Types of breast reconstruction

There are 2 main options for breast reconstruction surgery to create a new breast shape: using breast implants and using your own tissue. Not all options are possible or suitable for everyone.

Breast reconstruction using breast implants

This procedure uses silicone or saline implants. This option may be a single surgery (‘one-stage’) or separate surgeries ‘(two-stage’).

• Breast reconstruction using implants – when this may be suitable and the advantages and disadvantages
• About breast implant surgery – the one-stage and two-stage procedures, potential risks and complications.

Breast reconstruction using your tissue (flap surgery)

In tissue flap surgery, a surgeon uses tissue, fat, muscle and blood vessels to create a new breast mound. They take this from another part of your body, such as the tummy, back or thighs. Different types of surgery include 'DIEP flap' and 'Lat Dorsi'. This is also called ‘autologous reconstruction’.

We describe and show the most common types.

• Breast reconstruction using your own tissue – when this may be suitable and the advantages and disadvantages.
• Types of tissue flap reconstruction – the variations such as DIEP flap and Lat Dorsi (LD) flap procedures.

Differences and other factors to consider

The differences between implant reconstruction and tissue flap reconstruction may affect your decision. These include:

• how long surgery will take
• risks and benefits
• time to recover from surgery
• how many different operations you may need
• what the end result could look like
• the costs of surgery
• whether you need to be able to do any particular activities after surgery, such as physical work or a favourite sport
• any previous surgeries to parts of your body where tissue may be taken from.

Once you have the information you need, think about the risks, side effects and benefits of each type and what is important to you.

Your surgeon can explain the options and show pictures of what a good result might look like. Talking to your breast care nurse, family and friends, and people who have personal experience, can also be helpful. BCNA's Online Network has forums about surgery and a private group on breast reconstruction.

With any type of reconstruction, some people need several operations to achieve the result they are satisfied with.

Summary of options

Reconstruction surgery can happen during a mastectomy operation or later.

Type of reconstruction: Immediate reconstruction with implant(s)

During mastectomy?

Yes: if ‘one-stage implant’ surgery

Reconstruction as separate surgery

No: only if revisions are needed

Type of reconstruction: Delayed reconstruction with implant(s)

During mastectomy?

Partially: if ‘two-stage implant’ surgery, tissue expander can be inserted during mastectomy

Reconstruction as separate surgery

Yes: both stages of two-stage implant surgery can happen after the mastectomy has healed

Type of reconstruction: Tissue flap (‘autologous’) reconstruction 

During mastectomy?

Yes but can depend on factors including HER2+/- status, whether chemotherapy is neoadjuvant or adjuvant, and the person's health.

Reconstruction as separate surgery

Yes