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Breast reconstruction


Methods of Breast Reconstruction after Mastectomy

Breast reconstruction is distinguished:

  • in immediate recovery at the same surgical time as mastectomy, and
  • in rehabilitation at a later time, i.e. after the disease has been controlled.

Plastic Surgery of breast reconstruction after mastectomy includes many different methods that usually require more than one surgical time.
The choice of the most suitable method of reconstruction depends on the circumstances and the type of mastectomy, i.e. the skin that remains on the breast after the mastectomy.
Different methods of recovery should be discussed in detail before surgery.
Each method has different results in terms of projection – the shape of the breast, recovery time and possible side effects – complications.
It is a personal decision that the patient must make first, in consultation with her plastic surgeon.

The recovery methods are distinguished in:

  • in the methods in which a silicone prosthesis is placed, such as:
    • placement of a silicone prosthesis of a certain volume
    • placement of a stretcher-type silicone prosthesis
    • placement of a silicone prosthesis in conjunction with the latissimus dorsi dermatomuscular pedicle flap
  • to methods that restore the breast exclusively with autologous tissues, such as:
    • repair with the rectus abdominis dermatomuscular flap
    • rectus abdominis skin flap repair
    • gluteal skin flap repair

Each of the above methods has specific indications, different surgical times, different recovery times and different results in terms of breast shape and projection.
Restorations with dentures have a shorter recovery time, but lack projection and shape. In addition, they can have long-term side effects, such as the creation of a sagging capsule around the prosthesis and its replacement.

Restorations exclusively with autologous tissues have a longer recovery time, but give more natural results without any long-term side effects.

Reconstruction surgery procedure after mastectomy
The operation should be preceded by all the pre-operative control, and the disease should be under control. The operation is performed under general anesthesia. The surgical incisions are proportional to the restoration method. In any case, they are hidden inside the bra.

Depending on the method of restoration, the duration of the operation ranges from a medium duration to a long duration operation. When restoration is done with the rectus abdominis or gluteal muscle free skin flap, then the operating time is longer, due to the use of the microscope for the preparation and anastomosis of the vessels.

After the surgery, it is recommended to stay in the clinic from 2 days to one week, depending on the recovery method.

Recovery – Recovery time after mastectomy 
Recovery depends on the method of recovery. Return to work may be allowed in 10 days or even a month. The patient should be regularly checked in the first period by the Plastic Surgeon.

Additional Information on Breast Reconstruction after Mastectomy
Breast reconstruction has no age limit, and can be applied to older women as well. The creation of the nipple and areola takes place in the second year, after three months. This is because we are waiting for the breast to take its normal position. In the third trimester, the restored breast will ‘soften’ and ‘descend’ to the position it should be. In addition, the projection and shape of the breast will have taken their normal position. The formation of the nipple is done under local anesthesia, and a local flap is preferred. The coloring of the areola is done by creating a tattoo. In this case, it is recommended to tattoo both breasts so that they are similar in color and shape.

Side effects – Complications after mastectomy breast reconstruction
Side effects are proportional to the method of recovery. When prostheses are used, the possible side effects are hematoma, inflammation, formation of a shriveled capsule (reactive tissue around the prosthesis), displacement of the prosthesis, impaired skin healing, etc. When autologous tissues are used, then the possible side effects are hematoma, inflammation, necrosis of the flap or part of it, the creation and retention of fluid in the area of receiving the autologous tissue, as well as disorders of healing or restoration of the receiving area.

Outcomes of rehabilitation after mastectomy
The results are permanent, and the patient enjoys the new breast.

Cost of rehabilitation after mastectomy
The cost is mainly determined by the restoration method. Funds may cover all or part of the operation.


Breast reconstruction after mastectomy is a personal matter for the patient. The patient has the first say in the rehabilitation method. Recovery often requires time and psychological support. The Plastic Surgeon should weigh the risk of each method, in relation to the patient’s expectations. Plastic surgery offers many solutions to breast reconstruction, and the patient must be informed about all of them before surgery.