Your Breast Reconstruction Options

After a breast cancer surgery, many women choose to rebuild and reshape the removed breast. There are several options available using either saline or silicone implants, or autologous tissue (tissue from another part of the body). Sometimes both are used together. The surgery can happen immediately or be delayed.

The final stage of surgery may recreate the nipple and areola if they weren’t preserved in the surgery. Sometimes surgeons work on both breasts so they will match in size and appearance.

 

Your breast reconstruction surgical options

Legacy Cancer Institute surgeons have years of experience with all types of breast reconstruction, including microsurgical procedures using your own tissue to rebuild your breast and nipple-sparing mastectomy. Your breast surgical oncologist and your reconstructive plastic surgeon can help you decide which option is best for you and coordinate your cancer care with your reconstruction.

 

 

Compare your choices

Many factors go into the type of reconstructive surgery you and your doctor may choose. They include the shape and size of the breast being rebuilt, your age and health, your health history, risk factors, the location of your tumor and how much tissue is available on other parts of your body that can be used.

 

Oncoplastic surgery

Oncoplastic surgery is tumor removal combined with cosmetic breast reshaping to restore a natural appearance. The opposite breast is reduced, so both sides match. Women tend to like the "lifting" effect. 

Best for women 

• Who undergo breast-conserving surgery and/or radiation therapy that will leave the breast distorted 
• With large or very large breasts

What to consider

• Only one surgery needed
• Maintains breast shape after cancer treatment 
• Reduces risk of complications from radiation therapy 
• May lose feeling in the nipple
   

Learn more about our experts.

 

Nipple-sparing mastectomy

The nipple and/or areola are left in place while the breast tissue under them is removed. 
Reconstruction may be done at the same time as the nipple-sparing mastectomy or at a later time.

Best suited for women

• Who have a small, early-stage cancer near the outer part of the breast, with no signs of cancer in the skin or near the nipple

What to consider

• Spares the nipple, for a more natural-looking breast after reconstruction 
• Little or no feeling left in the nipple

Learn more about our experts. 

 

DIEP flap

DIEP flap (deep inferior epigastric perforators) is an advanced microsurgical technique that uses excess fat and skin from the lower abdomen to reconstruct the breast after a mastectomy. No muscle tissue is used.

Best suited for women

• With excess fat on their lower abdomen. However, if women do not have enough abdominal fat, tissue may sometimes be used from another part of the body.

What to consider

• Natural-looking results
• A “tummy tuck” effect, while preserving abdominal muscles and strength
• Scar at the bikini line Minor surgery may be required on the opposite breast so they match
• Six to eight weeks of recovery
• May not be possible for women who smoke, are obese or have diabetes 

Learn more about our experts. 

 

Implant-based breast reconstruction

In implant-based breast reconstruction, a breast implant is used to recreate the breast. The implant is a silicone shell filled with either silicone gel or a salt water solution (saline), including the new teardrop shape. 

Immediate or staged reconstruction is possible, depending on the circumstances. Delayed reconstruction is also possible. 

Best suited for women

• Without excess fatty tissue and who do not need radiation treatment

What to consider

• No additional scars on the body other than those on the breasts
• Three to four weeks of recovery. However, at least two surgeries and multiple visits to the plastic surgeon’s office are usually required.
• Not generally recommended if radiation is required 
• For women having a mastectomy on only one breast, exactly matching the other natural breast with an implant can be difficult
• Risk of complications requiring more surgery to correct

Learn more about our experts.

 

Tattoos of the nipple areola

Tattoos of the nipple areola provide the finishing touch to breast reconstruction.

Best suited for women

• Who have had breast reconstruction with or without reconstruction of the nipple

What to consider

• Can be done in the doctor’s office
• More than one procedure may be required for a color match

Learn more about our experts.

 

 

What happens next

Any type of reconstruction increases the number of side effects you may have than from breast cancer surgery alone. Your Legacy Cancer Institute team will watch you closely for complications that can happen months or years after your surgery.

You may consider physical therapy to improve your range of motion, gain strength, adjust to new limitations and find the safest way to perform everyday activities. Breast reconstruction does not increase the chance of cancer returning. 

Depending on your surgeries and your risk, there are different recommendations about follow-up mammograms. Breast augmentation (implants) have the same mammogram screening recommendations as the general population.

If you have implant reconstruction after mastectomy, mammograms usually are not done. Mammograms are necessary on breasts that were not removed during cancer treatment or that were reconstructed in other ways. Talk to your care team to learn what to expect for your follow-up care.