Making your decision

It is important to feel happy about your decision whether to have breast reconstruction. You can talk it over with your surgeon, breast care nurse, or any family or friends you want to involve.

Make sure you have realistic expectations. Breast reconstruction does not result in a ‘perfect’ breast, but there can be many benefits. It can help restore your confidence, make you look the same in clothes as before your mastectomy. And you won’t have to wear a breast prosthesis.

But having reconstruction will mean more time in hospital. Most women need further minor operations to get the best cosmetic result. You are unlikely to have much sensation in your new breast.

You will also need to think about timing. Immediate reconstruction often leaves a better appearance and you will not be without a breast shape. Delayed reconstruction is usually always available, even years later and it means you have your surgery in stages.

You are the best person to know what feels right for you.

Thinking about breast reconstruction

Deciding whether to have breast reconstruction or when to have it will depend on your individual situation. You are the best person to know what feels right for you.

It is important you feel happy with your decision. You can discuss it with your surgeon and breast care nurse. You can also talk about it with a relative or friend you trust. You might want to contact an organisation such as Breast Cancer Care.

Breast reconstruction is available on the NHS. There are many options available.

It is important to discuss your options for breast reconstruction before you have a mastectomy. You do not have to make a definite decision about it at this stage. But it will help the surgeon to plan your initial surgery.

Should I have breast reconstruction surgery?

Women have breast reconstruction for different reasons. You may choose it so that you will not need to wear a false breast (breast prosthesis/form). Or you may feel that it will improve your confidence about how you look and feel about your body after breast surgery. 

You may decide that you are comfortable wearing a breast prosthesis. You may not want to go through the additional surgery that breast reconstruction involves.

Some women plan to have breast reconstruction but then decide not to. They find that losing their breast does not trouble them as much they thought it would.

Some women feel ready to have breast reconstruction years after surgery for breast cancer.

Important things to think about

If you decide to have breast reconstruction, you will need to think about when to have it. It may be possible to have it at the same time as your mastectomy. This means you will have a breast shape immediately after the operation.

Other factors may also affect your decisions about reconstruction. These may include:

  • your general health
  • your relationships
  • your commitments and priorities.

It is important to have realistic expectations about breast reconstruction. It cannot give you a perfect breast. A reconstructed breast will not have as much sensation and may not move as well as your natural breast did.

If you are only having one breast reconstructed, your surgeon will aim to match it to your other breast. But there may be differences in the size, shape or position of the two breasts. Most women are pleased with the results of their surgery, but some women are disappointed.

Breast reconstruction usually involves having two or more operations. These are usually done over a period of 6 to 12 months.

Breast reconstruction does not increase the chance of a cancer coming back or developing in the breast. Reconstruction does not make it harder for your doctor to diagnose a possible recurrence. They can still check any changes in the breast area.

It may be helpful to think about the possible benefits and limitations of breast reconstruction before making your decision.

Benefits of breast reconstruction

  • You will look the same in clothes (including underwear) as you did before surgery.
  • You will not have to wear a prosthesis or a special bra.
  • You will regain your breast shape.
  • It can help restore your confidence in yourself and how you think and feel about your body (body image).

Limitations of breast reconstruction

  • You will spend more time in hospital.
  • You will take longer to recover from your operation.
  • Most women need further minor operations to get the best cosmetic results.
  • As with all operations, there can be complications.
  • You are unlikely to have much sensation in the new breast.
  • You may have scars elsewhere on your body, depending on the type of reconstruction you have.
  • You may not be happy with the result.
  • You may need to have an operation on your other breast, so that both breasts look the same.

Deciding when to have breast reconstruction

Reconstruction can be done at the same time as a mastectomy, or some time later.

Immediate reconstruction

An immediate reconstruction is done at the same time as a mastectomy. It is often possible for the surgeon to leave most of the skin that covers the breasts when they remove the breast tissue. Doctors call this a skin-sparing mastectomy. It leaves less scarring than a delayed reconstruction. This is because less skin is removed.

This operation usually removes the nipple, the dark area around the nipple (areola) and a small circle of skin around the areola.

Sometimes it is possible to leave the nipple in place attached to the breast skin. Doctors call this a nipple-sparing mastectomy. Sometimes the nipple is removed and then put back on to the reconstructed breast.

Benefits of immediate reconstruction

  • Immediate reconstruction often gives a better appearance than delayed reconstruction. This is because it is easier to keep more of the breast skin.
  • There is less scarring than with delayed reconstruction.
  • You will not be without a breast shape at any time.

Limitations of immediate reconstruction

  • You may have to wait longer to have your mastectomy if two teams of surgeons are involved.
  • Immediate reconstruction involves a longer operation and recovery time.
  • If you need chemotherapy or radiotherapy after surgery, this could be slightly delayed. For example, this might happen if problems such as infection slow your recovery. But this is uncommon.
  • Having radiotherapy after breast reconstruction may affect the appearance of the reconstructed breast. If you need radiotherapy, your doctors may suggest delayed breast reconstruction.

Delayed reconstruction

You can have breast reconstruction after you have recovered from your other treatments. This is called delayed reconstruction. For example, if you have radiotherapy, you will usually wait about 6 to 12 months before having reconstructive surgery. This gives the skin on your chest time to recover.

There is no time limit for having delayed breast reconstruction. Some women choose to have it years after a mastectomy.

Benefits of delayed reconstruction

  • Delayed reconstruction is usually always available – even years after your original surgery.
  • You will have your surgery in stages. This means that you will have a shorter recovery time after each procedure.
  • Reconstructive surgery will not delay other cancer treatments.
  • You have more time to think about whether reconstruction is right for you.
  • It gives you time to concentrate on each individual treatment. You can focus on your cancer treatment, and then think about reconstructive surgery later.

Limitations of delayed reconstruction

  • You will not have a breast shape for a period of time.
  • The appearance of the reconstructed breast may not be as good as with an immediate reconstruction.
  • You will need at least one additional operation, which requires a general anaesthetic.

Back to Having breast reconstruction

Talking to your surgeon

Your reconstruction surgeon will explain what types of operation can be done and answer any questions you have.

Your feelings

Breast reconstruction surgery can cause many different emotions. It can take time to adjust to your new breast(s).