Breast cancer

17 September 2015

What you need to know about breast reconstruction

Breast reconstruction plays an important part in building emotional resilience in women who lose their breasts to cancer.


Breast augmentation is a plastic surgery term for breast enlargement surgery. This can be done with implant insertion or fat grafting surgery. Here fat is removed from other body areas that can be cosmetically enhanced through liposuction and then this fat is injected into the breast to increase the size and projection. 

In terms of breast cancer patients, implant reconstruction or reconstruction with own tissue is used to rebuild a breast after mastectomy. Breast reconstruction surgery is done to correct defects after the removal of cancerous tissue.

Read: All about breast augmentation 

Being diagnosed with any form of cancer is emotional and traumatic, and when the treatment involves removing parts of your body it can be even more so. Women who lose breasts to cancer have a long road of fighting the disease ahead of them and it’s important for them to find the emotional strength needed to face this challenge. I believe that breast reconstruction plays an important part in building emotional resilience.

There are things that need to be considered however before the decision to have breast reconstruction is made.

- The best time to have breast reconstruction is during your mastectomy. Although not essential, the results and psychological well-being tend to be better when breast reconstruction is done at the same time as the mastectomy during one operation.

- It’s important to note that the sensations in your breast will no longer be the same. There won’t be feeling in the nipple for example.

- Having a reconstruction does mean that recovery will be longer so it will take longer to return to normal activities – although I believe the longer term benefits far outweigh the initial inconvenience.

- If you have a very active job or are an athlete then it’s important to consider how your motion will be affected once you have fully recovered. Down time is less after implant reconstruction compared to reconstruction with abdominal perforator flaps for example. On the other hand studies have shown that the patient satisfaction rate is higher in the long run with own tissue reconstructions than with implant reconstructions.

And then there are various types of reconstructions available. These include two main techniques:

 - Implants: a salt water or silicone implant is inserted (possibly the more well-known of the options).

- "Flap" reconstruction: in this case tissue is transplanted from another part of your body (like your stomach, thigh or back).

Read: The different types of breast reconstruction surgery

There are pros and cons to each. Very simply, implant reconstructions are easier to perform and have less recovery time but long term they might be  prone to problems. "Flap" surgery does take longer to recover from but they have better long term results. And in the case of "perforator flap" surgery – a relatively new and ground-breaking procedure – the invasiveness of the surgery is limited as muscle tissue is not used.  It’s important to ask your plastic surgeon to carefully outline all the options.

What questions should I be asking?

- What is the ideal timing for my reconstruction in relation to my other treatments?

- How long will the surgery take?

- Is there anything I can do prepare for the surgery

- What anaesthesia will I need?

- How much discomfort or pain will I feel?

- Will you insert drains? And, will I need help caring for these at home?

- How long will I need to be in hospital for?

- How long is my recovery likely to be at home?

- What will and won’t be possible after the surgery? Will I need help at home?

Surgery is more than likely going to be your first line of attack against your cancer, so it is worthwhile considering, while undergoing that surgery, to have your breast or breasts reconstructed. It’s difficult to tell how someone will react emotionally to having a breast removed as it’s a part of the body inextricably linked to being a woman. And we believe that the emotional strength gained from feeling "whole" is a vital part of a woman’s fight against her cancer.

Read more: 

Q&A on breast surgery

Why go for breast reconstruction? 

Quiz: is breast augmentation surgery right for you?


Ask the Expert

Breast cancer expert

Dr Gudgeon qualified in Birmingham, England, in 1968. She has more than 40 years experience in oncology, and in 1994 she founded her practice, Cape Breast Care, where she treats benign and malignant breast cancers. Dr Boeddinghaus obtained her qualification at UCT Medical School in 1994 and her MRCP in London in 1998. She has worked extensively in the field of oncology and has a special interest in the hormonal management of breast cancer. She now works with Dr Gudgeon at Cape Breast Care. Read more.

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