After a mastectomy, some women choose to have cosmetic surgery to recreate their breast. This surgery can be performed during mastectomy itself or later.
The breast is usually reshaped in two stages, or surgeries. During the first stage, a tissue expander is used. An implant is placed during the second stage. Sometimes the implant is inserted in the first stage.
If you are having reconstruction at the same time as your mastectomy, your surgeon may do a skin-sparing mastectomy. This means only the area around your nipple and areola is removed and skin is left to make reconstruction easier.
If you will have breast reconstruction later, your surgeon will remove enough skin over your breast during the mastectomy to be able to close the skin flaps.
Breast reconstruction with implants is usually done in two stages, or surgeries. During the surgeries, you will receive general anesthesia (asleep and pain-free).
In the first stage:
In the second stage:
You may have another minor procedure later that remakes the nipple and areola area.
You and your doctor will decide together about whether to have breast reconstruction, and when to have it.
Having breast reconstruction does not make it harder to find a tumor if your breast cancer comes back.
Getting breast implants does not take as long as breast reconstruction (which uses your own tissue). You will also have fewer scars. The size, fullness, and shape of the new breasts are more natural with reconstruction that uses your own tissue.
Many women choose not to have breast reconstruction or implants. They may use a prosthesis (an artificial breast) in their bra that gives them a natural shape, or they may choose to use nothing at all.
Women who have had a lumpectomy rarely need to have breast reconstruction.
Risks of any surgery are:
Risks of breast reconstruction with implants are:
Tell your surgeon if you are taking any drugs, supplements, or herbs you bought without a prescription.
During the week before your surgery:
On the day of your surgery:
You may be able to go home the same day as the surgery. Or you will need to stay in the hospital overnight.
Results of this surgery are usually very good. It is nearly impossible to make a reconstructed breast look exactly the same as the remaining natural breast. You may need more "touch up" procedures to get the result you want.
Reconstruction will not restore normal sensation to the breast or the new nipple.
Having cosmetic surgery after breast cancer can improve your sense of well-being and your quality of life.
Breast implants surgery
McGrath, MH, Pomerantz J. Plastic surgery. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 19th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 69.
Roehl KR, Wilhelmi BJ, Phillips LG. Breast reconstruction. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 19th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 37.
Updated by: Debra G. Wechter, MD, FACS, General Surgery practice specializing in breast cancer, Virginia Mason Medical Center, Seattle, Washington. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, Bethanne Black, Stephanie Slon, and Nissi Wang.
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