Breast Reconstruction Overview

Reconstructive surgery i.e. forming an artificial breast, happens most often after a breast mastectomy. For any patient who has undergone either a lumpectomy or mastectomy, reconstruction is offered as a standard procedure. The reasons why women choose to have, after breast cancer, reconstruction is varied and obviously a very personal matter. Some of the most obvious reasons are:

• so that the chest looks more balanced when wearing a underwear or swimwear;
• so that clothes are a better fit;
• to avoid the use of silicone prostheses;
• to generally feel better about oneself

Most research papers show that breast reconstruction improves a woman’s sense of well-being and contributes favourably to their quality of life. Often surgeons will advise patients to have breast reconstruction after mastectomy and radiation treatment which may follow.

Many breast reconstruction after mastectomy pictures (UK – based surgeons) can be found on the Internet.

For any patient who has undergone either a lumpectomy or mastectomy, breast reconstruction is offered as a standard procedure.

As already mentioned breast reconstruction after cancer is probably the most usual scenario. After treatment for breast cancer, reconstruction of the affected breast will often boost the self-confidence and general well-being of the woman. When cancer is found in a breast, a woman will often be advised to have a mastectomy or a lumpectomy, depending on the type of cancer and on how big the tumour is. When a mastectomy is carried out, the entire breast is removed.

After a breast cancer mastectomy, reconstruction of the breast will normally be routinely offered, however it is up to the woman to decide if she wants it or not. The breast cancer mastectomy and reconstruction of the breast may be performed in one go or may take place with two separate procedures.

Where the choice of delayed or immediate breast reconstruction is available, the ultimate decision is left to the patient.

A lumpectomy involves the removal of the tumour and some of the surrounding tissue, so breast construction after lumpectomy is often not required. However, occasionally this procedure may leave the breast misshapen or a different size to the other breast. Over time, sometimes, unsightly dimpling may occur or even dents or bulges. Often, a surgeon will recommend that the patient waits until at least six to twelve months after the original surgery before considering breast reconstruction. This is in order to allow the breast tissue to heal and also for any distortions to stabilise.

Where the choice of delayed or immediate breast reconstruction is available, the ultimate decision is left to the patient. Reconstruction can be performed at any time after mastectomy. The advantage of having the reconstruction at the same time as a mastectomy is that both procedures will form part of one ‘operation’, so there is only ‘one’ recovery time. (Although it should be borne in mind that, ultimately, breast reconstruction may need more than one procedure.) The aesthetic and psychosocial effect of immediate breast reconstruction after mastectomy are better, however there is a slightly lower risk of surgical complications with delayed reconstruction.

Some women may feel that they are simply not up to making a decision about reconstruction after mastectomy when they are still concerned and worried about their cancer prognosis. Research in 2008 estimated that about 20% of patients have immediate breast reconstruction after mastectomy, although it is not known what percentage of patients could not consider immediate reconstruction due to further radio- or chemotherapy treatment.

Reconstruction after mastectomy is routinely offered to women either as an immediate or as a delayed procedure. Occasionally, a doctor may advise a patient not to have breast reconstruction after mastectomy, if they believe that existing medical conditions could cause problems e.g. increase the risk of complications. If a doctor advises against reconstruction they should always explain the reason for this decision. 

For those patients who will need further treatment using radiotherapy, it is not advisable to have breast removal and reconstruction at the same time. Radiotherapy may cause capsular contracture  which is a hardening of the scar tissue around an implant. Even when the new breast is constructed with the patient’s own tissue, radiotherapy may make the breast feel firmer, reduce its size and/or alter its shape. If it is probable that a patient will have follow-up treatment with radiotherapy, she will be advised to wait up to 12 months after the end of the treatment before considering breast reconstruction.

Doctor may advise a patient not to have breast reconstruction after mastectomy, if they believe that existing medical conditions could increase the risk of complications

Breast removal and reconstruction often applies to just one breast, however, sometimes both breasts are removed, especially where it is discovered that a woman carries the faulty BRCA1 or BRAC2 gene which may put her into a very high risk category of developing breast cancer. This is known as a double mastectomy or bilateral mastectomy. Breast reconstruction after double mastectomy may take place in exactly the same way as for one breast only.

There are various ways to perform breast reconstruction after breast removal, as will be explained later in this article. It is difficult to confirm the best breast reconstruction after mastectomy as every woman is different, every procedure is different and each body reacts in a slightly different way to surgery. It is very important to have detailed discussions with the plastic surgeon prior to the procedure, to ascertain which would be the best option taking all the different factors into consideration. According to NHS guidelines, a doctor  should offer all suitable post mastectomy reconstruction options, even if they are not available locally. 

Breast reconstruction is not usually offered to men who have a mastectomy for breast cancer. However, some sort of reconstruction after mastectomy is available which can help to improve the appearance and evenness of the chest area.

What Is Mastectomy?

Most surgeons will suggest breast conserving surgery i.e. a lumpectomy, rather than a mastectomy, wherever possible. However, it may be necessary to perform mastectomy surgery in certain situations including:

• when the lump is large compared to the size of the breast;
• where the cancer is in different parts of the breast;
• the patient has already had radiotherapy on the chest in connection with a previous cancer;
• where there is a family history of breast or ovarian cancer.

A mastectomy definition is: the removal of the whole breast. There are in fact five different types of mastectomy. The most suitable one for any particular woman will be the subject of a discussion between the patient and her surgeon. This table highlights the main points of the each mastectomy:

How long does a mastectomy take? Most operations of this type take around 90 minutes with the recovery time after mastectomy about 4-6 weeks. Mastectomy scars usually go across the chest and into the armpit. They fade over time, but will probably never disappear and the area will always feel numb. Before the mastectomy a patient will be asked if she wants breast reconstruction at the same time. Having the reconstruction done at the same time can be convenient as it means one recovery time from one operation. However, sometimes it is not possible and sometimes the woman feels that she is not yet ready for this surgery. That is not a problem as reconstruction surgery can be done at any time. After a mastectomy most patients can go home after one or two days, with a mastectomy and breast reconstruction a patient may have to stay in hospital for up to a week. Depending on the speed of the mastectomy recovery, time off work may be up to 8 weeks.

Occasionally a double mastectomy, also known as a bilateral mastectomy, is necessary. This usually only happens if cancer is found in both breasts or if the woman is genetically predisposed to breast cancer, in which case the mastectomy is a preventive measure. Generally, the double mastectomy recovery time is a little longer than for a single breast, but as always recovery times do very much depend on the patient. It is perfectly possible to have a double mastectomy and reconstruction at the same time, however, as with a single mastectomy, the option to have breast reconstruction at some later date also exists.

Having the reconstruction done at the same time as mastectomy can be convenient as it means one recovery time from one operation.

Breast reconstruction is not normally recommended prior to radiotherapy. If done before, the reconstructed breast may change colour, texture and appearance as well as losing some of its volume. In some circumstances, it may even interfere with the radiotherapy treatment.

Most doctors advise against immediate breast reconstruction after radical mastectomy or any of the other types of mastectomy where radiotherapy or chemotherapy will form part of the ongoing treatment. How long after radiotherapy can you have breast reconstruction? The usual advice to patients is to wait until their course of radiotherapy or c

There are a variety of different breast reconstruction options, however they all fall into two main types of breast reconstruction:

• Implant Breast Reconstruction: This is where a surgeon will insert a saline or silicone gelimplant to form the breast. This type of surgery is easier to perform and easier to recover from, however implants are more prone to problems over time and may need additional surgery further down the line.
• Autologous Breast Reconstruction: This is where a surgeon will use tissue from another part of the body. Sometimes an implant may also form part of the procedure. Generally this type of reconstruction is a longer procedure with a longer recovery time, however once the reconstruction is finished it will usually last a lifetime without the need for any further surgery.

Within these two breast reconstruction types there exists many different procedures. In addition, the latest treatment involves the use of stem cells in order to ‘grow’ a new breast. Breast reconstruction stem cells are taken from the existing fat in the body. This is a very new technology and initial trials have shown that this procedure may, unfortunately, promote cancer growth and metastasis. However, further research is currently being carried out to establish how this new procedure may be used safely in breast reconstruction.

Depending on the surgeon, the type and the circumstances of the breast reconstruction surgery, it may be split into a number of different stages. So, often, doctors talk about one stage or two stage breast reconstruction and sometimes even three-stage. These stages may include the expansion of the skin, insertion of the implant and/or tissue, symmetrisation with the other breast, formation of a new nipple (where required) and creation of the areola. According to the literature there are seven different types of breasts/shapes. By the end of the breast reconstruction procedures both the shape and the breast cup size should be the same as before and, obviously, match the existing breast.

By the end of the breast reconstruction procedures both the shape and the breast cup size should be the same as before and, obviously, match the existing breast.

Another exciting proposition is the use of breast inflation with air rather than normal expanders. This procedure is still not widely used, and has its advantages and disadvantages when compared to inflation with, for example, saline, however it may become more widely used as time goes on.

A double breast mastectomy reconstruction is no different to that for a single breast. The type of procedure will depend, as above, on the surgeon and circumstances. On the upside, for a woman who has had a double mastectomy, reconstruction of the breast may take any shape, form or size.

A tissue flap procedure or autologous tissue reconstruction is the name given to a variety of breast reconstruction procedures which use tissue from different parts of the body. A breast reconstruction flap has some advantages over a breast reconstruction implant procedure. It generally looks more natural and like natural breast tissue will get bigger or smaller with weight gain or loss. Sometimes, however, a breast flap reconstruction may require an implant as well.

It pays to be familiar with the different types of flap for breast reconstruction, so let’s have a brief look at some of the most common:

• Tram flap breast reconstruction – tram stands for transverse rectus abdominis muscle i.e. the tissue is taken from the abdomen. Sometimes this is known as abdominal flap breast reconstruction. Where a double mastectomy has taken place bilateral tram flap breast reconstruction is often used.
• Ld flap breast reconstruction – is a breast construction using latissimus dorsi flap i.e. the tissue is taken from the back.
• Tug flap breast reconstruction – tug stands for transverse upper gracilis i.e. tissue is taken from the inner thigh.

Diep Breast Reconstruction

Diep or diep flap breast reconstruction is very similar to Tram flap reconstruction inasmuch as tissue from the abdomen is used for both procedures. However with diep breast construction no muscle is moved or cut, which means the abdomen wall is not weakened. DIEP stands for the deep inferior epigastric perforator artery – the blood vessel which runs through the abdomen.

The surgeon makes an incision along the bikini line and fat, skin and small blood vessels are taken from the lower part of the abdomen. The blood vessels are connected to the blood vessels in the chest using microsurgery and a breast is formed using the skin and fat. The whole process takes 6-8 hours. This is quite a technically demanding breast construction – diep surgery is not performed by all surgeons.

Latissimus Dorsi Flap Breast Reconstruction

Breast created with flap technique looks more natural and like natural breast tissue will get bigger or smaller with weight gain or loss.

The latissimus dorsi is situated in the back just under the shoulder blade. It is one of a few muscles which help to move the arm, so, sometimes patients may feel a weakness in this arm after the surgery. With breast construction using latissimus dorsi flap the surgeon carefully moves this muscle around to the front of the chest and, with the help of the skin and fat covering it, forms a new breast. In this way the new breast retains the original blood supply to the muscle, so microsurgery to attach blood vessels is not required in this breast cancer reconstruction.

Latissimus dorsi flap breast reconstruction, however, may require an additional implant as there is little fat on the back and so the breast will be quite small. The other option, of course, is to reduce the size of the other breast to match the newly formed one. The latissimus dorsi flap breast reconstruction recovery time is about 4 weeks, slightly shorter than for the breast reconstructions which use tissue from the abdomen.

ADM Breast Reconstruction

ADM breast reconstruction is a technique used by surgeons when they are using breast implants for reconstruction. ADM stands for acellular dermal matrix which is a type of surgical mesh made from either a synthetic material or from the skin of cows or pigs. It basically holds the implant in place and creates a natural droop. Its collagen structure becomes incorporated into the recipient’s own tissue over time and the addition of this extra layer of tissue helps to disguise the implant.

When it comes to immediate implant breast reconstruction, one of the most popular surgery techniques is ADM breast reconstruction. UK figures show that 30%-50% of immediate reconstructions are implant-based constructions and the use of ADM as a surgery technique is increasing. However, there are some concerns about its higher infection rate compared to other techniques.

Prepectoral Breast Reconstruction

Traditionally, one way of inserting implants for breast reconstruction has been the subpectoral method. This is a two-stage process with a tissue expander being placed in the chest immediately after the mastectomy, with a second procedure, at a later date, placing the implant under the pectorals major muscle. This means that the implant has a tendency to move up and down as the muscle contracts and relaxes.

A prepectoral breast reconstruction is a newer version of this technique. It can be performed as a one-stage or two-stage procedure and the implant is placed above the muscle rather than under it. This, however, means that the implant is not protected by any muscle coverage so it must be covered in ADM.

Breast Reconstruction with Implants

Breast reconstruction with implants is usually performed using either silicone or saline implants. Silicone implants are more widely used these days as they feel more like natural breast tissue than saline implants. However, silicone breast construction still does not feel as natural as implants made from natural tissue.

Silicone is safe, but it is something ‘foreign’ to the body, so, in some cases, may provoke a reaction. With silicone implants the most common reaction is capsular contracture. This is where the body forms hardened tissue around the breast implant. This usually happens over a period of time and means that the breast may feel hard and uncomfortable and may even change shape. Statistics show that women with breast implants more often require additional surgery than those who have breast construction without implants. With breast construction silicone implants, the procedure may have to be done in a two-stage process. The first stage will be the implantation of a tissue expander. This will stretch the skin to ensure that there will be enough skin to form the breast shape.

Breast reconstruction with implants is performed using either silicone or saline implants.

A tissue expander is an implant, constructed from silicone which, over time, is gradually filled with saline in order to stretch the skin and chest muscles. The empty implant is placed in the chest and, after the scars have been healed, it is expanded with a saline solution. More and more solution is added every couple of weeks through a valve attached to the implant. It will probably take about 8-12 weeks to stretch the skin by the desired amount, and the entire process may last anything up to about six months. Tissue expanders may not be available for women with large breasts or for those who have had radiotherapy in the chest area which leads to a decline in the skin’s flexibility.

Some patients may decide to just stay with the saline filled tissue expander as it can be permanently left under the skin as a form of breast reconstruction. It is best for those women with small breasts. A permanent expander is one of the one-stage breast reconstruction implants which are available. It can be performed as immediate breast reconstruction with implants or as delayed breast reconstruction with implants after mastectomy. The surgeon will inflate the expander until it is slightly bigger than the other breast. It will then be left for a few months to ‘settle’. In the final step the surgeon will deflate the tissue expander until it is the correct size and remove the valve. This creates a natural droop of the breast.

Where the tissue expander is being replaced by a silicone implant, an operation will be required to extract the tissue expander and replace it with a silicone implant. Both silicone and saline implants have their advantages and disadvantages and it pays to discuss the options with the surgeon.

Breast reconstruction after mastectomy with implants is more straightforward than with tissue, however as time goes on the new breast may harden and become less of a match for the other breast which may naturally droop with age. Many breast constructions with implants will need to be renewed. The average implant lasts about 10-20 years with up to 20% of people having their implants replaced after 8-10 years.

Breast Reconstruction Using Body Fat

Breast reconstruction using body fat is known as fat grafting or autologous fat transfer. It is a comparatively new technique which involves extracting fat tissue from, usually, the thighs, belly or buttocks, processing it into a liquid and then injecting it into the chest to recreate a breast.

‘Lipofilling’, also known as fat transfer breast augmentation, is a similar procedure, which has been in use for a number of years. Lipofilling is used to fix the small differences which may occur in a reconstructed breast when compared to the existing breast. The fat from a different area of the body is extracted using liposuction and then injected into the breast or breasts. Due to its success in this situation, some surgeons are starting to use this fat transfer as a technique for reconstructing a whole breast. Total breast construction using own body fat, however, is a very new technique so no large clinical studies have been done on this procedure. It is, therefore, unclear if fat transfer to totally construct a breast will, in fact, be successful over the long-term.

Initially, the surgeon has to inject more fat than is needed into the area because the body will reabsorb some of the injected fat and therefore the breast will decrease in size. An important consideration is that if the fat transfer to breast technique is not successful and flap surgery is required in the future, an important source of tissue e.g. from the belly, will no longer be available. In connection with total reconstruction of a breast, fat transfer is still a largely unproven technique.

Breast and Nipple Reconstruction

Wherever possible a surgeon will aim to save the nipple during a mastectomy, however often it is not possible for a variety of different reasons. Where the possibility exists, there are two ways for preserving the nipple. The first method is to leave the nipple attached to the skin of the breast and just remove the tissue under the skin; the second method is to remove the nipple either with or without the surrounding darker skin (areola) and then graft it onto the reconstructed breast.

In the vast majority of cases, however, the nipple must be removed with the diseased breast tissue. A nipple is not a necessity on a reconstructed breast, but many women want one for aesthetic reasons. A nipple reconstruction after breast cancer is a common procedure. Breast reconstruction and nipple reconstruction are usually performed at different times. After the breast surgery, nipple reconstruction takes place about 4-6 months later, once the new breast has healed and settled. Nipple reconstruction after breast cancer can take a variety of different forms:

• a skin flap – skin from the reconstructed breast is formed into a nipple shape. It will probably be slightly bigger than normal initially because over time it will shrink and flatten;
• a nipple sharing graft – part of the nipple from the other natural breast is taken and placed on the reconstructed breast.

Both procedures are normally performed under local anaesthetic and most patients can go home the same day. It is important to note that an ‘artificial’ nipple will not react in the same way as a natural nipple. It will neither respond to hot/cold temperatures nor to touch and it will not have the same feeling/sensation.

Breast reconstruction and nipple reconstruction are usually performed at different times.

So, after the breast reconstruction, nipple replacement has taken place and just one more step is required to make the breast appear as natural as possible – the areola. The new nipple shape and the area around it can be tattooed to match the colour of the other breast. This is sometimes called micro-pigmentation and is usually carried out by a medical tattooist. The tattoo usually lasts about two years and the procedure takes only 30-40 minutes.

Silicone nipples for breast reconstruction known as a nipple prosthesis is another way of creating a nipple without surgery. These are simply attached to the breast with a special adhesive. A variety of shapes, sizes and colours are available and they can look very realistic. Custom-made nipple prostheses are also available, to exactly match the other natural nipple. They have to be taken off at night and placed back in the morning.

The breast reconstruction procedure may take place at the same time as a mastectomy or at a completely different time. If there are no medical reasons why the two procedures can take place at the same time, the choice will always rest with the patient. Some women, still in shock or, at least,  concerned about their cancer diagnosis may feel that they are not in a fit state to make such a decision and opt to wait. This is absolutely fine. The advantage, of course, of having both procedures at the same time is that there is only one recovery period, albeit maybe slightly longer than for a mastectomy only.

Often breast reconstruction is not just one procedure, but takes place over an average of at least two surgeries, although about one-third of women may require up to four operations.  The breast reconstruction procedure steps may look something like this:

• initial ‘major’ surgery to reconstruct the breast;
• one or more minor operations to reshape the breast/ or insert an implant;
• nipple reconstruction;
• further surgery may be needed at a later stage to replace implants or refine the previous surgery.

It should be borne in mind that the procedure for breast reconstruction after mastectomy will vary greatly from one patient to another and the surgeon will tailor the procedures to each individual. The flap or autologous breast reconstruction procedure will look different to an implant procedure. Sometimes a tissue expander is required with either type of breast reconstruction, sometimes it is not. It is wise to check out all the possibilities and then have a discussion with the surgeon who is probably best-placed to advise what  exactly is needed and why.

About one-third of women may require up to four breast reconstruction operations.

Smoking and breast reconstruction are two things that do not go well together.  Patients who smoke are advised to stop smoking at least six weeks prior to the breast reconstruction surgery. Smoking can cause problems with normal heart and lung functions,  complicate the anaesthesia and hinder wound healing.

How Long does Breast Reconstruction Take?

The initial (major) surgery connected with breast reconstruction can take up to eight hours in total.  This includes a one to two hour preparation period prior to the actual procedure. The surgery itself can take between one and six hours depending on exactly what needs to be done. Possibly the most intricate surgery, and therefore the longest, is flap surgery where the blood vessels have to be reconnected.

Breast Reconstruction Tissue Expansion

Following a mastectomy, there may be a need for breast reconstruction tissue expansion, particularly if a woman has chosen to have breast implants. This expansion of the tissues is required to ensure that there is enough space to fit the final implant.  On occasions tissue expansion is also used in flap breast reconstruction. A tissue expander is an implantable balloon-like device made of silicone, designed, over time,  to stretch the breast skin and chest muscles. One of these  breast reconstruction tissue expanders can be inserted during the mastectomy or anytime after when a woman decides that she would like breast reconstruction. Each expander has either an internal or external valve.

Breast reconstruction with tissue expanders after mastectomy can be done at any time.

When the incisions from the surgery have healed, approximately four weeks later, the tissue expansion can commence. Every few weeks, a saline solution is added to the tissue expander, either through the external valve or through the skin into the internal valve. The saline will gradually expand the silicon tissue expander. Various factors, including the size of the eventual implant, will influence how long the expansion process takes – anything from two to six months. Immediately after the extra saline has been added there may be some pain from tissue expanders for breast reconstruction as the muscles are stretched.  This should only last a few days.

A slightly newer technique now exists, where the tissue expander is inflated with carbon dioxide. Gas from an internal reservoir is released by remote control.  This new technology, however, is still not widely available.

Breast reconstruction using tissue expanders is a very common, safe and effective technique, however during the treatment it is best to avoid strenuous activities that cause the breasts to bounce or any strength training exercises which tighten the chest muscles. Wearing soft, supportive bras without underwires as well as loose blouses and tops will also help. About 4-6 weeks after the last saline fill, the surgeon will remove the tissue expanders; breast reconstruction using an implant can be carried out at the same time. 

Risks associated with tissue expanders are minimal. There is a very small risk of infection where the expander has an external port, but this can normally be resolved with antibiotics. In exceptional circumstances, where this does not solve the problem the tissue expander may have to be taken out and a new one inserted at a later date. There is also the small risk that the tissue expander will leak or break and the saline solution will leak out. This poses no danger – the saline will simply be absorbed by the body, however further surgery will be needed to repair the expander or to insert a new one.

Breast reconstruction with tissue expanders after mastectomy can be done at any time.  Those women whose treatment includes radiotherapy may be advised against tissue expanders as radiated skin loses its flexibility. The surgeon may be able to provide a suitable alternative.

As with many surgical interventions the recovery time plays a vital part in the overall success of the procedure and breast reconstruction recovery is no different.  Many patients need time to adjust to this ‘new’ part of their body and it may be difficult, at first, to accept it, however as time goes on the woman will get used to it.  The time required for breast reconstruction implants recovery tends to be shorter than for the body tissue surgeries such as breast reconstruction tram flap recovery.

Caring for the surgical wounds is very important. Once they have healed, massaging the scars once a day with moisturising cream will help prevent a build-up of hard scar tissue. Although the scars will never completely go away, they will fade over time. Where possible surgeons will cite incisions in places less obvious e.g. where a bra strap usually sits, however this is not always possible.

Breast Reconstruction Surgery Recovery Time

How long is recovery after breast reconstruction? Breast reconstruction surgery recovery time will vary from person to person and will depend on the type of reconstruction performed. It is also important to remember that less major surgery may be required following the initial procedure. Normal activities can be resumed some time between two weeks and three months. With implant surgery there is a much shorter recovery time; breast reconstruction with body tissue takes longer. The time needed to return to work will also vary from person to person and will also depend greatly on the type of job. More physical jobs, especially those involving lifting, will take longer to return to than more sedentary work. It may be worth asking if a more phased return can be arranged. Most patients will be given some exercises to perform at home in order to build the muscles weakened by the operation.

Here are some guidelines for resuming certain tasks:

With a return to driving it is important that the driver feels that they have complete control of the car. This includes being able to make an emergency stop and having full control of the steering wheel. Different car insurance companies have different rules and regulations regarding returning to driving after major surgery. It is advisable to check with the insurance company concerned before starting to drive again.

How long before breast looks in final form after breast reconstruction? After breast reconstruction, the new breast may not match the other natural breast. It may be firmer, and flatter or rounder. Breast reconstruction with implants will generally take 6-12 weeks to adjust and look more natural. Different factors like age and the amount of swelling will affect this timeframe. Analogous breast reconstruction with body tissue may even take a little longer. It is also worth remembering that often women have further procedures, after the initial surgery, to perfect the shape of the new breast.

Breast Reconstruction Bras

After a breast reconstruction it is important that the new breast is well supported. Usually a patient will come round from the surgery already wearing an after surgery bra or post-surgical bra. These are the best bras after breast construction as they support and help to maintain the shape of the breast. They are also sometimes called compression bras. This garment has a front fastening with eyelets and a zip and should be worn at all times, day and night, except for when, for example, washing or to change it for a clean one. This type of support bra after breast surgery should be worn until the patient is advised that it is no longer necessary – this may be any time between two and six weeks.

After this period, it is advisable to wear soft bras for up to a year. After breast reconstruction, bras should have a wide underband, deep front and side panels and full cups – sports bras are very good. Can you wear underwire bras after breast reconstruction? It is definitely advisable not to wear these types of bras as they may irritate the wound and skin area.

It can take up to a year for the nerves to repair and the area to fully recover. During this time the size and shape of the breast may change, so it best to get a professional bra fitting. A bra that fits on the loosest hook is a good buy because it can be gradually tightened as the swelling subsides. Once the area has healed and settled down, less restrictive bras can be worn.

Breast Reconstruction Swelling

Swelling after breast construction surgery is a normal part of the healing process.

Swelling after breast construction surgery is a normal part of the healing process. The initial post-surgery swelling may last a few weeks, but residual swelling may last longer – up to eight weeks. For those women who have had flap surgery there may also be swelling around the donor site. Swelling after breast reconstruction should not be of any concern unless it is accompanied by redness and/or fever, in which case it may be best to talk to the doctor about it. Wearing a soft supportive bra will ease any feelings of heaviness associated with the swelling. Cold compresses applied to the breast area may also help to alleviate the breast construction swelling.

Pain After Breast Construction

How long does pain last after breast reconstruction? Post breast reconstruction, pain will be experienced as it would with any surgery procedure. There may also be a feeling of pulling or stretching in the breast area. It is not unusual for patients to need painkillers for the first few weeks after the operation but gradually the pain should subside.

For some people the pain can linger for months or even years. Nerves which have been stretched or damaged either during the surgery or with the formation of the scar tissue can cause long-term breast construction pain. After reconstruction pain which hasn’t been properly controlled may lead to long-term pain, although there may also be many other reasons. If over-the-counter painkillers do not resolve the issue, then it is worth discussing the matter with the doctor. Regular exercise is known to relieve some pain symptoms as are some complementary therapies such as acupuncture, reflexology and reiki. Persistent pain after breast reconstruction should always be checked out.

Sex After Breast Reconstruction

How long after breast surgery can you have sex? Probably the most important thing is that sex after breast reconstruction should feel comfortable. Having sex while in pain is not a pleasant experience and may, in fact, have a long-term negative impact on getting in the mood for sex in the future. Getting used to the new breast may take some time and so a woman needs to regain her confidence before she feels ready for intimacy. Most doctors advise waiting at least a few weeks for sex after breast reconstruction to ensure wounds are healed, however the ultimate decision rests with the woman. She must decide when she feels ready and comfortable to resume her sex life again.

Nipple Tattooing After Breast Reconstruction

Nipple tattooing after breast reconstruction is a non-invasive method of creating the illusion of a nipple. Usually nipple reconstruction or nipple tattooing will be offered as a matter of procedure after breast reconstruction.

For those women who do not want to, or indeed cannot, for some reason, go through a nipple construction, some medical units offer 3D tattooing. The breast cancer reconstruction tattoos are created by inserting pigment into the skin with needles. With the use of different colours the medical tattooist creates the illusion of a nipple and areola in 3D. Breast tattoos after reconstruction can look extremely authentic and an experienced medical tattooist can create an incredibly realistic nipple which is, in fact, flat to the touch.

Where a woman still has one natural nipple, the tattooist will match the size and colour of the nipple on the other breast. The whole process may take around one hour. As the reconstructed breast does not have the same sensations as a natural breast, the tattooing procedure usually does not hurt. Some women, however, say they experience mild discomfort. When the tattoo is complete it will be covered with a dressing and the area will take about 7-10 days to heal properly.

A breast reconstruction tattoo avoids the surgery of a nipple reconstruction and, of course, the pain and scarring that goes with it. In addition, the healing and recovery process are much quicker and easier.

With the use of different colours the medical tattooist creates the illusion of a nipple and areola in 3D.

Breast Surgery Recovery Tips

Here are some top breast reconstruction recovery tips:

• After any operation including breast reconstruction, rest is very important in order to allow the body to recover;
• Before the procedure stock up with healthy foods like fruit and vegetables which will speed the recovery of the body;
• Drink plenty of water;
• Ask for help for the first few days after surgery;
• Wear a surgical bra as instructed by the doctor, followed by a soft sports bra without underwires;
• Except for given physio exercises, do not do any other activities until the wound has healed – be very careful with lifting particularly anything heavy;
• Contact the doctor if there are any concerning changes to the skin, excessive pain, swelling or lumps or fluid leaking from the donor site, breast or armpit;
• For breast reconstruction some time after mastectomy, there may be a period of emotional readjustment. It will take time to think of the reconstructed breast as ‘normal’;
• The final result – shape and texture – may take some time to appear so it pays to be patient;
• Immediately after the operation there will be some tingling and numbness. Some of this will dissipate over time, but there will always be some numbness in the breast;
• There is a lot of other information available on the internet. General plastic surgery recovery tips are also useful.

The ideal result of reconstructive breast surgery is a balanced appearance, with both breasts looking the same and being evenly balanced. This is known as breast symmetry. Despite the constant refinement of techniques, there is a possibility that not all women will be pleased with their breast construction results. Often, this is due to a lack of discussion prior to the surgery. It is very important to spend time with the medical team, establishing exactly what the desired outcome is and even talking to other women who have been through the same experience. It also pays to remember that the result immediately after surgery will be very different from the result later, after the swelling has gone down and the breast has settled in place.

The four main areas where there may be some dissatisfaction are:

• Size – although initially after surgery, the breasts will be asymmetrical, this should resolve itself over time as the swelling subsides. When there is still a noticeable difference, the surgeon can decrease the size of the reconstructed breast by removing some of the fat.

• Weight Gain – this is particularly a problem with implants, which will not naturally gain and lose weight as the body does. If a patient gains weight after surgery, the implant may have to be replaced by a bigger one. This is much less likely to happen with a breast constructed with a flap procedure, however very sudden and significant weight gain or loss can create an imbalance between the natural breast and the reconstructed breast.

• Drooping/Sagging – it is very difficult for the surgeon to match the natural droop of a breast. Over time a flap breast reconstruction, with the pull of gravity, may develop some sort of sag. A breast reconstructed with an implant will rarely sag and over time may become higher and firmer than the natural breast. The main resolution to this problem is to have surgery to reduce and/or lift the natural breast to match the reconstructed breast.

• Breast Sensation Changes – during breast reconstruction (and mastectomy) many of the nerves in the chest area are cut. They do have the potential to regrow but this can take anything up to two years and there will not be a total return to the sensations experienced prior to the surgery. Where breasts are an important erogenous zone this may be of concern to some women. Lack of sensation in the breast however may be tempered by a return of sensation to area(s) near the breast. Some women have reported that the armpit next to their breast has become a new erogenous zone for them.

On the whole women are satisfied with their reconstructed breast, however it may take some time to adjust and get used to. It is not unusual for a second procedure to take place to ‘tweak’ the shape and size and the plastic surgeons are usually happy to perform this. Good exploratory discussions with a clear outcome on size and shape will lead to greater satisfaction after the initial breast reconstruction procedure.

Breast reconstruction result immediately after surgery will be very different from the result later, after the swelling has gone down and the breast has settled in place.

Wherever possible a surgeon will endeavour to ensure that any breast reconstruction scars are placed in the least noticeable places, however this is not always possible. Good post-operative care can ensure minimal scarring and these scars will fade over time although not disappear completely.

The extent of the scars will vary from person to person and also depend on the type of procedure carried out. Flap breast reconstruction will leave some scarring on other places of the body (the donor site) as well as the chest area, while implant breast reconstruction will only leave scarring in the breast area.

Breast reconstruction scar tissue will be slightly raised and thicker than the surrounding skin. Wearing a support bra will support the new breast and prevent the wound/scar being stretched. As with any scar, massaging it three or four times a day for 10-15 minutes with a non-perfumed moisturising lotion will help it to heal better. Massaging a scar will help to break down the ‘hard’ scar tissue. This can be done for up to six months or more after the operation. As always, staying hydrated, eating a well-balanced diet and giving up smoking will affect immensely how the wounds heal and the subsequent breast reconstruction scar tissue.

Good post-operative care can ensure minimal scarring and these scars will fade over time although not disappear completely.

Any scarring, including scar tissue after breast reconstruction is very susceptible to the sun’s UV rays. These can lead to damage and darkening of the scar marks. If any of the scar marks will be exposed to the sun ensure that a high-factor sun cream is applied regularly.

A research paper was published in 2018 – Scarless Breast Reconstruction: Indications and Techniques for Optimizing Aesthetic Outcomes in Autologous Breast Reconstruction – which demonstrated how surgery may be performed without scars, however this type of surgery can be performed on only a very narrow category of patients and is not widely used.

As with any surgery, there are a number of risks associated with breast reconstruction. Usual surgery risks include blood clots in the legs, wound infection and healing, bleeding and problems with the anaesthetic. Any of these complications may arise in all major procedures, however there are some specific complications of breast reconstruction after mastectomy.

Breast reconstruction procedures have advanced considerably over the last 20 years and there are now far fewer problems after breast reconstruction. One complication, however, is a fluid build-up under the wound, known as a seroma (water) or a haematoma (blood). Often the patient will have drains inserted after the surgery so that the excess fluid can drain out of the body, however, sometimes the body will reabsorb the fluid itself or it can accumulate under the wound. If it continues to collect it may have to be extracted with a needle and syringe. In extreme cases, a breast implant may need to be taken out and re-inserted a few months later.

Other complications of breast reconstruction after mastectomy may be connected with flap surgery. When the body tissue is disconnected and reconnected to the blood supply there is a risk that it may die. Some women can develop problems with the flap blood supply during the first few days after the surgery. In this scenario, they will be given urgent surgery in order to try to save the flap. Sometimes this is possible, but for about 3% of patients the cells in the flap die and the flap has to be removed. Where this happens, there will be a wait of 6-12 months until the body is fully recovered before reconstruction surgery can take place again.

Longer term risks of breast reconstruction surgery include:

For implant surgery:

• A hardening and change in shape of the implant – this is often due to capsular contracture, when the body forms a fibrous capsule which may squeeze and harden the silicone implant over the implant.
• Leakage of the implant fluid – may occur but is unlikely. Minor bumps to the breast will not damage the implant. If silicone does leak out, it can make the lymph glands under the arm swell up. If it does leak the implant will have to be removed and replaced.
• Unequal breasts – weight loss or gain, or movement of the implant may mean that the breasts look unequal. The only solution is to remove and replace the implants with bigger/smaller ones or to perform surgery on the natural breast to make it look the same as the breast with an implant.
• Implant replacement – although breast implants do not have ‘sell-by’ dates, they will probably need to be replaced every 10-15 years.

For body tissue (analogous surgery):

• Loss of part of the flap – first the area is painful and hard and it creates a hard scar within the breast. The size of the breast is reduced. This is one of the breast reconstruction complications seen more commonly in smokers and those with poor circulation.
• Abdominal hernia – removing tissue and a small part of the muscle from the abdominal area means that the risk of an abdominal hernia is slightly increased.
• Dog Ears – these are little folds of skin which may appear at each end of the abdominal scar where the tissue for the reconstruction was collected from. Usually they disappear by themselves over time, however sometimes removal is required by surgery or liposuction.

As with any surgery, there are a number of risks associated with breast reconstruction.

Another of the breast reconstruction problems after reconstruction surgery is the aesthetics issue. After all, breast reconstruction is carried out for essentially aesthetic purposes and when this aim is not achieved it can be extremely disappointing. Some women are just not happy with breast reconstruction outcomes.

As mentioned earlier, one way to avoid this is with lengthy discussions with the surgeon and his/her team to ensure that everybody is clear exactly what is required. With the best will in the world, it is still sometimes difficult for the surgeon to get it exactly right. In addition, the shape and form of the breast immediately after surgery will not be the same as the final version. Where there is genuine disappointment, most surgeons are quite happy to perform further surgery in order to ‘tweak’ the breast.

Fat Necrosis After Breast Reconstruction

In rare cases, fat necrosis after breast reconstruction may occur about 6-9 months after flap breast construction surgery. This is due to a lack of blood flow to certain parts of the implanted flap tissue. As time goes by this fat hardens and becomes firm scar tissue. These are not cancerous lumps, but where they are causing pain or a distortion to the shape of the breast they can be surgically removed.

If possible, liposuction is used to extract the necrosis because it is less likely to leave a ‘hole’ in the tissue. If this is not possible, the area of fat will have to cut out and the tissue rearranged to fill in the ‘hole’. Necrosis after breast reconstruction after radiotherapy or, indeed, an injury to the breast.

Lump In Breast After Mastectomy And Reconstruction

It is very easy for a woman to panic when she finds a lump in breast after mastectomy and reconstruction, however, there are a quite innocent reasons why a lump may appear.

Firstly, as described above, fat necrosis or tissue necrosis can cause lumps in the tissue of the breast. Unlike cancer, they will usually remain the same size or even get smaller over time. A mammogram or ultrasound examination can easily pick up the difference between benign necrosis and a cancerous tumour.

With implant surgery, lumps may be felt in the breast tissue due to capsular contracture and a hardening of the implant. Obviously, it is important to talk to a doctor when lumps occur and to have them checked. With mammograms on breasts with implants, additional views are necessary because the x-rays cannot pass through the silicone/saline implant.

Breast Reconstruction Pain Years Later

Pain after breast reconstruction will normally subside after a few weeks, although a small amount of mild pain may be experienced after this as the breast settles in. In a minority of cases, however, there can be an occurrence of breast reconstruction pain years later, or it may be that the pain from the initial surgery just never subsides.

This type of pain is almost always caused by nerves being damaged at the time of surgery. It may even take the form of phantom breast and/or nipple pain. It is important to consult with a doctor when pain becomes long-term as it can be very debilitating. Where usual over the counter painkillers, such as paracetamol or ibuprofen do not solve the problem, the doctor may suggest antidepressants or anti-epileptic drugs which have been proven to be very effective in treating nerve pain.

The most important thing is to get help in managing long-term breast construction pain. There are many ways nowadays in which it can be controlled.

Breast Cancer Recurrence After Mastectomy and Reconstruction

There is no doubt that there is a small chance of recurrence of breast cancer after mastectomy and reconstruction. The rate of a local recurrence varies between 2.1% and 11.7%, with rates higher in women where axillary lymph nodes are found to be cancerous.

A mastectomy will prevent the immediate spread of cancer but it does not completely remove the chances of cancer re-emerging in the chest area. However, research undertaken in 2018 – Breast cancer recurrence after reconstruction: know thine enemy – did come to the conclusion that breast reconstruction is safe and has no direct link to the recurrence of breast cancer.

Breast Reconstruction Revision Surgery

Breast reconstruction revision is essentially a second operation on the reconstructed breast. This may be required soon after the initial surgery or some years later. Unless the situation is extremely urgent or even life-threatening most plastic surgeons will advise patients to wait at least until a few months have passed since the initial surgery.

Breast revision after reconstruction may occur for a variety of different reasons. Breast implants are usually expected to last for 10-15 years, so, often, an implant will need to be changed for a new one at some stage. Other reasons for breast implant revision may be:

• A need to change the size of the breasts, particularly due to an increase or decrease in weight.
• Pain from capsular contracture.
• Due to a rupture of the implant or if it has moved to a different position.
• To change from saline to silicone or a different type of breast implant.

Breast reconstruction using natural tissue, unlike a breast implant, is for life and, therefore, a revision of breast reconstruction is usually performed for different reasons. It is not unusual for breast reconstruction revision surgery to be carried out a few months after the initial surgery. This may be simply to ‘tweak’ the shape and form of the new breast, so it meets the patients expectations. Other reasons for additional surgery after a breast reconstruction using the flap method may be:

• Necrosis of the breast skin, tissue flap or fat.
• The effects of radiotherapy treatment.
• Breast symmetry.
• Nipple reconstruction problems.

Generally, revision surgery after breast reconstruction carries the same risks as for the initial surgery. There is an increased risk however if, after multiple breast surgeries in the past, there is a lot of scarring, the skin is particularly thin or there has been some other damage to the breast tissue.

Breast reconstruction revision surgery carries the same risks as for the initial surgery.

There is no reason why the breast creonstruction cannot take place later, when the woman feels she is in a better place emotionally to make such decisions.

There are many decisions to make when it comes to the question of breast reconstruction. Although it is probably easier to have a breast reconstruction at the same time as a mastectomy, this is a big decision to make at a time when there may still be a maelstrom of emotions from the cancer diagnosis. Apart from some physical reasons (e.g. pending radiotherapy), many women will feel that they have not had the time to consider the pros and cons of breast reconstruction after mastectomy and its methods. This is fine and, as mentioned previously, there is no reason why the breast construction cannot take place later, when the woman feels she is in a better place emotionally to make such decisions.

Firstly, let’s consider the pros of breast construction. The advantages of breast construction are mainly tied into aesthetics. However, when it comes to a mastectomy, this is a very important aspect. For some women a loss of one or both breasts can be linked to their femininity and how they see themselves. Breast reconstruction can give them back their self-esteem and may mean that they can feel more confident in social situations as well as in bed. Loss of a breast is a constant reminder of the cancer that robbed them of it.

What is the downside of breast reconstruction? For some women the thought of more surgery is very difficult. With breast implants, particularly, tissue expanders may need to be placed initially before the implant is put into place and there is the prospect of surgical procedures every 10-15 years (this may vary from person to person) to replace the implants in addition to the initial operation. With tissue breast construction this will mean a surgery site in two places on the body, although there is, of course, no need for renewal of the implant. It is not unusual for there to be at least one more operation, shortly after the first, to correct any flaws in the shape and size.

Every woman’s ‘cancer journey’ is slightly different and their reactions to the situation are unique to each person. It is essential to find out as much as possible about the pros and cons of breast construction after mastectomy, discuss it with a surgeon at length, talk to other women who have been through the same thing and finally make a decision based on personal feelings.

With many national health services, breast reconstruction may be offered automatically. However, some women opt to have breast reconstruction privately. Breast reconstruction surgery cost is high. It is classed as major surgery and requires specific training. It is important to bear in mind that, in addition to the breast reconstruction cost, there will probably be extra costs like consultations and possible additional surgery to adjust the shape and form. It is very very important therefore to check with the clinic exactly what is included the breast reconstruction price and what potential additional charges may exist. Remember, like any surgery, it may not go as planned or the results may be different from those expected.

It is also wise to check out the surgeon and his qualifications. How can you check out the best breast reconstruction surgeon? A good place to start is the British Association of Plastic Reconstructive and Aesthetic Surgeons (BAPRA), the General Medical Council (GMC) and the British Association of Aesthetic Plastic Surgeons (BAAPS) websites. Only those surgeons whose training is recognised by the GMC Specialist Register are allowed to call themselves ‘plastic surgeons’. Other useful websites, particularly for those living outside the UK are The International Society of Aesthetic Plastic Surgery and the European Association of Plastic Surgeons.

Breast Reconstruction UK

The exact price of surgery for each patient will vary depending on whether the surgery is by implant or tissue, where exactly the tissue (flap) is taken from and other variants specific to each patient.

There are many private clinics and establishments offering breast surgery. For example, googling ‘breast reconstruction Manchester’ will provide several pages of possible providers. As one can imagine a search using London would throw up even more. How to find the right surgeon/hospital/clinic for you? UK private cosmetic surgery providers, hospitals and clinics are regulated and inspected by the Care Quality Commission. The latest reports for each establishment can be found on their website listed below. Unlike many other cosmetic procedures where something is being ‘taken away’ from the body, with breast reconstruction something is being ‘added’ and it is very important that the patient is happy with this ‘addition’.

It is essential to find a surgeon who feels right for you as well as checking out their credentials. Most surgeons will keep pictures of the work they have done in the past. It is also worth asking them if they can give you the contact details of any patients they have already performed breast reconstruction surgery. Remember to check the surgeon on the appropriate websites above.

Breast Reconstruction Cost UK

How much does breast reconstruction cost? UK prices for private treatment vary considerably between surgeons and hospitals/clinics. It is estimated that breast reconstruction surgery cost UK-wide is somewhere between £3500 and £8,000. The exact price for each patient will vary depending on whether the surgery is by implant or tissue, where exactly the tissue (flap) is taken from and other variants specific to each patient. In addition, this price will often not include essential pre-surgery consultations and of course any adjustments that need to be made post-surgery. The final figure for the total treatment could be much higher.

NHS breast reconstruction after mastectomy, in normal circumstances, is offered as a matter of procedure. Providing there are no medical reasons which preclude a woman from such surgery, patients are offered either implant, flap or free flap breast construction at the same time as a mastectomy is performed. Those women who elect to wait a while should also be eligible for breast reconstruction – NHS-funded. Most NHS trusts will allow three or four surgeries to be performed after the mastectomy. This may include procedures such as the initial breast reconstruction, adjustments for breast asymmetry and nipple reconstruction. However, with this funded breast reconstruction after cancer, NHS will not normally provide surgery later e.g. when an implant needs replacing.

After breast cancer, reconstruction NHS-wise is routinely funded, however there are currently some issues because the bulk of NHS resources are now being used to fight the Covid epidemic. Breast reconstruction is not classed as an emergency procedure and therefore patients will be allocated a place on a waiting list.

NHS breast reconstruction after mastectomy, in normal circumstances, is offered as a matter of procedure.

NHS Waiting Times For Breast Reconstruction

The NHS target for non-urgent surgical procedures is 18 weeks from the day the appropriate doctor registers the patient on the e-referral NHS system. However, in light of the current health crisis caused by the Covid pandemic, NHS waiting times for breast reconstruction are getting ever longer. NHS patients now do have the freedom to choose where they are treated (NHS England- anywhere in England, NHS Scotland – anywhere in Scotland etc), so sometimes it is possible to find shorter waiting lists in another part of the country.

Does insurance cover breast reconstruction? Generally, UK private health insurance will not cover cosmetic surgery and the majority of insurance companies will view breast reconstruction as a cosmetic procedure. However, each company and policy type has its own conditions and it is definitely worth contacting your private medical insurance provider to check whether they would consider funding such a procedure.

Breast reconstruction abroad, not only as a cosmetic procedure, but also as a post-mastectomy procedure, has become more and more popular in recent years. The current situation with the national health services in many countries has led patients to consider private treatment. Private surgery in the UK, however, is often beyond the means of some people and this is why breast construction abroad, which is usually much cheaper, has been steadily rising.

Similarly to choosing private treatment in the UK, it is essential to check out information about the health centres and surgeons of any country which offers such surgery. Always check out the surgeon’s qualifications and where possible talk to any former patients. In this respect, booking agents can be very useful as they give an extra layer of security. Their extensive knowledge of some of the best breast reconstruction surgeons in a particular country means that they can assist in finding a good match between patient and surgeon. It is important to not only check out plastic surgeons; breast reconstruction should be their speciality.

What’s also important, patients can get secured for their medical trip abroad, which makes their travel and stay much safer. Clinic Hunter & AXA Partners have created a medical insurance for overseas dedicated solely to medical tourists.

As in the UK, the cost of breast reconstruction will vary enormously depending on the type of reconstruction and the specific requirements of the patient. However, in countries where the cost of living is considerably lower, savings of up to 50% can be made. As usual, patients should check out exactly what the price includes. In many cases, flights and any additional hotel accommodation are extra costs.

Breast Reconstruction in Poland

Poland is now one of the top medical tourism destinations in Europe because of a combination of highly skilled medical staff together with a relatively low cost of living.

When it comes to plastic surgery, Poland is now one of the top destinations in Europe. Why is this so? A combination of highly skilled medical staff together with a relatively low cost of living means that when it comes to plastic surgery, Poland prices can be up to 50% of the equivalent cost in western European countries with a very high cost of living. There are many excellent plastic surgeons in Poland, breast surgery being just one of the many procedures they can offer. Their clinics are equipped with the latest cutting edge equipment and doctor’s training is of, at least, the same standard as in the UK. English is now taught, as standard, in all schools from an early age so that all medical staff speak English as does most of the younger population.

Breast surgery in Poland is definitely an option worth exploring. It is a relatively short flight from the UK (approx 2.5 hours) and there are frequent services from many UK airports. Cheap flight tickets are often available and, where needed, comfortable hotel accommodation can be found for a much lower price than in some other European cities. The best clinics are given accreditation by the Polish Health Ministry. Many also have certification from the following organisations – ISO (International Organisation for Standardisation), ESQH (The European Society for Quality in Healthcare) and TAS (The Treatment Abroad Scheme). When considering breast surgery, Poland ticks many of the boxes.

Our consultants can provide specific details on the clinics we represent together with testimonies from other patients who have had breast reconstruction in Poland.

Breast Reconstruction in Turkey

Turkey is the third most visited country when it comes to medical tourism.

Turkey is the third most visited country when it comes to medical tourism. It is estimated that about one third of patients treated in Turkish medical centres are actually from abroad. Similarly to Poland, the main attraction of Turkey as a medical centre is its well-trained doctors and well-equipped clinics/hospitals together with its low costs. Breast surgery in Turkey costs only 50-70% of the usual prices in the UK and western Europe.

Certainly, for those thinking of breast surgery, Turkey is an option worthy of consideration. Flights from London to Istanbul are just under 4 hours and flight costs are very reasonable. All medical staff speak English in Turkey; breast surgery is certainly one of their most frequent procedures for foreign visitors.

Our consultants can provide specific details of clinics in Turkey which would best suit the needs of the individual patient.

Other Locations For Breast Reconstruction Abroad

There are, of course, other countries which major in medical tourism and breast surgery abroad is big business. However, patients should consider the following points:

• How long is the flight to/from the country (long flights can mean a higher risk of blood clots after surgery).
• Cost and frequency of flights to the country.
• In some countries, reduced prices may mean less well-equipped clinics/hospitals.
• Always ensure that, in whichever country selected, the surgeon(s) are specialised in breast reconstruction.
• Do all the medical staff speak good English.

Remember to always do your homework and check out the medical facilities and doctors before making a decision. Medical tourism agents are very helpful in this respect.

Although it does pay to be prudent when checking facts on the Internet, there is no doubt that some very valuable information can be gleaned from it. Personal blogs and articles written by people who have actually gone through the process are invaluable especially for those women who are still weighing up breast reconstruction options. In addition, they are helpful for those in a specific situation e.g. breast reconstruction after radiation reviews. As mentioned earlier, it is so important that anybody considering breast reconstruction is aware of all their choices and options, so checking out breast reconstruction reviews is a very useful exercise.

The decision as to whether or not to have breast reconstruction after mastectomy can be a difficult call for many women. Breast reconstruction performed at the same time as a mastectomy has some advantages, however it may not be suitable for all women either due to medical reasons or because emotionally they do not feel ready to take such a step.

Breast reconstruction with implants is an easier procedure initially, however the implant will need replacing every 10-15 years. There are also risks associated with implants such as ruptures and movement of the implant. Breast reconstruction using the patients own tissue is potentially more painful and complicated initially, however once done it is permanent and barring any complications will last a lifetime. It is also worth remembering that after the initial surgery there may be further procedures such as a breast reconstruction revision to adjust the form, size and breast asymmetry as well as possible nipple reconstruction.

Some women are happy just to wear a prosthesis which will give then the desired shape under clothes, but for others a breast reconstruction will give them back their self-confidence and make them feel like a woman again after the trauma of breast cancer.

Should I Get Breast Reconstruction Surgery? – https://www.cancer.org/cancer/breast-cancer/reconstruction-surgery/should-i-get-breast-reconstruction-surgery.html

Reconstruction After Lumpectomy – https://www.breastcancer.org/treatment/surgery/reconstruction/types/lumpectomy

What is a mastectomy – https://www.breastcancer.org/treatment/surgery/mastectomy/what_is

Mastectomy NHS – https://www.nhs.uk/conditions/mastectomy/

Timing of breast reconstruction: immediate versus delayed – https://pubmed.ncbi.nlm.nih.gov/18677129/

Types of Breast Reconstruction – https://www.breastcancer.org/treatment/surgery/reconstruction/types

Adipose tissue-derived stem cells in breast reconstruction – https://stemcellres.biomedcentral.com/articles/10.1186/s13287-020-01955-6

The three stages of breast reconstruction – https://www.thepmfajournal.com/features/post/the-three-stages-of-breast-reconstruction

A Novel Technique of Breast Reconstruction: Inflation of Breast Tissue Expander with Air – https://journals.lww.com/prsgo/fulltext/2018/12000/a_novel_technique_of_breast_reconstruction_.36.aspx

Breast Reconstruction Using Your Own Tissues (Flap Procedures) – https://www.cancer.org/cancer/breast-cancer/reconstruction-surgery/breast-reconstruction-options/breast-reconstruction-using-your-own-tissues-flap-procedures.html

Breast Construction using body tissue – https://www.cancerresearchuk.org/about-cancer/breast-cancer/treatment/surgery/breast-reconstruction/using-body-tissue

Breast construction using implants – https://www.cancerresearchuk.org/about-cancer/breast-cancer/treatment/surgery/breast-reconstruction/using-implants

How long do breast implants last – https://www.healthline.com/health/how-long-do-implants-last

Fat Grafting – https://www.breastcancer.org/treatment/surgery/reconstruction/types/autologous/fat-grafting

Nipple reconstruction – https://www.macmillan.org.uk/cancer-information-and-support/breast-cancer/nipple-reconstruction

How tissue expanders are used in breast reconstruction – https://www.verywellhealth.com/tissue-expanders-and-breast-reconstruction-430401

Recovering at home after breast reconstruction – https://www.macmillan.org.uk/cancer-information-and-support/breast-cancer/recovering-at-home-after-breast-reconstruction

Post-operative information for breast reconstruction surgery during Covid-19 pandemic – https://www.qvh.nhs.uk/wp-content/uploads/2015/09/Breast-Reconstruction-Post-Op-Handbook-0443-1.pdf

Satisfaction With Breast Reconstruction Results – https://www.breastcancer.org/treatment/surgery/reconstruction/satisfaction

Scarless Breast Reconstruction: Indications and Techniques for Optimizing Aesthetic Outcomes in Autologous Breast Reconstruction – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5865925/

Fat necrosis in the tissue flap – https://www.breastcancer.org/treatment/surgery/reconstruction/corrective/fat-necrosis

Possible problems with breast reconstruction – https://www.cancerresearchuk.org/about-cancer/breast-cancer/treatment/surgery/breast-reconstruction/possible-problems

Breast cancer recurrence after reconstruction: know thine enemy – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6021250/

Corrective Breast Reconstruction – https://www.breastcancer.org/treatment/surgery/reconstruction/corrective

BAPRAS – https://www.bapras.org.uk/home/find-a-member

GMC – https://www.gmc-uk.org

BAAPS – https://www.baaps.org.uk

Care Quality Commission – https://www.cqc.org.uk/