implants or tissue from other parts of the body are needed for this procedure. It’s usually recommended for people with larger breasts or those with more of a droop (known as ptosis).
If you’re having lumpectomy, fat grafting, which uses fat tissue from another part of the body, can be used to fill in dents or divots. Your surgeon also may be able to rearrange the remaining breast tissue for the same purpose. Flap or implant reconstruction may be options, depending on how much breast tissue your surgeon removes, but are less common.
Your breast surgeon and plastic surgeon can help you decide which procedure may be best for you.
Finding a qualified plastic surgeon
A good place to start is by asking your breast surgeon or others who’ve had reconstruction for recommendations. If you decide to have reconstruction a number of years after mastectomy or lumpectomy, you can also search the American Society of Plastic Surgeons’ directory of plastic surgeons to find a board-certified plastic surgeon in your area.
Plastic surgeons who do breast reconstruction have different skill levels and offer different types of reconstruction procedures. It’s a good idea to schedule a consultation to make sure you’re comfortable with the surgeon’s style and expertise in the type of reconstruction you would like to have.
Here are some questions about the surgeon, the surgery, and the results you may want to ask.
Risks and complications of breast reconstruction surgery
Like any surgery, breast reconstruction has possible risks and complications. Each type of breast reconstruction has slightly different risks.
The main risks and complications of implant breast reconstruction include:
implant rupture or displacement
capsular contracture, a condition where the scar tissue capsule that surrounds the implant becomes unusually hard and dense
The main risks and complications of flap breast reconstruction include:
flap necrosis, which happens when the blood supply to the tissue flap used to recreate the breast is cut off and the tissue starts to die
fat necrosis, which happens when the blood supply to some of the fat used to reconstruct the breast is cut off and the fat starts to die
hernia or bulging at the site tissue was taken from to rebuild the breast; this risk is larger for procedures that use part of the abdominal muscle, such as TRAM flap surgery
The main risks and complications of fat grafting include:
infection
fat necrosis
Paying for breast reconstruction surgery
Many but not all health insurance plans in the United States cover breast reconstruction after mastectomy or lumpectomy. Contact your insurer to find out the specifics of coverage under your plan.
Learn more about how to find out in advance what your out-of-pocket costs for breast reconstruction will be, including any co-pays and deductibles.
Corrective breast reconstruction surgery
Talking to your breast surgeon, your plastic surgeon, and others who have had breast reconstruction before you have any surgeries can help you to have a better sense of what you want from breast reconstruction.
If you’re not satisfied with the results of your breast reconstruction surgery, there are corrective breast reconstruction procedures that can make the shape and size of the breast more to your liking. Other corrective techniques can change the position of the breast and ease any pain or discomfort you’re feeling.
Corrective surgery is always tailored to your specific situation. Your plastic surgeon will recommend options based on what you would like to change and what happened during your original breast reconstruction surgery.
Screening after breast reconstruction surgery
Screening after breast reconstruction depends on a number of factors, such as:
whether you have a breast implant
the type of mastectomy or lumpectomy you had
your risk of recurrence, if you’ve been diagnosed with breast cancer
your risk of developing breast cancer, if you’ve never been diagnosed
Going flat
Breast reconstruction isn’t right for everyone. After mastectomy, you may prefer to leave one or both sides of your chest flat rather than have the breast or breasts recreated. This is called going flat.
Doctors sometimes assume that everyone wants breast reconstruction after breast cancer surgery. If your doctor doesn’t offer going flat as an option, you may have to advocate for yourself and start the discussion.
Studies show that there is no difference in quality of life, body image, or sexuality between people who have breast reconstruction and people who go flat.
You may decide that after having a mastectomy, you would prefer to leave one or both sides of your chest flat rather than have breast reconstruction surgery with tissue flaps or implants.
— Last updated on July 30, 2025 at 3:35 PM
This information made possible in part through the generous support of www.BreastCenter.com.
