Do You Need Breast Reconstruction After Mastectomy?

The right choice is the one that fits your cancer treatment, health, body, values, and willingness to have further procedures. Reconstruction can sometimes begin during mastectomy or take place later, and deciding against it now does not always prevent reconsideration later.

Reconstruction creates a breast shape using an implant, your own tissue, or a combination. It cannot restore the original breast, and sensation commonly changes after mastectomy. Further procedures may be offered to adjust shape or reconstruct the nipple and are separate choices.

Immediate reconstruction starts at the mastectomy operation; delayed reconstruction happens after recovery or other cancer treatment. The plan can be influenced by radiotherapy, smoking, diabetes, previous abdominal or chest surgery, available donor tissue, healing risk, and whether surgery is on one or both breasts. Choosing a flat closure should include discussion of chest contour and scar placement.

Ask to meet a reconstructive surgeon before mastectomy when possible, even if you lean toward no reconstruction. Request an explanation of options suitable for your anatomy and cancer plan, likely scars, expected sensation, recovery needs, implant monitoring, and the possibility of later revision surgery.

Think about clothing, exercise, sleep position, work, caregiving, future pregnancy plans, and how you feel about implants or scars elsewhere on the body. Photographs of typical results and a conversation with a trained peer supporter may help. If no reconstruction is chosen, ask about an aesthetic flat closure and when an external breast form can be fitted.

After mastectomy or reconstruction, contact the surgical team urgently for a sudden change in breast or flap colour, increasing swelling, a rapidly enlarging firm area, worsening redness or heat, pus, fever, wound opening, or pain that is escalating despite the prescribed plan.

Seek emergency help for chest pain, severe breathlessness, collapse, heavy bleeding, or a painful swollen leg. Follow the team's instructions for drains and dressings, and report a drain that suddenly stops while swelling increases rather than trying to unblock it yourself.

You could ask: Which choices are compatible with my cancer treatment? How might radiotherapy affect the result? What sensation can I expect? Where will scars be? What help will I need at home? Could I choose reconstruction later? If I stay flat, how will you plan the chest contour?