As with any procedure, there are potential risks, including the need for additional surgery. It’s important to understand your options to make the right decision for you.

When to Consider a Breast Reconstruction

Although breast reconstruction can be done at any time after a mastectomy (known as delayed breast reconstruction), some choose to do both procedures at the same time (immediate reconstruction). 

Northwestern Medicine Plastic Surgeon Michael A. Howard, MD, performs immediate breast reconstruction surgery at Northwestern Medicine Lake Forest Hospital. “This allows patients to recover from both procedures at the same time and potentially reduce the number of surgeries needed in the reconstruction process,” he says. 

However, not everyone is a good candidate for immediate reconstruction. “For instance, we may suggest a delayed breast reconstruction if you are going to have radiation treatment, as it may alter the healing,” says Dr. Howard. You may also choose to delay the procedure due to other health issues or personal preference. 

Types of Breast Reconstructive Surgery 

If you decide to have breast reconstruction surgery, there are two types.

Prosthetic reconstruction. “During prosthetic reconstruction, we insert silicone or saline implants in front of the pectoralis muscle to shape the breast,” says Dr. Howard. This procedure can take two or three hours, typically causes less scarring and has a shorter recovery time. However, Dr. Howard cautions, this type of procedure is not without risks of complications. There is a possibility that an implant will need to be replaced in the future. 

Tissue flap (autologous tissue) reconstruction. A tissue flap reconstruction uses tissue from your abdomen, buttocks, back or thighs to rebuild your breast and help it feel more natural. It can take about three hours per breast. “This type of procedure involves additional incision sites, may entail a slightly longer recovery and includes a hospital stay, approximately of one to two days after your surgery, to ensure that blood supply is being circulated into the new tissue,” says Dr. Howard.

Factors to Consider

“Undergoing breast reconstruction surgery is a very personal decision,” says Dr. Howard. “We are here to support you and provide the information you need to make your decision.” 

There are several factors to consider when weighing which option may work best for you:

• The type of mastectomy. These include total mastectomy, partial mastectomy, nipple-sparing mastectomy and skin-sparing mastectomy. The type is determined by the location and size of your tumor. 
• What cancer treatments you’ve received. Your treatments can affect how you heal from breast reconstruction. For example, if you’ve had radiation treatments in the past, your body may be more likely to reject implants from prosthetic reconstruction. 
• Your body type. People with larger breasts may request volume reduction to create more symmetrical breast tissue. Meanwhile, people with smaller breasts may not have enough tissue for a large breast volume after tissue flap reconstruction.

Many people have difficulty with their body image and self-esteem after breast cancer diagnosis and treatment. In addition to removing the breast tissue, surgery can cause scarring and a loss of feeling in your breast. However, research shows that patients who have had breast reconstruction surgery tend to have better psychological outcomes than those who have had a mastectomy with no reconstruction. 

“It’s rewarding to be able to work with patients and give them back a sense of confidence,” says Dr. Howard.

Learn more about breast health.