Should I Get Breast Reconstruction Surgery?

A woman who has surgery to treat breast cancer might also choose to have surgery to rebuild the shape and look of her breast. This is called breast reconstruction surgery. If you are thinking about having this done, it is best to talk about it with your surgeon and a plastic surgeon experienced in breast reconstruction before you have surgery to remove the tumor or breast. This lets the surgical teams plan the best treatment for you, even if you decide to wait and have reconstructive surgery later.

Reasons to have breast reconstruction

A woman might choose to have breast reconstruction for many reasons:

  • To make her chest look balanced when she is wearing a bra or swimsuit
  • To help make clothes fit better
  • To permanently regain her breast shape
  • So she won’t have to use a breast form that fits inside the bra (an external prosthesis)
  • To feel better about her body

Breast reconstruction often leaves scars, but they usually fade over time. Newer techniques have also reduced the amount of scarring. When you’re wearing a bra, your breasts should be alike enough in size and shape to let you feel comfortable about how you look in most types of clothes.

After a lumpectomy or mastectomy, breast reconstruction can make you feel better about how you look and renew your self-confidence. But keep in mind that the reconstructed breast will not be a perfect match or substitute for your natural breast. If tissue from your tummy, back, thigh, or buttocks was used as part of the reconstruction, those areas will also look different after surgery. Before you make your decision, talk with your surgeon about scars and changes in shape or contour. Ask where they will be, and how they will look and feel after they heal.

Risks of breast reconstruction

Of course, it's important to consider the potential risks and side effects of breast reconstruction surgery as well. These are discussed in What to Expect After Breast Reconstruction Surgery.

Can reconstructed breasts hide cancer or make it come back?

Studies show that reconstruction does not make breast cancer come back. If the cancer does come back, reconstructed breasts should not cause problems finding the cancer or treating it.  

If you are thinking about having breast reconstruction, either with an implant or tissue flap (your own tissue), you need to know that reconstruction rarely hides a return of breast cancer. You should not consider this a big risk when deciding to have breast reconstruction.

Some important things to think about

  • You might have a choice between having breast reconstruction at the same time as your breast cancer surgery (immediate reconstruction) or later (delayed reconstruction).
  • Some women don’t want to make decisions about reconstruction while being treated for breast cancer. If this is the case, you might choose to wait until after your surgery to decide about delayed reconstruction.
  • You might not want to have more surgery than is absolutely needed.
  • Not all reconstructive surgery is a total success, and the result might not look the way you had hoped. It is important to discuss expectations with your plastic surgeon. 
  • The cancer surgery and reconstruction surgery will leave scars on your breast and any areas where tissue was moved to create the new breast mound, such as the buttocks, tummy, thigh, or back areas.
  • A rebuilt breast will not have the same feeling as the natural breast. Sometimes, it may have little or no feeling at all. The places the tissue to rebuild the breast was taken from (donor sites) might also lose some feeling. Over time, the skin might become more sensitive, but it won’t feel the same as it did before the surgery.
  • You might have extra concerns if you tend to bleed or scar more than most people.
  • Poor blood flow might cause some or all areas of the breast skin or flaps to die after reconstructive surgery. This death of the tissue is called necrosis. If it happens, healing is delayed and more surgery is often needed to fix the problem.
  • Healing could be affected by previous surgery, chemotherapy, or radiation therapy. It can also be affected by smoking, diabetes, being obese, and other factors.
  • Surgeons might suggest you wait to have reconstruction, especially if you smoke or have other health problems. It’s often recommended to quit smoking at least 2 months before reconstructive surgery to allow for better healing. You might not be able to have reconstruction at all if you are obese, actively smoke, or have blood circulation problems.
  • The surgeon might suggest surgery to reshape your other breast to match the reconstructed breast. This is a called a symmetrizing procedure. This could include reducing or enlarging its size, or even surgically lifting the breast.
  • If radiation will be part of a woman's treatment, the types of immediate reconstruction surgery she will be able to have might be limited. Certain types of reconstruction done before radiation can cause problems and lower the chances the rebuilt breast will look and feel as natural as possible, after the radiation is given.  You should discuss your best options with your plastic surgeon before surgery.
  • Meeting with a plastic surgeon and knowing your reconstruction options before surgery can help you have more realistic expectations for the outcomes.

Help and support from someone who’s been there

It's important to know that there is advice and support out there to help you understand your reconstruction options as well as cope with the changes you’re going through if you have chosen reconstruction. Speaking with your doctor or other members of your health care team is often a good place to start. If you would like to talk with someone who has had your type of reconstruction, ask about our Reach to Recovery® program. Reach To Recovery volunteers are breast cancer survivors trained to support others facing breast cancer, as well as those who are thinking about having breast reconstruction. They can give you suggestions, reading material, and advice. Ask someone on your cancer care team to refer you to a volunteer or program in your area or call us at 1-800-227-2345.

The American Cancer Society medical and editorial content team

Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

American Society of Plastic Surgeons. Breast Reconstruction. Accessed at https://www.plasticsurgery.org/reconstructive-procedures/breast-reconstruction on July 20, 2021.

Clemons MW and Horwitz SM. NCCN Consensus Guidelines for the Diagnosis and Management of Breast Implant-Associated Anaplastic Large Cell Lymphoma. Aesthet Surg J. 2017; 37(3): 285-289.

Djohan R, Gage E, Bernard S. Breast reconstruction options following mastectomy. Cleve Clin J Med. 2008;75 Suppl 1:S17-23.

Farhangkhoee H, Matros E, Disa J. Trends and concepts in post-mastectomy breast reconstruction. J Surg Oncol. 2016;113(8):891–894.

Jagsi R, King TA, Lehman C, Morrow M, Harris JR, Burstein HJ. Chapter 79: Malignant Tumors of the Breast. In: DeVita VT, Lawrence TS, Lawrence TS, Rosenberg SA, eds. DeVita, Hellman, and Rosenberg’s Cancer: Principles and Practice of Oncology. 11th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2019.

Ho AY, Hu ZI, Mehrara BJ, Wilkins EG. Radiotherapy in the setting of breast reconstruction: types, techniques, and timing. Lancet Oncol. 2017 Dec;18(12):e742-e753.

Leberfinger AN, Behar BJ, Williams NC, Rakszawski KL, Potochny JD, Mackay DR, Ravnic D. Breast Implant-Associated Anaplastic Large Cell Lymphoma: A Systematic Review. JAMA Surg. 2017 Dec 1;152(12):1161-1168.

McCarthy CM, Loyo-Berríos N, Qureshi AA, Mullen E, Gordillo G, Pusic AL et al. Patient Registry and Outcomes for Breast Implants and Anaplastic Large Cell Lymphoma Etiology and Epidemiology (PROFILE): Initial Report of Findings, 2012-2018. Plast Reconstr Surg. 2019 Mar;143(3S A Review of Breast Implant-Associated Anaplastic Large Cell Lymphoma):65S-73S.

Nahabedian M and Gutowski KA. Complications of reconstructive and aesthetic breast surgery. In Collins KA, ed. UpToDate. Waltham, Mass.: UpToDate, 2021. https://www.uptodate.com. Accessed July 19, 2021.

National Cancer Institute. Breast Reconstruction After Mastectomy. 2017. Accessed at https://www.cancer.gov/types/breast/reconstruction-fact-sheet on July 20, 2021.

National Comprehensive Cancer Network (NCCN). Practice Guidelines in Oncology: Breast Cancer. Version 5.2021. Accessed at https://www.nccn.org/professionals/physician_gls/pdf/breast.pdf on July 20, 2021.

US Food and Drug Administration. Breast Implant Surgery. Updated March 31, 2021. Accessed at https://www.fda.gov/medical-devices/breast-implants/breast-implant-surgery on July 20, 2021.

US Food and Drug Administration. Questions and Answers about Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL). Updated October 23, 2019. Accessed at https://www.fda.gov/medical-devices/breast-implants/questions-and-answers-about-breast-implant-associated-anaplastic-large-cell-lymphoma-bia-alcl on July 20, 2021.

US Food and Drug Administration. Risks and Complications of Breast Implants. Updated September 28, 2020. Accessed at https://www.fda.gov/medical-devices/breast-implants/risks-and-complications-breast-implants on July 20, 2021.

US Food and Drug Administration. Things to Consider Before Getting Breast Implants. Updated September 28, 2020. Accessed at https://www.fda.gov/medical-devices/breast-implants/things-consider-getting-breast-implants on July 20 2021.

Weathers WM, Wolfswinkel EM, Hatef DA, et al. Implant-associated anaplastic large cell lymphoma of the breast: Insight into a poorly understood disease. Can J Plast Surg. 2013;21:95-98.

References

American Society of Plastic Surgeons. Breast Reconstruction. Accessed at https://www.plasticsurgery.org/reconstructive-procedures/breast-reconstruction on July 20, 2021.

Clemons MW and Horwitz SM. NCCN Consensus Guidelines for the Diagnosis and Management of Breast Implant-Associated Anaplastic Large Cell Lymphoma. Aesthet Surg J. 2017; 37(3): 285-289.

Djohan R, Gage E, Bernard S. Breast reconstruction options following mastectomy. Cleve Clin J Med. 2008;75 Suppl 1:S17-23.

Farhangkhoee H, Matros E, Disa J. Trends and concepts in post-mastectomy breast reconstruction. J Surg Oncol. 2016;113(8):891–894.

Jagsi R, King TA, Lehman C, Morrow M, Harris JR, Burstein HJ. Chapter 79: Malignant Tumors of the Breast. In: DeVita VT, Lawrence TS, Lawrence TS, Rosenberg SA, eds. DeVita, Hellman, and Rosenberg’s Cancer: Principles and Practice of Oncology. 11th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2019.

Ho AY, Hu ZI, Mehrara BJ, Wilkins EG. Radiotherapy in the setting of breast reconstruction: types, techniques, and timing. Lancet Oncol. 2017 Dec;18(12):e742-e753.

Leberfinger AN, Behar BJ, Williams NC, Rakszawski KL, Potochny JD, Mackay DR, Ravnic D. Breast Implant-Associated Anaplastic Large Cell Lymphoma: A Systematic Review. JAMA Surg. 2017 Dec 1;152(12):1161-1168.

McCarthy CM, Loyo-Berríos N, Qureshi AA, Mullen E, Gordillo G, Pusic AL et al. Patient Registry and Outcomes for Breast Implants and Anaplastic Large Cell Lymphoma Etiology and Epidemiology (PROFILE): Initial Report of Findings, 2012-2018. Plast Reconstr Surg. 2019 Mar;143(3S A Review of Breast Implant-Associated Anaplastic Large Cell Lymphoma):65S-73S.

Nahabedian M and Gutowski KA. Complications of reconstructive and aesthetic breast surgery. In Collins KA, ed. UpToDate. Waltham, Mass.: UpToDate, 2021. https://www.uptodate.com. Accessed July 19, 2021.

National Cancer Institute. Breast Reconstruction After Mastectomy. 2017. Accessed at https://www.cancer.gov/types/breast/reconstruction-fact-sheet on July 20, 2021.

National Comprehensive Cancer Network (NCCN). Practice Guidelines in Oncology: Breast Cancer. Version 5.2021. Accessed at https://www.nccn.org/professionals/physician_gls/pdf/breast.pdf on July 20, 2021.

US Food and Drug Administration. Breast Implant Surgery. Updated March 31, 2021. Accessed at https://www.fda.gov/medical-devices/breast-implants/breast-implant-surgery on July 20, 2021.

US Food and Drug Administration. Questions and Answers about Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL). Updated October 23, 2019. Accessed at https://www.fda.gov/medical-devices/breast-implants/questions-and-answers-about-breast-implant-associated-anaplastic-large-cell-lymphoma-bia-alcl on July 20, 2021.

US Food and Drug Administration. Risks and Complications of Breast Implants. Updated September 28, 2020. Accessed at https://www.fda.gov/medical-devices/breast-implants/risks-and-complications-breast-implants on July 20, 2021.

US Food and Drug Administration. Things to Consider Before Getting Breast Implants. Updated September 28, 2020. Accessed at https://www.fda.gov/medical-devices/breast-implants/things-consider-getting-breast-implants on July 20 2021.

Weathers WM, Wolfswinkel EM, Hatef DA, et al. Implant-associated anaplastic large cell lymphoma of the breast: Insight into a poorly understood disease. Can J Plast Surg. 2013;21:95-98.

Last Revised: September 19, 2022

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