Breast reconstruction

NHS surgeons can build new breasts for women who have mastectomies. Chris Caddy, consultant plastic surgeon at Northern General NHS Trust, explains how.

“Breast reconstruction is the process of recreating a breast mound to match the remaining natural breast,” says Caddy. “If your treatment plan includes mastectomy, you'll need to decide what you want to do about your missing breast.”

Some women choose to have a flat chest on one side and use a prosthesis (false breast) inside their bra. Others choose to have a reconstruction.

If you're considering reconstruction, find out about your options. “Your breast surgeon, GP and breast care nurse will advise you. You may be offered the opportunity to meet a reconstructive plastic surgeon,” says Caddy.

If you have a mastectomy, there is still a chance that the cancer will come back.

When is reconstruction done?

It depends on your situation. Reconstruction surgery can be carried out at the same time as your mastectomy (immediate reconstruction), but this isn’t always possible. If you have radiotherapy after your mastectomy, you’ll be advised to wait until after this has finished.

The benefits of immediate reconstruction include having only one anaesthetic, one hospital stay and one recovery period. However, the anaesthetic and recovery period will be longer than if you just have a mastectomy. Reconstruction surgery can be carried out some time after initial mastectomy surgery. This is called delayed reconstruction.

How is reconstruction done?

“There are two main types of reconstruction,” says Caddy. “These are prosthetic reconstruction, where artificial implants are used, and autogenous, where tissue from elsewhere in the woman’s body is used to create the breast mound.”

The surgery for prosthetic reconstruction is shorter than for autogenous reconstruction. The implants are usually expandable and are slowly enlarged over three to six months until they are the desired size. This is so that the skin can gradually stretch.

In an autogenous implant, tissue is moved from the back, buttocks, thighs or abdomen to the chest. It is shaped under the skin to make the new breast. “The tissue is alive and natural, so it provides the most natural shape and feel to the reconstructed breast,” says Caddy.

Autogenous reconstruction is major surgery, and you have to stay in hospital for longer. You’ll have scars where the tissue is removed from your body, and the new breast is likely to change shape and size in the first few months. 

Once the breast has settled on its final shape and size, your surgeon can perform a nipple reconstruction. This can involve taking part of the nipple from your remaining breast to attach it to the new breast, and tattooing colour on to the skin.

Will the new breast match?

Your surgeon will match your new breast as closely as possible to your existing breast. In some cases, women consider surgery on both of their breasts to ensure a good match.

This can involve lifting the existing breast, or making it larger or smaller. Some women with a high risk of breast cancer choose to have both breasts removed (a double mastectomy) and two reconstructed breasts made, to reduce their risk of getting cancer again.

How can I make up my mind?

If you're considering reconstruction, talk to your GP, breast care nurse and surgeon, and have a consultation with a reconstructive plastic surgeon.

Pauline Polley, 44, was diagnosed with breast cancer in 2001 and had a delayed breast reconstruction using tissue from her back. Pauline says: "Talk to a surgeon to find out your options. And try to see some women in the flesh who have had it done. I’m always happy to show women mine.

"I think it's a good idea to have a reconstruction done at the same time as your surgery, if it’s possible. That way, you won’t have the feeling of nothing being there for a while.”

Read Pauline's story

Reconstruction advice from Macmillan

Macmillan Cancer Support has information on breast reconstruction, including:

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Media last reviewed: 14/07/2015

Next review due: 14/07/2017

Page last reviewed: 14/07/2014

Next review due: 31/08/2016

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