Breast reconstruction after mastectomy

Reconstruction may begin during the mastectomy or at a later operation. It is optional, and choosing a flat closure or an external breast form is also valid.

Implant reconstruction may place an implant directly or use a tissue expander first to create space gradually. Tissue-based reconstruction moves skin and fat from another part of the body to form the breast mound. Each approach creates different scars and has its own recovery and future-procedure considerations.

Cancer treatment influences timing. The breast and plastic surgeons consider the planned mastectomy, possible radiotherapy, healing ability, previous operations, body tissue available for reconstruction, and what matters most to you. Reconstruction changes breast shape but does not restore the removed breast or normal sensation.

Meet the reconstructive surgeon before mastectomy when possible, even if you are undecided. Discuss the expected breast size and symmetry, scars on the chest and any donor site, nipple reconstruction options, and whether procedures on the other breast might be considered.

Prepare for practical recovery needs such as help with meals, transport, wound care, drains, and limits on lifting or arm movement. Follow instructions for smoking cessation, medicines, washing, supportive garments, and physiotherapy. Keep every surgical and oncology team informed if another treatment is being scheduled.

Contact the surgical team promptly if a breast or donor-site wound becomes hotter, redder, more swollen, opens, drains cloudy fluid, or develops worsening pain. Also report fever, a sudden change in breast colour, a new fluid collection, or a drain that stops working unexpectedly.

Emergency assessment is needed for chest pain, severe breathing difficulty, fainting, uncontrolled bleeding, or sudden painful leg swelling. A rapidly darkening or unusually pale skin flap also needs immediate contact with the reconstructive team because blood flow may be affected.

Ask which methods suit your anatomy and cancer plan, whether reconstruction should be immediate or delayed, and how radiotherapy might affect the result. Request a clear explanation of where scars will sit and what sensation changes to expect.

Discuss how many operations the proposed pathway may involve, what implant or donor-site monitoring is required, how problems are managed, and whom to call outside clinic hours.