Breast reconstruction is achieved through several plastic surgery techniques that attempt to restore a breast to near normal shape, appearance and size following a mastectomy. 

Tissue Expander - Breast implants

This is the most common technique used worldwide. The surgeon inserts a tissue expander, a temporary silastic implant, beneath a pocket under the pectoralis major muscle of the chest wall. In a process that can take weeks to months, saline solution is injected into the implant through an internal valve to progressively expand the overlaying tissue. Once the expander has reached an acceptable size, it is removed and replaced with a more permanent implant.  

Flap reconstruction

The second most common procedure uses tissue from other parts of the patient's body, such as the back, buttocks, thigh or abdomen.

• The latissimus muscle dorsi flap is the donor tissue available on the back. It is a large flat muscle which can be employed without significant loss of function.

• The abdominal flap for breast reconstruction is the TRAM flap (Transverse Rectus Abdominis Myocutaneous flap). In a TRAM procedure, a portion of the abdomen tissue group, including skin, adipose tissues, minor muscles and connective tissues, is taken from the patient's abdomen and transplanted onto the breast site.

Reconstruction of the areola and nipple are usually performed in a separate operation after the skin has stretched to its final size.

Although breast reconstruction can rebuild your breast, the results are highly variable:

• A reconstructed breast will not have the same sensation or feel as the breast it replaces.
• Visible incision lines will always be present on the breast, whether from reconstruction or mastectomy.
• Certain surgical techniques will leave incision lines at the donor site, commonly located in less exposed areas of the body such as the back, abdomen or buttocks.

A note about symmetry: If only one breast is affected, it alone may 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.