Breast reconstruction · Implant and flap reconstruction
Breast reconstruction: Compare practices from our network
Breast reconstruction rebuilds the breast after a mastectomy or lumpectomy, with implants, your own tissue, or both. Whether and when to have it is your choice.
Our network
Breast reconstruction providers from Adoreal's partner network.
East Grinstead · United Kingdom
PANTHEONS Clinic
Implant-based and autologous (flap) reconstruction, immediate or delayed, in a team with NHS microsurgical breast reconstruction experience.
East Grinstead · United Kingdom
PANTHEONS Clinic
Implant-based and autologous (flap) reconstruction, immediate or delayed, in a team with NHS microsurgical breast reconstruction experience.
Ready to see who performs breast reconstruction near you?
Compare ProvidersDecision support
How to choose a breast reconstruction surgeon
Board certification is the starting point. The details below are worth weighing carefully when you're choosing the surgeon who's right for your goals.
Here's what to look for before you decide:
A good reconstructive surgeon plans around your cancer treatment.
Whether you need radiotherapy or chemotherapy affects both the timing and the method. A surgeon worth trusting works with your breast surgeon and oncology team, and explains how your treatment plan shapes the options open to you.
You should hear about every option, including not reconstructing.
Implants, your own tissue, a combination, fat transfer, an external prosthesis, or staying flat are all legitimate choices. Not every clinic or hospital offers every method, so ask which ones this surgeon performs, and where you would be referred for the others.
The best surgeons are honest that reconstruction is usually a series of steps.
An expander exchange, adjustments for symmetry, scar corrections and nipple reconstruction often follow the first operation. A surgeon who maps out the likely stages up front respects your ability to plan your life around them.
Transparency about your plan and expectations is non-negotiable.
Your surgeon should be comfortable documenting the method, the planned stages, where scars will sit (including any donor site), how sensation is likely to change, and what recovery looks like week by week, and sharing that with you in writing.
Before your consultation, prepare this question
“Which reconstruction options are realistic for me, and how many operations should I expect in total?”
A surgeon who answers directly, rather than deflecting, is one who puts your outcome above the booking.
Find a Breast Reconstruction ProviderAbout the treatment
About breast reconstruction
Breast reconstruction is surgery to recreate the shape of one or both breasts after a mastectomy (removal of the breast) or a lumpectomy (removal of part of the breast). It can also be part of a risk-reducing mastectomy for people with a high inherited risk of breast cancer.
There are two main approaches. Implant-based reconstruction uses a breast implant, often after a temporary tissue expander has stretched the skin. Autologous, or flap, reconstruction uses skin, fat and sometimes muscle from another part of your body, most often the abdomen or the back. The two can be combined, and fat transfer can add volume or refine the shape.
Reconstruction can happen in the same operation as the mastectomy (immediate reconstruction) or later (delayed reconstruction), for example once radiotherapy has finished. It does not affect the cancer or the ability to treat it.
What is breast reconstruction?
Breast reconstruction recreates the shape of one or both breasts after a mastectomy or lumpectomy, or as part of a risk-reducing mastectomy. It uses an implant, your own tissue, or both, and can be done at the same time as the mastectomy or later.
Reconstruction does not affect the cancer or the ability to treat it, and it is always optional.
Who considers reconstruction
Reconstruction is planned around your cancer treatment, your health and your body. It might be something to explore if:
- A mastectomy is planned and you want to know whether the breast can be rebuilt at the same time
- You have had breast cancer surgery and want to understand your options
- You have had radiotherapy and need a plan that allows for its effects
- You are considering a risk-reducing mastectomy
- You would like the two breasts to match more closely
- You want an adjustment or nipple reconstruction after earlier surgery
Implant or your own tissue
Implant-based reconstruction often starts with a tissue expander that is filled over a few visits and later exchanged for a permanent implant. It usually means a shorter operation and recovery.
Reconstruction with your own tissue moves skin and fat, and sometimes muscle, to the chest:
- DIEP flap: skin and fat from the abdomen, with the blood vessels reconnected under a microscope.
- LD flap: a back muscle with skin and fat, often combined with an implant.
- Fat transfer: fat removed by liposuction and injected, alone or with other methods.
Own-tissue reconstruction often feels more like a natural breast and usually lasts a lifetime, but recovery is longer and there is a scar where the tissue was taken.
The treatment, step by step
Consultation. Your surgeon reviews your diagnosis, treatment plan and health, and coordinates with your breast team where needed.
Anesthesia. General anesthesia; around 1.5 hours for an implant and four to six hours for a DIEP flap.
Reconstruction. An implant or expander is placed, or tissue is moved from another part of your body.
Closing. Incisions are closed and drains are often placed for a few days.
Further stages. Expander exchange, symmetry surgery or nipple reconstruction may follow once the breast has healed.
Recovery and aftercare
Expect tightness and soreness at first, and a hospital stay of one to seven days depending on the method.
- Do the shoulder and arm exercises you are given
- Avoid heavy lifting for one to two months
- Attend follow-ups so healing and any expander fills can be managed
Time off work typically ranges from one to six weeks, and is usually longer after reconstruction with your own tissue.
Risks and side effects
All operations carry a risk of infection and bleeding. Other possible complications depend on the method:
- Infection or bleeding
- Capsular contracture around an implant, which is more likely after radiotherapy
- Reduced blood flow to transferred tissue, which may need another operation
- Fluid collecting where tissue was taken
- Harmless fat cysts or lumps after fat transfer
- Scarring on the breast and, with your own tissue, at the donor site
- Changes in breast and skin sensation
- Asymmetry or the need for further surgery
- Very rarely, a lymphoma linked to breast implants (BIA-ALCL)
Common questions
Breast reconstruction questions, answered.
If your question isn't here, ask us directly. A real person answers, and we won't push you toward anything.
Talk to us →Do I have to have reconstruction?
No. Reconstruction is entirely optional. You can choose an external prosthesis that sits in your bra, or leave the chest as it is after surgery. You can also decide later: reconstruction can be done at a later date.
Can reconstruction be done at the same time as the mastectomy?
Often, yes. Immediate reconstruction is done in the same operation, usually with an implant. Delayed reconstruction is common if you need more treatment afterwards, for example radiotherapy, when the skin and tissue may need time to heal first.
Implant or my own tissue: what's the difference?
Implants usually mean a shorter operation and a quicker recovery, but can feel firmer and less natural, and may need correcting or replacing later. Your own tissue often feels more like a natural breast and usually lasts a lifetime once complete, but the operation and recovery are longer and there is a second scar where the tissue was taken.
What is a DIEP flap?
A DIEP flap uses skin and fat from the lower abdomen to create the new breast. DIEP stands for deep inferior epigastric perforator, the blood vessels in the tissue, which the surgeon reconnects to vessels in the chest under a microscope. The operation typically takes four to six hours.
How many operations will I need?
Usually more than one, whichever method is used. Later procedures may adjust scars or the size and shape of the breasts, exchange an expander for an implant, or reconstruct the nipple. These are often smaller operations, and many people go home the same day.
Will the reconstructed breast have feeling?
Sensation is usually reduced after a mastectomy, with or without reconstruction. Some feeling may return over time, but full sensation cannot be guaranteed. Ask your surgeon what to expect with the method they recommend.
Can the nipple be reconstructed?
Yes, if you want. Once the breast has fully healed, a nipple can be shaped from a small flap of skin on the new breast or from a skin graft, or created with a 3D tattoo. The areola can be tattooed too. Nipple reconstruction is optional.
Does reconstruction affect cancer treatment or follow-up?
Reconstruction does not affect the cancer or the ability to treat it. Follow-up continues as your breast team recommends, including breast awareness and any imaging they advise.
Does radiotherapy change my options?
It can. After radiotherapy, the skin and tissue may need time to heal before reconstruction, and the risk of capsular contracture around an implant is higher. Your surgeon may recommend a particular method or timing for this reason.
Is reconstruction covered by public healthcare or insurance?
Often, yes. In Sweden, your doctor can refer you to a plastic surgeon through public care, though the methods offered can differ between regions. In the US, most health insurance plans are required to cover reconstruction after mastectomy. Ask your breast team and the practice directly.
