American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

Breast Reconstruction

Breast reconstruction rebuilds the breast mound and restores the look of the breast. It can be done at the same time as the mastectomy or sometime later. It can be done using your tissue or synthetic materials.

You should talk with your surgeon and a plastic surgeon before your operation. This will help you and your surgical team to plan the treatment that is best for you. You may choose to wait and have the surgery later. Insurance companies typically cover breast reconstruction, but you should check so you know what is covered.

Types of Breast Reconstruction

There are two main types of breast reconstruction:

Implant reconstruction uses a round or teardrop-shaped pouch inserted in the breast to replace the breast tissue. It is filled with saltwater (saline), silicone gel, or a combination of the two. Your plastic surgeon will help you chose the best shape.

Breast implant held in two gloved hands

Autologous (flap) reconstruction uses tissue taken from another part of your body, such as your abdomen, thigh, or back. This may also include an implant.

Breast Reconstruction

Nipple Reconstruction

You also can choose to reconstruct your nipple. A nipple-sparing mastectomy may be possible, which means that your own nipple is saved. Otherwise, a tattoo can be placed to darken the tissue to look like a nipple.

You may have a choice of when to do your reconstruction.

Immediate breast reconstruction is also called direct-to-implant reconstruction. Right after the surgeon removes the breast tissue, a plastic surgeon puts in a breast implant. The implant is placed under the muscle on your chest. A skin graft or an absorbable mesh holds the implant in place.

Delayed breast reconstruction is done after the operation to remove the breast cancer. A tissue expander is placed under the breast skin to stretch it like a balloon. This empty expander is filled with salt water (saline) over several weeks or months. Another surgery is done to remove the expander and put in the permanent implant. If radiation treatment is needed, the final implant will not be placed until the treatment is done.

Implants do have some risks. Talk with your surgeon about long-term safety. The Food and Drug Administration offers a Risks and Complications of Breast Implants guide to review the risks and help with decisions.

Reasons to Delay Breast Reconstruction

  • You have trouble coping with the cancer treatment.
  • You have other health issues.
  • If you smoke, it is best to quit smoking at least 2 months before reconstructive surgery to allow for better healing. Talk with your health care team and refer to the ACS Quit Smoking before Surgery resource.
  • You need radiation therapy. Radiation treatment can cause delayed healing and scarring.