Breast Reconstruction

There are two main types of breast reconstruction. Breast reconstruction is sometimes done in multiple stages.

1. Implant-based breast reconstruction – These involve silicone or saline implants to recreate the natural shape and feel of a breast. Implants are considered less invasive and can sometimes be completed during the same procedure to remove the original breast tissue.
2. Autologous reconstruction – These involve using your own body tissue to recreate the natural shape and feel of a breast. This type of surgery is more involved and can have longer recovery time. The results may look and feel more natural, however.

In some cases, you may have been able to preserve the nipple and areola during surgery to remove part or all of the breast. This is called a “nipple-sparing mastectomy.” Following the mastectomy, the nipple and areola can often be restored as part of the breast reconstruction surgery. If the nipple and areola were removed along with the other breast tissue—for instance, if the cancerous breast tissue was too close to the nipple—there are additional options to recreate them.^{3 4 8}

Breast reconstruction is an optional procedure. Some people prefer to “go flat,” or to use a removable prosthesis that provides the appearance of a natural breast shape under clothing. There is no single solution.^{1 4}

Some people may not be a good candidate for breast reconstruction. Certain chronic or immune conditions can create risks, as can smoking, having diabetes or being overweight. Circulatory issues (how well your blood moves through your body) can also impact your eligibility to get reconstructive surgery. You can talk with your provider about your options.

If you do decide to pursue reconstruction surgery, it’s important to consider what kind of procedure is right for you. For instance, because autologous reconstruction sometimes use tissue or muscle from elsewhere on your body, this could have an impact on athletic activities that use those muscles. Past surgeries could also complicate the ability to transplant tissue.³ Implants are not considered lifetime devices. You also need enough remaining muscle and/or skin to successfully cover the implant. With either procedure, you may not have much or any sensation in the reconstructed breast(s). Sometimes you can regain sensation over time. Breast reconstruction can create scarring. Scars often become less visible with time.²

Talk with your doctor and don’t hesitate to get a second opinion if you’re unsure.

You do not need to decide right away about breast reconstruction surgery. While some people prefer to have it performed right away, you may want to wait. There is no single timeline that meets every patient’s needs.

Before getting a mastectomy, you can talk with your care team about what next steps you’d like to take. This includes not just what kinds of reconstruction options are available, but also what your surgical journey might look like. Some patients feel a single surgery is priority, while others would prefer to lessen the intensity of each surgery by going through a staged process. In some cases, you can receive implant reconstruction at the same time that you receive a mastectomy. There is no single right path, each patient’s journey looks different.

As with all surgeries, there can be risks to breast reconstruction. Please note this is not a full disclosure of all risks.

Scarring, infection, blood clots (especially with autologous reconstruction) or dissatisfaction with the final appearance of the reconstructed breast could all occur. Implants could rupture. In very rare instances, they could increase your risk of developing a second cancer.¹ Autologous reconstruction could cause lasting pain and weakness in the area where the flap was removed from. There is also a risk of failure (if, for example, the transplanted “flap” dies).

Smoking, being significantly overweight or having diabetes can all increase your risk of complications. It may be recommended to quit smoking and/or lose weight before having the procedure. Previous surgeries or cancer treatments may impact recovery. Talk with your care team about these and other risk factors could increase the chance of complications.^{2 3}

Reconstructed breasts are designed to mimic the natural appearance of natural breasts. However, they may not exactly match what you had before. Loss of feeling is common in reconstructed breasts. The texture of the breasts may be different, although autologous reconstruction may feel more natural than implants. If you undergo mastectomy on only one breast, the reconstructed breast may not match your other breast. You can talk with your care team about surgical options to improve symmetry of your breasts.

If you were not able to retain your nipple and areola during your mastectomy, other nipple reconstruction options include skin grafts (taking skin from another part of your body). 3D tattoos can also mimic the appearance of an areola and/or nipple.^{3 4}

Your healthcare provider will provide detailed information and instructions for recovery after surgery. Recovery time will vary from person to person, but usually takes weeks. You will likely spend at least a day in the hospital following the reconstruction procedure. Sometimes follow-up procedures are needed. These are done without a hospital stay.⁴ As you recover, it’s important to stick to gentle activities. If you notice any signs of infection, excessive pain or other indications that you are not healing as expected, contact a healthcare provider right away.³ Scarring is typical for breast reconstruction surgery. Scars may become less prominent with time.

See our note on common risks of breast reconstruction above and always discuss a detailed list of risks with your care team.

Researchers are continuously investigating potential new and more effective treatments. For guidance on the best treatment options for you—and to determine if you may qualify for a clinical trial—please speak with your healthcare provider.