A guide to breast reconstruction for breast cancer patients

This article explains the various breast reconstruction options available after a mastectomy.

By Dr Tasha Gandamihardja

WHAT ARE MY BREAST RECONSTRUCTION OPTIONS?

If you have been recommended to have a mastectomy, you can also choose to have a reconstruction. You don’t have to go down this path if you don’t want to, but if you do, then there are a few options.

In the first instance, your reconstruction can happen either in the immediate setting (immediate reconstruction), or after you have completed your cancer treatment (delayed reconstruction).

Breast reconstruction can either use implants, or your own body tissue (autologous reconstruction). There are certain factors you need to consider when choosing which reconstruction is most suited for you, such as surgery time, recovery time and the need for maintenance / multiple surgeries. Other factors such as body shape, BMI and whether you smoke, may also play a role in determining your suitability to certain types of reconstructions.

IMPLANT SURGERY

Implant surgery is the quickest to recover from, and it will result in usually just one scar. However, it is very likely you will need further surgery in the future as implants will rupture and will need to be replaced. When this will happen is difficult to predict.

AUTOLOGOUS BREAST RECONSTRUCTION

Autologous breast reconstruction involves more invasive surgery. There are a few areas from which we can take tissue from and use to create a new breast. This includes the latissimus dorsi (LD) muscle, which is a large muscle on your upper back, the fat on your tummy (deep inferior epigastric perforator flap – DIEP flap) or even the tissue from your inner thighs (transverse upper gracilis – TUG flap).

Autologous reconstruction surgery is performed jointly between your breast surgeon and a plastic surgeon. It takes longer to do than an implant based reconstruction and longer to recover from. You will also have two scars, one on the breast, the other depending on where the ‘donor site’ is.

However, a successful operation means that no future surgery is needed, unlike implant surgery. Plus, it feels more natural than an implant.

THE POSSIBLE DISADVANTAGES OF BREAST RECONSTRUCTION:

1. More invasive surgery may lead to higher risk of complications

2. Need for maintenance surgery such as in the case for implant surgery

3. If you have an immediate reconstruction, any complication may potentially delay further treatment such as chemotherapy or radiotherapy

4. Longer surgery and recovery time

FINAL THOUGHTS…

Being told you have breast cancer is life changing. The moment you get that diagnosis, your thoughts are racing, you will experience a wide ranging of emotions and you may feel lost and confused.

It is important to take your time in making any decision regarding your treatment. Don’t be afraid to ask your surgeon any questions you may have. Voice your concerns and worries and do involve your breast care nurse as well.

If you are unsure about what decision to take, try to speak to others who have gone through the same surgical path.

We are here to help you through your cancer treatment. It is important for you to be fully informed so that you are completely satisfied and happy with the decision you make.

About the author

Dr Tasha Gandamihardja is an consultant oncoplastic breast surgeon BSc MBBS MEd PhD FRCS. Tasha shares more helpful information via her website, podcast and YouTube channel.

Further information

Future Dreams hold a range of support groups, classes, workshops and events to help you and your carers during your breast cancer diagnosis. These are held both online and in person at the London-based Future Dreams House. To see what’s on offer and to book your place, see here.

To return to the homepage of our Information Hub, click here where you can access more helpful information, practical advice, personal stories and more.

Reviewed February 2023

The information and content provided in all guest articles is intended for information and educational purposes only and is not intended to substitute for professional medical advice. It is important that all personalised care decisions should be made by your medical team. Please contact your medical team for advice on anything covered in this article and/or in relation to your personal situation. Please note that unless otherwise stated, Future Dreams has no affiliation to the guest author of this article and he/she/they have not been paid to write this article. There may be alternative options/products/information available which we encourage you to research when making decisions about treatment and support. The content of this article was created by Dr Tasha Gandamihardja, an oncoplastic breast surgeon and podcaster and we accept no responsibility for the accuracy or otherwise of the contents of this article.

You can check her out at mybreastmyhealth.com where you will find links to a range of helpful videos about breast cancer treatment. You can also connect with her on Twitter and Instagram @DrTashaG.