What is breast reconstruction?

Breast reconstruction is surgery performed by a plastic surgeon to restore the appearance of the breast following surgery. Most women who have a mastectomy can have reconstructive surgery, while most women who have had a lumpectomy do not need reconstructive surgery. Depending on the treatment plan, immediate reconstruction may be able to be performed at the same time as the mastectomy. However, this is often not advised for women who will be receiving radiation therapy, as it could increase complication rates after surgery. It is important to discuss your desire for reconstructive surgery with your surgeon, as well as your plastic surgeon. If you elect immediate reconstruction, the scheduling of the surgery will be done to allow both surgeons to be present. There are several types of reconstructive procedures, including approximating the nipple-areola area through a tattooing technique that can take place after the initial procedure.
Ajay K. Sahajpal, MD
Transplant Surgery

Breast reconstruction is surgery to recreate a missing breast after mastectomy. There are three types of breast reconstruction surgeries:

  1. A flap procedure uses your own tissues to reconstruct a breast. This surgery can be time consuming and have higher risk of complication. The benefits using your own tissues include a breast that will more closely reflect your bodily changes of weight loss/gain and aging.
  2. Breast implant offers the least amount of surgery. This involves an implant placed under the chest wall to provide the appearance of a breast.
  3. Tissue expansion is done to stretch the skin to make room for the implant. A small bag is inserted under the chest wall and saline is added over time to expand the breast area. When the area has reached the desired size, the bag is removed and the implant is placed. 
Mark Sisco, MD
Plastic Surgery
Breast reconstruction is most commonly used to restore the form and shape of the breast after breast cancer. Learn more from Dr. Mark Sisco on behalf of NorthShore University HealthSystem about breast reconstruction.
Erik A. Hoy, MD
Plastic Surgery

Breast reconstruction is the process of rebuilding a breast which is both natural-looking and -feeling through a series of surgical procedures.  This can involve implant-based or autologous (rearranging the patient’s own tissues) reconstructions.  The first phase of the reconstruction can be done at the time of the breast cancer removal (immediate reconstruction), or be performed in a delayed fashion due to patient preference or the need to receive certain cancer treatments prior to reconstructing the breast.  In either case, plastic surgeons attempt to provide a medical and psychological means of dealing with the after-effects of breast cancer surgery.  These factors should be the reasons a patient undergoes breast reconstruction, not due to pressures from family members or peers.  The goal of breast reconstruction is to help restore a patient’s physical appearance and her psychosocial well-being.

Stuart A. Linder, MD
Plastic Surgery

Breast reconstruction is the procedure performed in order to reconstruct the breast and create a normal appearance and symmetry.  Patients who have had malignant cancers may undergo mastectomy with possible chemo or radiation therapy thereby requiring reconstruction of either one or both breasts.  Breast reconstruction can be performed in one of three manners.  The simplest approach is associated with an implant placed either silicone or saline.  Drawbacks to implants include radiated breasts in which scar tissue can be very severe and will require removal of the implant.  Second method includes tissue being transferred on a pedicle to the breast such as from the back muscle or latissimus dorsi flap or the abdomen referred to as a TRAM flap.  These tissues are maintained to their blood supply directly to the native site and then are transferred on a pedicle to the breast in order to reshape it.  Third or lastly, free tissue transfer can be performed.  This includes removing skin and fatty tissue with the blood supply to the breast and using a microscope to reanastomose the blood supply of this free flap to the breast area.

Breast reconstruction is restoration of the form and psycho-social function of the breast. This may be a total reconstruction (such as after mastectomy for breast cancer) or partial breast reconstruction (such as a lumpectomy defect). Correction of congenital defects of the breast many times are also classified as breast reconstruction.
Reconstruction can be divided into two general categories: implant-based reconstruction and autologous (own tissue). In implant-based reconstruction, a process of tissue expansion on the chest may be necessary to create a pocket in which to house the permanent implant. The implant may be made of silicone or filled with saline. This is different from an augmentation in that the implant makes up the entire mound; there is no breast tissue to augment. 

In autologous reconstruction, tissue is taken from somewhere else on the patient's body and transfered to the chest defect. This tissue is then used to shape a breast mound. Some methods that fall under this category are flaps such as DIEP, SIEA, S-GAP, TUG, TRAM, LD. Fat grafting is currently being looked into as a means of autologous breast reconstruction that may avoid large incisions and reduce operative times, hospital stays, and recovery days.

Choosing which reconstruction is right for a patient is dependent upon multiple factors which may include: extent of disease, other necessary cancer treatments, body shape, body mass index, patient goals, patient vocation or hobbies, other medical conditions.
Breast reconstruction is an option after a patient’s mastectomy. She has the option to have no reconstruction, do immediate reconstruction in the same setting as the mastectomy, or do a delayed reconstruction. Cosmetic results are usually best with an immediate reconstruction, however delayed reconstruction may be recommended if further treatment of the cancer takes priority.
Breast reconstruction is a plastic surgery procedure in which the shape of the breast is rebuilt. Many women who choose to have preventive mastectomy also decide to have breast reconstruction, either at the time of the mastectomy or at some later time.
Before performing breast reconstruction, the plastic surgeon carefully examines the breasts and discusses the reconstruction options. In one type of reconstructive procedure, the surgeon inserts an implant (a balloon-like device filled with saline or silicone) under the skin and the chest muscles. Another procedure, called tissue flap reconstruction, uses skin, fat, and muscle from the woman's abdomen, back, or buttocks to create the breast shape. The surgeon will discuss with the patient any limitations on exercise or arm motion that might result from these operations.
This answer is based on source information from the National Cancer Institute.
Breast reconstruction is a way to give women who have had a mastectomy a chance to have a normal appearing breast. There are several methods that sugeons use to reconstruct breasts. One is implantation of saline or silicone breast replacement implants under the skin. If there is not enough skin or tissue to do this a surgeon can sometimes take fat, muscle and skin from other areas and use them to make a natural looking breast so that the woman who has had breast cancer may lead as normal a life as possible after treatment for thier cancer.

Continue Learning about Breast Reconstruction Surgery

How should I decide when to have breast reconstruction after a mastectomy?
Columbia University Department of SurgeryColumbia University Department of Surgery
IImmediate reconstruction avoids the need for another operation at a later date, but it adds time to...
More Answers
What are the advantages of simultaneous breast reconstruction?
Ajay K. Sahajpal, MDAjay K. Sahajpal, MD
Breast reconstruction done simultaneous with a mastectomy has the advantage of decreasing the number...
More Answers
What Reconstruction Techniques Are Available After Breast Cancer Surgery?
What Reconstruction Techniques Are Available After Breast Cancer Surgery?
What Is Breast Reconstruction?
What Is Breast Reconstruction?

Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.