Breast Unit
Breast Reconstruction - Introduction
Breast reconstruction - introduction
Breast surgeon Richard Sutton with patient
Breast reconstruction involves the creation of a new breast shape using surgery. It is usually carried out following removal of the whole breast (mastectomy) but occasionally may be required after excison of part of the breast (a quadrantectomy or wide local excision).
Although the treatments that we have for breast cancer are evolving and improving with time it remains true that at least 40% of women who have surgery will require a mastectomy. All women who are recommended to have a mastectomy will be able to discuss breast reconstructive surgery with their breast care nurse or surgeon.
However, in the UK most women who have a mastectomy will not have a reconstruction. In fact, only about 20% will choose to have reconstructive breast surgery.
There are many surgical techniques that can be used to create a new breast. Perhaps the simplest method involves the use of a prosthetic implant.
More complicated techniques involve the use of a piece of your own tissue (muscle and/or fat and skin) transferred from another part of the body; usually from the back or abdomen.
For most women there are many options available and your surgeon will explain which are most appropriate for you. It is important that you take time to consider these options and that you don't feel under pressure to make a decision.
The reconstructed breast is unlikely to have a nipple. Surgery can also be used to create a new nipple although it is usual for this to be undertaken many months after the main operation. Alternatively, a prosthetic stick-on nipple can be used.
It is important to understand that breast reconstructive surgery should be viewed as a process, not just one operation. Many women will require a number of operations to achieve the final result or to maintain a good cosmetic result as the years pass by.
The aim of reconstruction is to create a breast that matches the remaining breast in size, shape and position and feels as soft and natural as possible. However, you will notice differences.
A reconstructed breast will not look or feel exactly the same as the breast you have lost. It is important to have realistic expectations about what can and what cannot be achieved through the process of breast reconstructive surgery. Your newly formed breast may feel firmer and sit higher than before.
You won't get the same sensations from your reconstructed breast as you used to and you may have no sensation at all. Indeed most reconstructed breasts are completely numb to touch.
It is also important to understand that it is very difficult to create a breast that is a perfect match when compared to the remaining breast on the other side. A reconstructed breast frequently has a slightly different size, shape and contour.
These differences should not be noticeable when you are clothed, in a bra or swimwear. However, out of clothes the differences are often much more noticeable. You will be able to see some scarring, although this will usually fade with time. Your natural, remaining breast will change over time and droop a little as you get older. However, your reconstructed breast will probably not change in the same way.
In general, many women find the results acceptable and, especially when dressed, feel confident about the way they look. The vast majority of women who have undergone breast reconstructive surgery report that they are either satisfied or very satisfied with the outcome.
Sometimes surgery on the remaining breast is recommended to achieve evenness and balance, but this is generally not performed at the same time as the reconstructive surgery. This is to allow the original surgery to settle into a permanent position and any swelling to reduce so that symmetry may be achieved at a later date.
Where both breasts are being reconstructed the aim is to recreate breasts that match and are in proportion to the woman's body shape. The overall aim is to make a woman feel confident about her restored shape.
Next Section: When can the reconstruction be done?
Also see
Breast Cancer Care
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Breast Cancer Care: Breast Reconstruction Link opens in new window
General Hospital Information
Your Hospital Stay (link opens a new window)
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