Facts about breast reconstruction

Breast Reconstruction: Yes or No?

Breast reconstruction is a procedure that is carried out to restore breast shape and replace breast tissue that is lost during a mastectomy or lumpectomy. The goal is to create breasts that look symmetrical, close to the original appearance and shape, and as natural as possible. 

Whether or not a breast reconstruction is performed depends on several factors: your personal decision, your physical condition and medical requirements. It is important that you understand every option available for breast reconstruction. Having the right information as a starting point for a full and frank discussion with your surgeon can help you in the journey to reconstruction. 

Disadvantages of breast reconstruction

There are several disadvantages and problems that may occur with breast reconstruction that need to be taken into account before making a decision to go ahead:3

  • Not all breast reconstruction procedures are a total success, and the result might not look like you expected
  • Additional corrective surgeries may be necessary and the revision rate is higher than in augmentation breast surgery
  • Surgery will leave scars on your breast and, in case of autologous reconstruction, in any areas tissue was taken from to create your new breast 
  • A reconstructed breast will not feel the same as a natural breast
  • In order to achieve symmetry between the reconstructed breast and the healthy one, reduction or enlargement of the latter may be necessary

For more information on the complications that you may encounter in case of breast reconstruction with implants, see the ‘Risks and complications of an implant’ section. 

It is important that you consider the risks and the benefits of each procedure, in order to reach a decision that is beneficial for your medical prognosis, your physical and mental health, and your personal circumstances. While cost should not be your primary driver, different procedures have different costs. You should discuss in detail with your surgeon the different techniques and implants available, and their respective pros and cons, as well as the options that are covered by your local health service or insurance.

At what stage is breast reconstruction performed?

Breast reconstruction can take place at two different times, depending on your medical condition, planned therapy, and where possible on your wishes:

  1. Immediate breast reconstruction is performed during the same surgery, following a prophylactic subcutaneous mastectomy or a tumour removal
  2. Delayed breast reconstruction is performed not only after mastectomy or lumpectomy surgery, but also after the radio- or chemo-therapies that follow such surgery, and can take place from 6 to 12 months up to several years later

The choice between immediate or delayed reconstruction is often determined by the need to undergo therapies that may negatively affect the outcome of reconstruction.

1. Roje et al., Breast reconstruction after mastectomy, Coll Antropol. 2010 Mar;34 Suppl 1:113-23. Trejo-Ochoa et al., Impact on quality of life with breast reconstructive surgery after mastectomy for breast cancer, Ginecol Obstet Mex. 2013 Sep;81(9):510-8.

2. Bajaj, The importance of Breast Reconstruction Awareness Day, American Society of Plastic Surgeons, https://www.plasticsurgery.org/news/blog/the-importance-of-breast-reconstruction-awareness-day

3. American Cancer Society. Should I get breast reconstruction surgery? Available at https://www.cancer.org/cancer/breast-cancer/reconstruction-surgery/should-i-get-breast-reconstruction-surgery.html