Breast reconstruction: advice from a breast cancer surgeon

Breast reconstruction: advice from a breast cancer surgeon

In this guide, Dr Tasha Gandamihardja, our good friend and oncoplastic breast surgeon, explains the various breast reconstruction options available after a mastectomy.

What are my breast reconstruction options?

If you have been recommended to have a mastectomy, you can also choose to have a reconstruction. You don’t have to go down this path if you don’t want to, but if you do, then there are a few options.

In the first instance, your reconstruction can happen either in the immediate setting (immediate reconstruction), or after you have completed your cancer treatment (delayed reconstruction).

Breast reconstruction can either use implants, or your own body tissue (autologous reconstruction). There are certain factors you need to consider when choosing which reconstruction is most suited for you, such as surgery time, recovery time and the need for maintenance / multiple surgeries. Other factors such as body shape, BMI and whether you smoke, may also play a role in determining your suitability to certain types of reconstructions.

Implant surgery

Implant surgery is the quickest to recover from, and it will result in usually just one scar. However, it is very likely you will need further surgery in the future as implants will rupture and will need to be replaced. When this will happen is difficult to predict.

Autologous breast reconstruction

Autologous breast reconstruction involves more invasive surgery. There are a few areas from which we can take tissue from and use to create a new breast. This includes the latissimus dorsi (LD) muscle, which is a large muscle on your upper back, the fat on your tummy (deep inferior epigastric perforator flap – DIEP flap) or even the tissue from your inner thighs (transverse upper gracilis – TUG flap).

Autologous reconstruction surgery is performed jointly between your breast surgeon and a plastic surgeon. It takes longer to do than an implant based reconstruction and longer to recover from. You will also have two scars, one on the breast, the other depending on where the ‘donor site’ is.

However, a successful operation means that no future surgery is needed, unlike implant surgery. Plus, it feels more natural than an implant.

The possible disadvantages of breast reconstruction:

1. More invasive surgery may lead to higher risk of complications

2. Need for maintenance surgery such as in the case for implant surgery

3. If you have an immediate reconstruction, any complication may potentially delay further treatment such as chemotherapy or radiotherapy

4. Longer surgery and recovery time

Final thoughts…

Being told you have breast cancer is life changing. The moment you get that diagnosis, your thoughts are racing, you will experience a wide ranging of emotions and you may feel lost and confused.

It is important to take your time in making any decision regarding your treatment. Don’t be afraid to ask your surgeon any questions you may have. Voice your concerns and worries and do involve your breast care nurse as well.

If you are unsure about what decision to take, try to speak to others who have gone through the same surgical path.

We are here to help you through your cancer treatment. It is important for you to be fully informed so that you are completely satisfied and happy with the decision you make.

Dr Tasha Gandamihardja is an oncoplastic breast surgeon and podcaster. You can check her out at You can also connect with her on Twitter and Instagram @DrTashaG.

January 2021

The information and content provided in all guest blogs is intended for information and educational purposes only and is not intended to substitute for professional medical advice. Please seek professional advice or speak to your medical team if you have any questions about the issues raised in this guest blog

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