Reconstructive surgery is used to create a new breast shape after surgery
If you are having a mastectomy you should be offered breast reconstruction either at the same time as your mastectomy (immediate reconstruction) or at some time in the future (delayed reconstruction).
Immediate reconstruction has the advantage that you will need fewer operations, and when you wake up following your mastectomy you will still have the appearance of two breasts.
But sometimes you may be advised against having immediate reconstruction as it might delay other treatments you need such as radiotherapy or chemotherapy. Radiotherapy can also sometimes affect the appearance of your reconstructed breast, so you may prefer to wait until after your radiotherapy has finished to have reconstruction.
If you are having breast conserving surgery you won’t normally need breast reconstruction. However, reconstruction may be necessary in some cases to improve the appearance of your breast, for example if the tumour was quite large.
What type of breast reconstruction will I have?
There are a number of techniques that can be used to reconstruct your breast after a mastectomy. Breast reconstruction sometimes requires more than one operation.
Reconstructive surgery is carried out by an oncoplastic surgeon (a breast surgeon also trained in specialist plastic surgery techniques), or by a breast surgeon working with a plastic surgeon.
Your surgeon can discuss the different types of breast reconstruction available to you and help you decide. They should be able to show you example photos of how your breast may look after surgery and after reconstruction. You may feel that having delayed reconstruction gives you more time to consider your options.
Reconstructing breast shape
One option for reconstruction is to create a new breast shape by inserting an implant under your chest muscle. This has the advantage of normally being a simpler operation, but you may find it doesn’t have a natural feel and shape.
Your surgeon may instead create a breast shape using a piece of tissue taken from another part of your body, usually your back or abdomen. This method has the advantage that the reconstructed breast may have a more natural feel than an implant, but it does involve more complicated surgery and you will have more scars. You may also experience problems in the area the tissue is taken from, such as an increased risk of developing a hernia when tissue is taken from your abdomen.
In some cases, for example if you have large breasts, you may have reconstruction which combines your own tissue with an implant.
If you are having reconstruction after breast conserving surgery, your surgeon can fill in the tissue removed by reshaping the remaining part of your breast or using tissue from another part of your body.
Surgery to the other breast and nipple reconstruction
It can be difficult to create a reconstructed breast that completely matches the size and shape of your other breast. If this is the case, you should be offered surgery on your other breast to match it to your reconstructed breast. This can involve increasing or decreasing its size, or changing its shape. Your nipple may need to be removed during a mastectomy or breast conserving surgery. If you would like, this can also be reconstructed. This will usually be the last part of your breast reconstruction.
What if I don’t have immediate reconstruction?
If you don’t have immediate reconstruction, or choose not to have reconstruction at all, you should be offered an appointment with a prosthesis fitting service.
Breast prostheses, which can be inserted into your bra or stuck directly onto your skin, can be used to even up the size and shape of your breasts under clothing. They are generally made of silicone and come in different sizes, shapes and colours so that you can find the best match for you.
Need more information?
Breast Cancer Care has more information on breast prostheses.
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