Reconstruction in breast cancer

My name is Alison and I am one of the Cancer Information Nurses with Macmillan Cancer support. Thank you for getting in touch with us and I hope you find the online community a helpful and supportive environment.

The good news is that breast reconstruction does not increase the risk of breast cancer recurrence. Studies have shown that whether the reconstruction is partial or complete, the risk remains unaffected. It’s important to continue regular check-ups and monitoring as advised by your healthcare provider to ensure any recurrence is detected early.

There are several types of breast reconstruction options available after a mastectomy. Here are the main ones:

1. Implant-Based Reconstruction

This involves using a silicone or saline implant to recreate the breast shape. It can be done in one stage or in two stages, where a tissue expander is first placed to stretch the skin before the implant is inserted.

2. Autologous or “Flap” Reconstruction

This method uses tissue from another part of your body, such as the abdomen, back, or thighs, to create a new breast. Common types of flap reconstruction include:

DIEP Flap: Uses skin and fat from the lower abdomen without taking muscle.

TRAM Flap: Uses muscle, fat, and skin from the abdomen.

Latissimus Dorsi Flap: Uses muscle, fat, and skin from the upper back.

3. Combination of Implant and Flap

Sometimes, a combination of both an implant and tissue from another part of your body is used to achieve the desired breast shape and size.

4. Fat Grafting

This involves transferring fat from another part of your body to the breast area. It can be used alone or in combination with other reconstruction methods to improve the shape and contour.

5. Nipple and Areola Reconstruction

After the breast shape is reconstructed, additional procedures can be done to recreate the nipple and areola, often using skin grafts or tattooing techniques.

Each method has its own benefits and potential drawbacks, and the best option for you will depend on various factors, including your body type, health status, and personal preferences. It’s important to discuss these options with your surgeon to determine the best approach for your situation.

Breast reconstruction surgery can have several side effects, both short-term and long-term. Here are some of the most common ones:

Short-Term Side Effects

Anaesthesia-related issues: Problems with anaesthesia can occur, such as nausea or allergic reactions.

Bleeding and blood clots: There’s a risk of bleeding and developing blood clots, particularly in the legs or lungs.

Infection: Infection at the surgery site is a possibility, which may require antibiotics or additional surgery.

Fluid build-up: Fluid can accumulate in the breast or donor site, causing swelling and pain.

Wound healing problems: Some patients may experience delayed wound healing.

Long-Term Side Effects

Changes in breast sensation: The reconstructed breast may have altered or reduced sensation.

Asymmetry: The reconstructed breast may differ in size or shape from the natural breast.

Scarring: Scarring is inevitable, and some patients may develop thick or raised scars.

Fat necrosis: This occurs when fat tissue in the reconstructed breast dies, leading to firm lumps.

Implant issues: For those with implants, there can be problems such as implant rupture or capsular contracture (hardening around the implant).

It’s important to discuss these potential side effects with your surgeon to understand the risks and benefits specific to your situation. They can provide personalized advice and help you make an informed decision.

If you have any more questions or need further support, feel free to ask. Wishing you all the best with your surgery and recovery!

Best wishes

Alison, Cancer Information Nurse Specialist 

You can also speak with the Macmillan Support Line team of experts. Phone free on 0808 808 0000 (7 days a week, 8am-8pm) or send us an email. 

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