After breast cancer surgery, a shape that is yours againBreast reconstruction, immediate or delayed

Breast Reconstruction (After Breast Cancer Surgery)

Breast reconstruction recreates the shape of the breast after breast cancer surgery. It is divided into immediate reconstruction, performed at the same time as the mastectomy, and delayed reconstruction, performed later.

Overview

Breast reconstruction recreates the shape of the breast after all or part of it has been removed for breast cancer. It is divided into immediate reconstruction, performed on the same day as the cancer surgery, and delayed reconstruction, performed separately once treatment is complete. The materials used for reconstruction are classified as implants, autologous tissue and autologous fat.

The timing and method of reconstruction depend on the stage of the cancer and the extent of resection, whether radiation therapy is involved, the condition of the remaining skin and tissue, and the size and degree of sagging of the other breast. The first step is to plan the reconstruction in consultation with the medical team treating the breast cancer, within a range that does not interfere with treatment.

Dr. Juyoung Go trained in both reconstructive and aesthetic plastic surgery as an intern, resident and clinical fellow in the Department of Plastic Surgery at Samsung Medical Center, and completed further training at MD Anderson Cancer Center. At Atelier Plastic Surgery we consult on immediate and delayed reconstruction, shape correction after reconstruction, balancing with the other breast, and nipple-areola reconstruction; immediate reconstruction is planned by coordinating the schedule and method with the hospital and surgical team performing the mastectomy.

Recommended for

Facing or having completed a total or partial mastectomy for breast cancer
Considering delayed reconstruction some time after mastectomy
Wanting to know whether implant or autologous tissue reconstruction is right for you
Wanting to match a difference in size or sagging between the reconstructed breast and the other breast
Wanting the nipple and areola created or reshaped after reconstruction
Capsular contracture, asymmetry or contour irregularity remaining after a previous reconstruction

Surgery & treatment methods

Immediate reconstruction

Reconstruction is performed on the same day as the mastectomy. When a mastectomy that preserves the skin, nipple and areola is possible, the breast can be reconstructed close to its original shape; the schedule and method are coordinated with the surgical team performing the mastectomy. If radiation therapy is planned, this is taken into account when choosing the method.

Suited for · When reconstruction can be prepared together at the mastectomy planning stage

Delayed reconstruction

Reconstruction is performed separately after chemotherapy and radiation therapy are complete. If the remaining skin is insufficient, it is stretched with a tissue expander and then replaced with an implant, or autologous tissue is used to supply both the missing skin and the volume.

Suited for · When treatment is complete or immediate reconstruction was not performed

Implant reconstruction

The volume of the breast is created with an implant. If there is enough skin, the implant is placed directly; if not, a tissue expander is inserted first to stretch the skin and later exchanged. No scar is created at another site and the surgery is relatively short, but the likelihood of capsular contracture is higher in tissue that has received radiation therapy.

Suited for · Good skin condition and no wish for an incision elsewhere

Autologous tissue reconstruction

The breast is created by transferring skin, fat and muscle from the abdomen or back. The feel is natural and it can be applied to tissue that has received radiation therapy, but a scar remains at the donor site and the surgery and recovery are longer. The scale of the surgery varies greatly by method, so we explain at consultation what can be performed.

Suited for · Having received radiation therapy or not wanting an implant

Fat grafting · contralateral correction · nipple reconstruction

Contour deficits in the reconstructed breast are filled with autologous fat, and the other breast is lifted, reduced or augmented to balance the two sides. The nipple and areola are reconstructed with a local flap and tattooing. These are often performed as the final stage of reconstruction.

Suited for · Refining contour, symmetry and nipple shape after reconstruction

Key facts

Surgery time: About 2–6 hours (varies by method)
Anesthesia: General anesthesia
Hospital stay: 1 day to several days (varies by method)
Stitch removal: About 10–14 days
Return to daily life: About 2–4 weeks
Follow-up visits: After surgery: 1 week · 2 weeks · 1 month · 3 months · 6 months

These may vary depending on your condition; we will give you precise details at your consultation.

Atelier Plastic Surgery's approach

01
Treatment comes first; reconstruction is planned within it
The timing and method of reconstruction are decided within a range that does not interfere with cancer treatment. We share the extent of resection, whether radiation therapy is involved and the chemotherapy schedule with the breast cancer treatment team, and decide on immediate or delayed reconstruction and the material accordingly.
02
Seen through training in both reconstructive and aesthetic surgery
Dr. Juyoung Go trained in both reconstructive and aesthetic plastic surgery in the Department of Plastic Surgery at Samsung Medical Center. Rather than stopping at creating volume, we design to aesthetic standards, including balance with the other breast, the nipple position and the height of the inframammary fold.
03
We explain the pros and cons of implants and autologous tissue as they are
Implant surgery is relatively simple, but in the long term there is a possibility of replacement or capsular contracture; autologous tissue feels natural but comes with a donor-site scar and a longer recovery. Which is right depends on your tissue condition and lifestyle, so we decide together at consultation.
04
Reconstruction may take place in several stages
Surgery to create volume is often followed by fat grafting to refine the contour, correction of the other breast, and nipple-areola reconstruction. We explain all of the stages from the outset and set the timing of each according to your recovery.

After surgery

Day of surgery
After general anesthesia, your condition is monitored in the recovery room and you rest in a private recovery room. Depending on the method, drains are kept in place, and the length of your hospital stay depends on the extent of surgery.
Week 1
Drains are removed and the wound is checked. Pain and swelling are present at this stage, and you take the prescribed medication; with autologous tissue reconstruction, the donor site is cared for as well.
Week 2
Stitches are removed. You return to light daily activities, avoiding raising your arms high and lifting heavy objects.
Month 1
Swelling has largely subsided. If a tissue expander was used, expansion proceeds in stages from this point, and the condition is checked with ultrasound.
Month 3
The shape begins to settle. Scar care continues, and we discuss the timing of the next stage, such as fat grafting or correction of the other breast.
After 6 months
The shape stabilizes. Nipple-areola reconstruction and the final refinements are planned, and we continue to monitor your progress regularly afterward.

Recovery care and the aftercare schedule are described in the Safety Care System. Safety Care System

Side effects · Precautions

After breast reconstruction, bleeding, infection, hematoma and seroma, and delayed wound healing may occur, and the likelihood is higher in tissue that has received chemotherapy or radiation therapy. A reconstructed breast often has no or reduced sensation, and only part of it recovers. With implant reconstruction, capsular contracture, implant malposition, rippling and implant exposure may occur, and replacement may be needed in the long term. With autologous tissue reconstruction, partial or total necrosis of the transferred tissue due to impaired blood supply, fat necrosis, donor-site scarring and muscle weakness, and abdominal hernia may occur. There may be differences in size, shape and sagging between the reconstructed breast and the other breast, asymmetry that develops over time, and a loss of projection after nipple-areola reconstruction, and staged surgery and revision surgery may be needed. Results vary by individual, and we explain everything fully at consultation.

The content on this page is general medical information provided in accordance with the Medical Service Act. The results of surgery and treatments and the recovery period may vary by individual. All surgeries and treatments carry a risk of side effects, so please decide after a thorough consultation with a specialist.

Related research

PaperCo-author

Management of Gestational Gigantomastia with Goldilocks Procedure after Mastectomy

Archives of Plastic Surgery · 2024DOI ↗

A case report of reconstruction applying the Goldilocks procedure, which forms the breast shape from the skin and subcutaneous tissue remaining after mastectomy

Each treatment page lists the items relevant to it; the full list is on the Academic Activities page. View all academic activities

FAQ

Q1Which is better, immediate or delayed reconstruction?

Immediate reconstruction preserves the skin, which is favorable for shape, and reduces the number of surgeries, but if radiation therapy is planned it may affect the result of the reconstruction. Delayed reconstruction can be planned in a stable condition after treatment is complete. The decision is made together with the breast cancer treatment team according to the stage and treatment plan.

Q2Which is right for me, an implant or autologous tissue?

If you have sufficient skin and tissue and have not received radiation therapy, implant reconstruction can be considered. If you have received radiation therapy, do not want an implant, or have spare tissue in the abdomen, autologous tissue reconstruction may be suitable. We explain the pros and cons of both methods as they are at consultation.

Q3It has been a long time since my mastectomy. Is reconstruction still possible?

Delayed reconstruction is possible even many years after mastectomy. Depending on the condition of the remaining skin and tissue and whether you received radiation therapy, a tissue expander or autologous tissue may be needed; we assess your condition at consultation and decide on the method.

Q4Does the other breast need surgery too?

If the reconstructed breast and the other breast differ in size or sagging, a lift, reduction or augmentation can be performed on the other side to achieve balance. It is not essential, and we decide together according to how much you wish to have done.

Q5Can the nipple and areola be made too?

If the nipple and areola could not be preserved, once the shape of the reconstructed breast has stabilized, the nipple is created with a local flap and the color of the areola with tattooing. This is often performed as the final stage of reconstruction.

Q6Is it covered by national health insurance?

Breast reconstruction after breast cancer surgery is covered by national health insurance in Korea; the scope of coverage depends on the time of diagnosis and the surgical method. We confirm whether it applies to you and advise you at consultation.

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