If you choose to have breast reconstruction, it could be done during your mastectomy. Depending upon the stage of your cancer, medical conditions, treatment and general preference, you may also have surgery later.
There is a lot to consider with breast reconstruction. While there are many advantages, it’s not for everyone. Let us help you explore your options and talk you through any questions you may have. Our caring team of experts is here to help with treatment options customized to your needs.
Both types of breast reconstruction are major surgery and will require a hospital stay. For the first few weeks following surgery, most women experience bruising, swelling and some pain. Within one to two months, you should be able to resume normal activities. However, it may take up to several years for your complete recovery.
Advantages and Disadvantages of Immediate vs Delayed Breast Reconstruction
Immediate Breast Reconstruction
Immediate breast reconstruction takes place at the same time as mastectomy surgery. As soon as the breast is removed, doctors reconstruct the breast using tissue, an implant or both during the same surgery. If you’re having prophylactic mastectomy to reduce your risk of breast cancer, reconstruction is commonly done immediately.
Advantages
- Immediate cosmetic results
- Reduced risk for social and emotional problems
- Fewer surgeries and potentially lower surgery cost
- Doesn’t affect or increase cancer reoccurrence or ability to detect cancer reoccurrence
Disadvantages
- May not always be possible due to other cancer treatments needed
- May be harder to detect problems with the healing of mastectomy skin
- Longer hospitalization and recovery times than mastectomy alone
- Possibly more scarring than mastectomy alone
- Potentially more complications than having just a mastectomy
Recovery Time
Recovery time with immediate breast reconstruction may be longer or more difficult than breast cancer surgery alone. In general, the procedure requires a four- to eight-week recovery period before returning to work or normal activities, and this depends on the type of reconstruction performed.
You may need or choose to wait until after breast cancer surgery before starting breast reconstruction. After breast cancer surgery to remove your breast and surrounding tissue, your doctor will close the incision. Your breast will be flat with a scar running horizontally. During delayed breast reconstruction, the original scar is opened and doctors use an implant and/or tissue and skin from other parts of your body to form a breast.
Advantages
- Limits delays in starting other cancer therapies immediately after mastectomy
- Can be done at any time – days, weeks or years following surgery
- Gives patients more time to plan and consider options
Disadvantages
- Until reconstruction, you have a mastectomy scar on your chest
- Additional surgery and recovery time
- Scarring may cause difficulties with the reconstruction
- Cosmetic results are delayed, which may delay emotional healing
Recovery time
With delayed reconstruction, your recovery time and experience will be like your cancer surgery. The procedure requires a hospital stay and a four- to six-week recovery period before returning to work or normal activities.
Services & Treatments
Related Searches
Care Providers
Locations
- Find a Doctor
- Services
- Locations
- Patients & Visitors
- Patient Services
- Questions About Your Bill?
- Urgent Care
- Where to Stay
- Patient & Family Services
- Clinical Services
- University of Utah Hospital
- University of Utah Hospital
- Staying at the Hospital
- Parking & Valet
- Looking for Another Location?
- General Questions
- 801-581-2668
- Find an Interpreter
- About U of U Health
- Find A U of U Health Doctor
- All U of U Health Services
- All U of U Health Locations
- For All U of U Health Patients & Visitors
- Patient Services
- Questions About Your Bill?
- Urgent Care
- Where to Stay
- Patients & Family Services
- Clinical Trials
- University of Utah Hospital
- University of Utah Hospital
- Staying at the Hospital
- Parking & Valet
- Looking for Another Location?
- General Questions
- 801-581-2668
- Find an Interpreter
- About U of U Health
- Patient Services
- Billing & Insurance
- MyChart
- Search
Healing & Recovering after Breast Reconstruction Procedures
When you have breast reconstruction surgery—to rebuild your breasts after a mastectomy or for another reason—our dedicated surgeons will be there to help you with every stage. This includes seeing you through recovery so you can get back to enjoying daily life and feel good about your results.
Breast Reconstruction Surgery Procedures
Your breast reconstruction may include one or more procedures. Your plastic surgeon will help you decide which procedures are best for you.
- Breast tissue expander placement — If you choose to have tissue-based/flap or implant-based reconstruction, your surgeon may place a tissue expander first, if needed for either of these procedures. A tissue expander will gradually expand your chest wall skin and/or muscle before your final reconstruction. We sometimes put a tissue expander in place at the same time as a mastectomy. However, we may also do it as a separate procedure.
- Tissue-based/flap reconstruction — In this procedure, your surgeon will use tissue from another part of your body to reconstruct your breasts. The most common areas to take tissue from are your lower abdomen (belly), back, thighs, and buttocks.
- Implant-based reconstruction — In this procedure, your surgeon will use either saline or silicone implants to reconstruct your breasts. We typically perform this surgery in stages, which first requires the placement of a tissue expander. However, in some cases, we can place an implant immediately after a mastectomy is performed using the same anesthetic.
As you decide between or prepare for any of these breast reconstruction procedures, it’s important to know what to expect during healing and recovery.
Breast Reconstruction Risks
Most women will not have complications (problems) during their breast reconstruction procedures. However, risks that may occur soon after each procedure include:
- bleeding,
- infection,
- fluid build-up (seroma), and
- wound reopening (dehiscence).
Hospital Care After Breast Reconstruction
The length of your hospital stay after surgery depends on the procedures you have to reconstruct your breasts.
- For tissue expander placement, you will go home the day after surgery.
- For tissue-based/flap reconstruction, you will be in the hospital for one to four days after surgery.
- If we are exchanging your tissue expanders for breast implants, you will go home the same day of surgery.
Before we discharge you, we will make sure that your pain is under control and give you a prescription for pain medication, if needed. If you have tissue expander placement and tissue-based reconstruction, we will also prescribe antibiotics to prevent infection while your surgical drains are in place. Your surgical drains will keep extra fluid away from your surgical area and stay in place for two to three weeks after both of these procedures. Learn more about breast surgical drain care and management after surgery.
Symptoms After Breast Reconstruction
After tissue expander placement or your final reconstruction, you may experience the following symptoms:
- minor swelling and bruising for up to eight weeks,
- discomfort, muscle spasm, and mild to moderate pain,
- crusting along incision lines,
- itching and shooting electrical sensations as nerves heal,
- numbness or lack of sensitivity for a few months or long term,
- scar redness, which usually lightens within three to six months
- tightness across your chest, and
- upper body weakness.
These symptoms are completely normal signs of healing. With a tissue expander in place, you may also have a contour that’s not yet smooth.
Reconstructive Breast Surgery Doctors Near You
Breast Reconstruction Recovery
What to Wear After Breast Reconstruction
You will wear a surgical bra for three to four weeks after surgery if you have implant-based reconstruction or tissue-based reconstruction using a latissimus flap.
Physical Activity
For at least three to four weeks after your breast reconstruction procedures, you should avoid:
- strenuous activity,
- repetitive arm motions, and
- lifting, pulling, or pushing anything over 10 pounds. This will help you avoid bleeding, bruising, or swelling too much.
As you heal, your surgeon may clear you to:
- start stretches for your upper body three to four weeks after surgery.
- gradually return to normal daily activities.
- four to six weeks after tissue expander placement or implant-based reconstruction
- six to eight weeks after tissue-based reconstruction
- add strenuous exercise.
- six weeks after tissue expander placement or implant-based reconstruction
- six to eight weeks after tissue-based reconstruction
Physical Therapy after Mastectomy and Reconstruction
Most people do not need physical therapy during breast reconstruction recovery. However, you may start it three to four weeks after surgery, if needed.
How to Sleep after Breast Reconstruction Surgery
For at least one week after your procedures, you should rest and sleep on your back with extra pillows to prop you up. This will help with swelling.
Do not sleep on your stomach until your surgeon says it is okay. If you want to sleep on your side, you should:
- alternate sides at first to help with any swelling.
- wait until three to four weeks after surgery or when it is comfortable, but only if your drains have been removed.
Showering & Bathing
You can shower daily once you return home from the hospital. You should not soak in a bathtub, pool, or hot tub until your incisions (cuts) heal or your surgeon says it is okay.
Returning to Work & Driving after Breast Reconstruction Surgery
In general, you should not drive until you:
- are off of any prescription pain medications for at least 24 hours,
- can safely operate a vehicle in traffic, and
- have your drains removed, if you have them.
Most people are ready to drive and return to work around:
- four to six weeks after tissue expander placement,
- four to six weeks after tissue-based reconstruction, and
- two weeks after implant-based reconstruction.
For work that requires heavy lifting, it may take longer or require temporary restrictions. Before you drive or return to work, it is best to get your doctor’s approval at a follow-up visit.
Flying after Breast Reconstruction Surgery
Air travel is generally safe after tissue expander placement and breast reconstruction. However, you should wait until your drains are taken out, if you have them.
Breasts After Reconstructive Surgery
How Long Does It Take for Implants to Drop?
If your reconstruction includes breast implants, expect them to settle into place within three months after surgery. It will be a gradual process.
In general, your breasts may not have the same shape after reconstruction as they did prior to mastectomy. It’s also common for your breasts to feel firmer.
Breast Implant Scars & Breast Reconstruction Scars
Your scars will start to fade within one to two years. Although, they may always be noticeable. Your surgeon can share ways to help your scars fade and soften.
Breast Sensation
When a surgeon removes breast tissue during a mastectomy, the process will cut delicate nerves. Therefore, you may not have normal sensation in your breasts. There are some reconstructive techniques that we can use to help restore sensation to your reconstructed breast. Your surgeon will discuss these with you.
Follow-Up Appointments & Other Procedures
After Tissue Expander Placement
Your surgeon will want to see you every week for about three to four weeks after tissue expander placement. It usually takes two to three weeks before we begin filling the tissue expander more—to gradually stretch your skin for breast reconstruction.
You may be ready for the final stage of breast reconstruction surgery three to four months after tissue expander placement. However, it may be longer if you need chemotherapy and/or radiation treatment first.
After Tissue-Based or Implant-Based Reconstruction
Your surgeon will want to see you every one to two weeks for the first two months after breast reconstruction surgery. After the inital two months, you will likely have follow-up visits on an annual basis.
Three months after your breast reconstruction, you may be able to undergo other procedures to fine-tune your results and reconstruct your nipples, if you choose.
Make an Appointment with Our Plastic Surgeons
We recommend that you consult with a plastic surgeon to discuss breast reconstruction surgery prior to undergoing a mastectomy. Our focus is to provide the knowledge you need to choose the best course of reconstructive treatment for you. If you already had a mastectomy, we are more than happy to speak with you at this stage as well.
Call our office at 801-581-7719 to schedule an appointment with one of our plastic surgeons who specialize in breast reconstruction.
Insurance Coverage
Many states require all health insurance providers, including Medicaid, to pay for reconstructive surgery after a mastectomy. We will contact your insurance company to determine your eligibility and request approval to cover your breast reconstruction.
Breast Implants and the Risk of ALCL
Hear From Our Patients
After being diagnosed with breast cancer, Terri Jones had a plan. “When it got to the idea of reconstructive surgery, all I knew is that I didn’t want anything foreign in my body,” Jones said. “I didn’t want implants and I thought that meant I wouldn’t have reconstruction at all.” After speaking to a friend who had breast cancer, Jones learned there are many more options when it comes to breast reconstruction than she realized. This meant she could make a choice right for her.
Read Terri's Story