Breast reconstruction

Breast reconstruction is the creation of a new breast shape (mound) using surgery. It may be done after removal of a whole breast (mastectomy) or part of the breast. You can either have reconstruction at the same time as the breast cancer surgery (immediate reconstruction) or months or years later (delayed reconstruction). Breast reconstruction is a process and often involves several operations to give you the best result possible.

There are usually different options available for breast reconstruction and your breast surgeon will explain which one is likely to suit you best.

Limitations of breast reconstruction

  • Reconstructed breasts will not feel and look exactly the same as before. They tend to be less sensitive and sometimes very numb.
  • Several visits to the hospital for appointments and further operations are often needed to get the best cosmetic result.
  • Recovery after breast reconstruction will take longer than after a mastectomy.
  • You may have scars on other parts of your body depending on the type of reconstruction.
  • The potential risk of complications is greater than having a mastectomy.
  • If you need radiotherapy after your reconstruction, this can affect the appearance of your reconstructed breast.
  • Reconstructed breasts don’t usually have a nipple, but one can be created with surgery usually at a later date.

Who can have a reconstruction?

Most women who have had a whole or partial mastectomy can have either immediate or delayed breast reconstruction.

Some people are advised not to have a breast reconstruction because of other existing medical conditions that might increase the risk of problems and complications following surgery. If it’s likely you’ll need radiotherapy this often influences the choice and timing of breast reconstruction.

If you’re advised against reconstruction your surgeon should explain why. You can ask for a second opinion if this would be helpful to you.

Immediate reconstruction (at the same time as mastectomy)

National guidance says the choice of immediate breast reconstruction should be discussed with all patients who are having a mastectomy. However, a delayed reconstruction may be a better option for some women. All appropriate breast reconstruction options should be offered and discussed, even if they are not available locally.

Delayed reconstruction
(mastectomy first, reconstruction later)

You can have a reconstruction months, or even years, after your breast surgery, so you have plenty of time to make a decision if you opt for a delayed operation. During this time you may adapt to your mastectomy and feel that you no longer want to go through further surgery; it is fine to change your mind.

Women who want reconstruction at a later date after completing treatment for breast cancer can still have their operation on the NHS. However, in some areas there may be a long wait.

There are three main types of breast reconstruction:

  • reconstruction using only a breast implant
  • reconstruction using your own tissue (a tissue flap). This tissue can be taken from a number of places in the body, although the most common sites are the back or the lower part of the abdomen
  • reconstruction using a combination of tissue and an implant.

Reconstructed breasts don’t usually have a nipple but one can be created with surgery. Otherwise prosthetic stick-on nipples can be used.

You may have a number of choices available to you, although one type of operation may be the most suitable for you depending on your shape and build, general health, your expectations and whether you are having or have had radiotherapy treatment to the breast.

You can watch animations of the main reconstruction techniques.

Content last reviewed September 2014; next planned review 2016.