Breast reconstruction is plastic surgery that rebuilds the breast mound, and often the nipple and areola, after all or part of a breast has been removed for cancer. It uses implants or the patient's own tissue, such as DIEP, TRAM or latissimus dorsi flaps, and can be done at the time of mastectomy or later.
- AnaesthesiaGeneral anaesthesia
- DurationTypically 2-8 hours, depending on technique
- Hospital stayTypically 1-5 days
- Back to routineUsually 6-8 weeks
What is breast reconstruction after mastectomy?
Breast reconstruction is part of oncological (cancer) care as well as restorative surgery. Most women who have had a mastectomy can have reconstruction; women who had a lumpectomy may or may not need it. It is a personal decision, and choosing not to have reconstruction, using an external breast form or no prosthesis, is equally valid.
Women choose reconstruction to balance their chest in bras and swimwear, to regain breast shape without an external prosthesis, and to feel better about their bodies. Modern techniques give better results than before, but the reconstructed breast will not be an exact match for the natural breast, and if tissue is taken from the abdomen, back or buttocks, that area will also look different. The size of the reconstruction depends on the extent of mastectomy and the size and location of the tumour.
Immediate reconstruction starts during the cancer operation and often preserves breast skin, which can improve results; further stages may still be needed. Delayed reconstruction suits women who prefer to focus on cancer treatment first, have other health problems, or need radiotherapy, which can slow healing and increase scarring, so flap surgery is often postponed until afterwards. Studies show reconstruction does not make breast cancer return and rarely, if ever, hides a recurrence, and it should not interfere with chemotherapy or radiotherapy.
Who is breast reconstruction after mastectomy for?
- Women who have had, or are about to have, a mastectomy
- Some women after lumpectomy (breast-conserving surgery) with a noticeable deformity
- Women who are physically healthy without conditions that impair healing
- Non-smokers, or those willing to stop at least 2 months before surgery
- Women with realistic expectations who have discussed timing with their cancer team
How is it done?
- Implant-based reconstruction uses a saline or silicone gel implant, sometimes after tissue expansion
- Autologous (own-tissue) reconstruction moves skin, fat and sometimes muscle from another area
- Common flaps: DIEP and TRAM from the abdomen, and latissimus dorsi from the upper back
- Can be immediate (at mastectomy) or delayed (after cancer treatment, including radiotherapy)
- Nipple and areola reconstruction is usually a final, separate procedure about 3-4 months later, with tattooing to match colour
What is recovery like?
- A support bra or elastic bandage is worn; a pain pump may be used initially
- Most women are back to usual activities in about 6-8 weeks
- Bruising and swelling typically settle over about 8 weeks
- Overhead lifting and strenuous sport are usually avoided for 4-6 weeks
- Scars typically fade over 1-2 years but do not disappear; sensation may partly return over years
What are the risks?
- Anaesthesia problems, bleeding, blood clots, fluid collection and infection
- Wound-healing problems, and partial or complete flap or skin loss (necrosis)
- Changes in sensation, and weakness or scarring at the donor site
- Implant problems, of which capsular contracture is the most common
- Asymmetry, and the need for further procedures to refine the result
Why choose Dr. Jithendran?
- Dual training in orthopaedics (MS) and plastic surgery (MCh, DNB), with hand and microsurgery experience from Ganga Hospital, Coimbatore
- Consults at five hospitals across Bengaluru, with 24×7 availability for emergencies
- Clear explanations in English, Tamil, Hindi and Telugu, and time to answer every question
- Strict sterilisation and patient-privacy standards
Frequently asked questions
Should I have reconstruction at the same time as my mastectomy?
Immediate reconstruction often preserves breast skin and avoids a period without a breast shape, but it may still need later stages. Delayed reconstruction may be better if you need radiotherapy, have other health problems, or prefer to focus on cancer treatment first. The decision is made together with your breast surgeon and oncologist.
Can breast reconstruction hide cancer or make it come back?
Studies show that breast reconstruction does not cause breast cancer to return. If cancer does recur, a reconstructed breast should not interfere with chemotherapy or radiotherapy, and reconstruction rarely, if ever, hides a recurrence. Regular follow-up with your cancer team remains essential.
Implant or my own tissue: which is better?
Implant reconstruction involves a shorter operation and no donor-site scar, while own-tissue (flap) reconstruction, such as DIEP or latissimus dorsi, tends to look and feel more natural and changes with body weight. The best option depends on your body, cancer treatment, radiotherapy and preferences.
Can the nipple be reconstructed?
Yes. Nipple and areola reconstruction is usually a final, separate minor procedure done about 3-4 months after the breast mound is rebuilt. A small nipple is shaped from local skin, and medical tattooing can be used to match the colour of the other side.
What if I decide not to have reconstruction?
That is a valid choice. Some women prefer not to have more surgery or are not fit for it. External breast forms (prostheses) that fit into a bra can mimic a natural breast, and some women choose to wear none. You can also consider delayed reconstruction years later.
