What is breast reconstruction?
Breast reconstruction is a surgical procedure to recreate the shape of a breast after removal of part or all of the breast. The aim is to restore a breast that is similar in size and shape to your natural breast.
This may be achieved using an implant or by using tissue (such as skin, muscle, or fat) from another part of your body.
Depending on your treatment plan, breast reconstruction can sometimes be performed at the same time as a mastectomy, or it may be delayed until a later stage.
In some cases, additional procedures may be considered after the reconstruction to refine the overall result, such as:
- Creating a new nipple (nipple reconstruction)
- Adjusting the shape or size of the other breast to improve balance
Do you need breast reconstruction following breast cancer?
Breast reconstruction can take many forms, but the approaches are generally divided into three main categories:
- Autologous reconstruction – using your own tissue, such as skin, fat or muscle, to create a breast shape.
- Alloplastic reconstruction – using an implant to recreate the breast.
- Hybrid reconstruction – combining both an implant and your own tissue.
Reconstruction may take place at the time of mastectomy (immediate reconstruction) or after cancer treatment has been completed (delayed reconstruction). The best approach depends on a number of individual factors, including the type of cancer treatment received and your overall health.
In some cases, breast reconstruction may use tissue from another part of your body, such as the abdomen, to form a new breast. This type of reconstruction can provide a breast that feels and moves more like natural tissue.
Reasons for breast reconstruction
MASTECTOMY
A mastectomy may be performed for two main reasons:
Preventative (prophylactic) mastectomy – this is done to reduce the risk of developing breast cancer in people considered at high risk.
Treatment mastectomy – this is carried out to remove breast tissue as part of treatment for someone already diagnosed with breast cancer.
In either situation, breast reconstruction is a surgical option that can rebuild the shape of the breast after a mastectomy. The aim is to restore a breast contour that is similar in size and appearance to your natural breast.
TUBEROUS BREAST DEFORMITY
Tuberous Breast Deformity
Tuberous breast deformity is a recognised anatomical variation of breast development.
It is typically identified by three key features:
- A shorter than normal distance between the nipple and the crease beneath the breast.
- A larger areola, with the breast tissue often pushing forward through the skin, creating a puffy appearance.
- Reduced breast volume, often with wide spacing between the two breasts.
MAJOR BREAST ASYMMETRY
It is common for breasts to have some natural differences in size or shape, although for some people the difference may be more noticeable. When this difference is significant, it can sometimes cause practical concerns, such as difficulty finding well-fitting bras.
If you are considering treatment, the first step is to clarify your personal goals. From there, a surgical plan can be discussed, which may involve adjusting one or both breasts with the aim of achieving improved balance and proportion. Outcomes can vary depending on individual factors.
UNDERDEVELOPED BREASTS OR NIPPLE POSITION DIFFERENCES
Most people considering breast augmentation already have some natural breast tissue and skin, but in some cases there may be very little present on the chest wall. In these situations, an implant alone may be the starting point, and techniques such as fat grafting can sometimes be added to enhance the result.
If there are concerns with nipple position, a staged approach may be required. This can involve inserting the implant first, and then repositioning the nipple at a later stage if necessary. It is important to note that small differences in nipple position are very common and, in most cases, do not require additional surgery, as the trade-off may involve more noticeable scarring.
CHEST WALL SHAPE AND ITS IMPACT ON BREAST SURGERY
The sternum and ribs act as the foundation on which the breasts sit. In some people, the chest wall may have natural variations such as a hollowed appearance (pectus excavatum) or, conversely, a more prominent shape (pectus carinatum). Scoliosis or rib irregularities can also influence how the chest looks and may affect both your surgical plan and the final result.
In most cases, these skeletal variations do not require separate surgery, as cardiothoracic procedures are generally reserved for more severe cases that also cause functional issues. For cosmetic or reconstructive purposes, careful selection of breast implants, often combined with fat grafting, can usually provide effective improvement in shape and balance.
FREQUENTLY ASKED QUESTIONS ABOUT OUR BREAST RECONSTRUCTION PROCEDURES
If pre- and post-operative images are shown on this site, they are provided for general information only and do not predict your outcome. Images are displayed using comparable lighting, positioning, background, and clothing where possible. Any gallery contains a prominent notice stating that results vary due to factors including individual anatomy and healing. Images are not digitally altered other than standard anonymisation and sizing for web display.
Dr Alex Phoon Specialist Plastic Surgeon
AHPRA registration number: MED0001587102
Registration type: Specialist registration
Recognised specialty: Plastic & Reconstructive Surgery
Patients may verify registration via the AHPRA public register.
All surgical procedures carry risks. Specific to mastopexy, these may include but are not limited to:
Anaesthetic risks, infection, bleeding, delayed healing, seroma, and scarring (including hypertrophic or keloid scars).
Changes in sensation of the nipple or skin-temporary or permanent.
Asymmetry, contour irregularities, or wound dehiscence.
Scarring that may not fade completely; healing varies by individual.
Rare but serious risks such as blood clots (DVT/PE) or death.
A comprehensive written risk summary will be provided during consultation.
It is essential that all risks & complications of surgery are understood before proceeding. For more information on risks & complications please visit our web page on Risks & Complications of Cosmetic Surgery – Dr Alex Phoon
If there is enough abdominal tissue available, it may be possible to use this tissue to reconstruct a breast. Two main types of abdominal tissue-based reconstructions are the TRAM flap and the DIEP flap. The main difference is that the TRAM flap uses a portion of the abdominal muscle (rectus abdominis), while the DIEP flap spares the muscle and instead relies on transferring skin and fat supplied by specific blood vessels.
For patients with suitable blood vessels and anatomy, a DIEP flap may allow the abdominal muscle to be preserved. However, not everyone is anatomically suited to this approach, and in some cases, a TRAM flap may be more appropriate. Surgeons generally consider multiple factors, including anatomy and overall health, before recommending the most suitable option.
It is difficult to provide a single cost for this type of procedure, as individual circumstances and surgical approaches vary. In some situations, procedures may be considered medically necessary, in which case Medicare and/or private health insurance may contribute to the costs. Patients are encouraged to discuss their level of coverage directly with their health fund and with the practice team.
Breast reconstruction following mastectomy for breast cancer is considered a medical procedure rather than cosmetic surgery. It is available in both the public and private health systems. In the public hospital system, there is no direct charge to the patient for breast reconstruction.
Many patients plan to take about a week away from work, although the exact amount of time needed for recovery can vary depending on the individual and the type of work they do.
Recovery can be considered in two stages. Many patients notice early changes in breast appearance at around 6 weeks, but it may take up to 6 months for the tissues to fully settle around the implant. The timing of recovery varies between individuals.
Risks and complications of cosmetic surgery
Cosmetic surgery is a form of surgery and, like all surgical procedures, carries risks and potential complications. It is important that anyone considering cosmetic surgery is provided with accurate and complete information about these risks before deciding whether to proceed.
Dr Alex Phoon is an Australian specialist plastic surgeon (specialist registration in Surgery – Plastic Surgery, AHPRA registration number: MED0001587102). He performs cosmetic and reconstructive procedures in accredited hospital facilities with appropriately qualified surgical, anaesthetic, and nursing teams.
This page outlines general categories of risks and complications that may be associated with cosmetic surgery. A full discussion of risks specific to an individual procedure will be provided in writing and during consultation as part of the informed consent process.
Scarring
Scarring is a common concern for people considering cosmetic surgery. All surgery results in some form of scarring, and while techniques are used to help reduce its appearance, it cannot be completely avoided. The extent and visibility of scars vary between individuals and depend on factors such as the type of surgery, healing response, and skin characteristics.
Read moreThe severity and appearance of scars can vary from person to person and depend on the type of procedure performed. Factors such as genetics, skin type, and individual healing responses can influence how noticeable scars may be. In many cases, scars may become less prominent over time, but this process is highly individual.
Scarring is a normal part of the body’s healing process. When the skin is cut or injured, the body forms new collagen fibres to repair the area. This healing response creates a scar, which may differ in colour and texture from the surrounding skin.
Different types of scars may occur after cosmetic surgery. For example, hypertrophic scars are raised, thickened areas that may be red or itchy. Keloid scars, which grow beyond the boundaries of the original wound, can occur in some people and may be more common in those with darker skin tones.
While surgical techniques aim to minimise tension on the skin and place incisions in less visible areas, scarring cannot be completely avoided. Patients are often advised to follow post-operative instructions carefully, which may include wound care, the use of silicone gels or dressings, and sun protection.
In some situations, scar management or revision procedures may be discussed. These may include treatments such as laser therapy, dermabrasion, or surgical excision. The choice of treatment depends on the type of scar and individual circumstances, and outcomes can vary.
It is important to have realistic expectations about scarring before undergoing surgery. Scars cannot be eliminated, but there are options to help improve their appearance. Patients are encouraged to raise any questions or concerns with their surgeon, so they can make an informed decision about the procedure and understand the potential risks and management strategies.
Infection
Infection is a potential risk of any surgical procedure, including cosmetic surgery. Although strict sterilisation and infection-control protocols are followed, it is not possible to remove this risk entirely. The likelihood and severity of infection can vary depending on individual factors and the type of procedure performed.
Read moreTo help reduce the risk of infection, surgeons may use antibiotics, follow strict aseptic techniques, and monitor patients for any signs of infection. Patients also play an important role in their recovery by carefully following post-operative care instructions, which can assist in lowering the risk of complications.
Infection is a recognised risk of all surgical procedures, including cosmetic surgery. Any time the skin is cut, there is an entry point for bacteria and other microorganisms. Although healthcare professionals follow strict sterilisation protocols to reduce this risk, it cannot be completely eliminated.
To help lower the likelihood of infection, surgeons may use antibiotics, follow strict aseptic techniques during surgery, and monitor patients carefully afterwards. Antibiotics may be prescribed before and/or after the operation, depending on the procedure and the patient’s individual medical circumstances.
During surgery, precautions such as using sterile instruments, maintaining a controlled environment, and wearing protective clothing are followed to help reduce the introduction of bacteria into the surgical site. Even with these measures, infections can still occur, which is why ongoing monitoring and early management are important.
Patients also play an important role in their recovery. Following post-operative instructions-such as keeping the surgical site clean and dry, avoiding activities that could interfere with healing, and promptly reporting any signs of infection (for example redness, swelling, pain, or discharge)-can assist in reducing the chance of complications.
While the risk of infection cannot be removed entirely, these combined strategies-both by the surgical team and the patient-are designed to support safer recovery and allow for timely management if infection develops.
Pain
Pain and discomfort are common after cosmetic surgery. These symptoms can vary between individuals and procedures, but strategies such as prescribed pain relief and supportive care are often used to help manage them.
Read moreThe level of pain experienced after cosmetic surgery can vary depending on the type of procedure, an individual’s pain threshold, and their healing response. Pain relief medications are often prescribed to help manage discomfort during recovery. Patients are encouraged to communicate openly with their healthcare team about their pain, as effective management is an important part of the recovery process.
Undesirable cosmetic outcome
Although cosmetic surgery is performed with the intention of improving appearance, there is a risk that the final result may not meet a patient’s expectations or may differ from the anticipated outcome.
Read moreOutcomes can be influenced by many factors, including individual healing responses and the expectations a patient brings to surgery. It is important for patients to have open and thorough discussions with their surgeon about what results are realistically achievable and any potential limitations. In some cases, further procedures may be considered if the initial outcome does not meet expectations.
Nerve damage
Nerve injury is a possible complication of cosmetic surgery.
Read moreSurgeons take care to minimise the risk of nerve injury during procedures, but this risk cannot be removed entirely. Nerve damage may result in altered sensation such as numbness, tingling, or reduced sensitivity in the area of surgery. In some cases, these changes improve over time, although recovery can vary and some effects may be long-lasting. Patients are encouraged to discuss this risk with their surgeon before making a decision about surgery.
Bruising and swelling
Bruising and swelling are expected effects after cosmetic surgery, especially during the initial stages of recovery.
Read moreBruising and swelling are part of the body’s normal healing response after surgery. Measures such as compression garments, elevation, and cold compresses may be recommended to help manage these effects. Although usually temporary, bruising and swelling can cause discomfort and may influence the recovery process. Following post-operative care instructions can assist in supporting recovery, but the duration and severity of these symptoms vary between individuals.
Bleeding
Bleeding during or after surgery is a possible complication of any surgical procedure, including cosmetic surgery.
Read moreSurgeons use techniques during surgery to help control bleeding, but some post-operative bleeding can still occur. Patients should contact their healthcare provider if bleeding seems excessive or does not improve with gentle pressure. In rare cases, more significant bleeding may require further treatment in hospital, which can include additional procedures or, occasionally, a blood transfusion.
Seroma
A seroma is a collection of fluid that may develop under the skin following surgery.
Read moreSeromas form as part of the body’s inflammatory response and are more common after larger surgical procedures. They may cause swelling or discomfort. To manage this, surgeons may use drains during surgery or remove fluid afterwards through a procedure called aspiration. While these measures can help reduce the likelihood of fluid build-up, seromas can still occur. Regular follow-up and monitoring allow for timely detection and management if they develop.
Anaesthetic complications
Complications related to anaesthesia are uncommon but can occur with any surgical procedure, including cosmetic surgery.
Read moreAnaesthesia is used during surgery to manage pain and keep patients comfortable. The risks associated with anaesthesia can vary depending on individual factors such as medical history, allergies, and overall health. Anaesthetists are specialist doctors who monitor patients throughout the procedure and use established techniques to help reduce these risks, although complications can still occur.
Death
Although rare, death is a possible risk with any surgical procedure, including cosmetic surgery. It is important for patients to be aware that all surgery carries inherent risks.
Read morePatient safety is a key focus in cosmetic surgery. Preoperative assessment, careful surgical planning, and adherence to established protocols are important in helping to reduce risks. Patients are encouraged to discuss their individual concerns and circumstances with their surgical team.
In conclusion, while cosmetic surgery may change a person’s appearance, it also carries risks and potential complications. Understanding these risks and discussing them openly with a surgeon supports informed decision-making and realistic expectations. Following post-operative care instructions and maintaining clear communication with the healthcare team can also play an important role in recovery.
