• The main aim of a breast reconstruction is to try to create breasts that look and feel as natural as possible with minimal discomfort but patients need to be aware that a reconstructed breast will not have the same sensation and feel as the breast it replaces
• Incision lines will always be visible on the breast, whether from reconstruction or mastectomy
• Certain surgical techniques will leave incision lines in the donor site commonly located in less exposed area of the body such as the back, abdomen or buttocks
• If only one breast is affected, it alone can be reconstructed. In addition, a breast lift, breast reduction or breast augmentation may be recommended for the opposite breast to improve symmetry of the size and position of both breasts
• It is very much the patient’s choice whether or not to have breast reconstruction and it can be done at the same time as a mastectomy or sometime later
• After the trauma of having a mastectomy many women prefer to wear breast forms or prostheses (false breasts) that are held in place by a special bra
• Advantages of having a breast reconstruction:
  • improvement in body image, self-esteem and femininity, attractiveness and sexuality
  • no need for prostheses or special bra
  • more clothing options; your appearance will be similar to before your mastectomy
  • confidence in taking up physical activities again
  • psychological factor of putting your cancer journey behind you
  • you will have a cleavage
  • breast reconstruction does not increase the chance of the cancer recurring
  • breast reconstruction is unlikely to interfere with cancer treatments, such as radiotherapy, chemotherapy and hormonal therapy
  • mammograms, scans and x-rays of the breast area can still be carried out and if the cancer returns in the breast area it can still be detected
• Possible disadvantages of having a breast reconstruction:
  • surgery can be long depending on the preferred procedure and further minor operations may be needed with several visits to the hospital
  • pain and discomfort during the recovery period
  • scars elsewhere on the body depending on the type of reconstruction
  • your new breast will not be as sensitive as your natural breast
  • the risk of infection or other surgical complications including possible failure

Looking at the general risks and complications in more detail:

• Bleeding: There is a risk that you may experience bleeding from the site of the operation. This may result in a collection of blood underneath the stitches. Pain and swelling may be experienced and the collection of blood may need to be removed, possibly meaning a further operation.
• Wound Infection: There is a risk that the wound could become infected which can occur any time after surgery. Signs of infection include increased swelling, redness, fluid leakage and increased pain at the site of the operation. Treatment is usually needed using antibiotics which may have to be given intravenously in hospital. As a result of infection your wound may take longer to heal and you nay need to have dressings on for longer than usual.
• Wound Breakdown: There is a possible risk that your wound could break down after surgery which can happen if the stitch line does not heal properly and the wound opens up or if the blood supply to the skin is interrupted. Signs of this include redness, swelling, tenderness and the skin around the wound becoming darker. If this happens dressings will need to be applied for longer than usual and, if severe, another operation may be needed to close the wound.
• Scarring: Your operation will leave you with permanent scars on your skin which should improve over a period of 12-18 months following surgery. Many patients find that regularly using _______ can help the healing process. In some patients scars can become raised, red and lumpy. This is beyond the control of the plastic surgeon; the way a scar develops can often depend on how the body heals.
• Chest Infection: A chest infection is something that can occur after any general anaesthetic. Patients can reduce this by taking regular deep breaths in and out following surgery. Sitting up and getting out of bed as soon as you feel well enough will also help providing you don’t exert yourself too much.

N.B. If you smoke you can reduce the risk of a chest infection by stopping smoking for a least a month before your surgery. It is also advisable not to smoke after your operation as this could lead to further complications.

• Anaesthetic risks : Your breast reconstruction operation will be performed up a general anaesthetic. Before your operation your anaesthetist will discuss specific issues with you
• Deep Vein Thrombosis (DVT): This is a blood clot that can arise in the deep veins of the leg and pelvis. A DVT can occur if your mobility is restricted or inactivity following surgery. Weaning the elasticated stockings, which will be provided, during and after your operation and moving your legs about on a regular basis will help reduce the risk. Occasionally DVT can lead to a blood clot on the lungs.