The Work of Rebuilding

The Reconstruction Procedure

Before making any decisions about reconstruction, you should know more about the procedures involved. In the basic operation, a surgeon restores the size and shape of your breast following a mastectomy, but it can happen several ways:

  • Using a breast implant
  • Using a “flap” of your own tissue
  • Some combination of the above

After restoring the breast’s shape, your surgeon can restore the nipple and areola (the darker area of skin surrounding the nipple) in a later procedure, usually 3-6 months afterward. This optional procedure uses your own tissue for the nipple. In another step, doctors can tint the areola with tattoo die.

Some new procedures—called nipple-sparing mastectomies—can make nipple reconstruction unnecessary. Not all women can have this procedure, though, so ask your doctor.

Understand that mastectomies result in a loss of sensation and breast function—and that breast reconstruction cannot completely restore them.

For more in-depth information on each type of operation, check out the Johns Hopkins Breast Center's interactive diagrams and videos.

Immediate or Delayed

One of the first decisions to make about breast reconstruction concerns timing. You can have it done right away or you can wait awhile:

  • Immediate reconstruction occurs at the same time as your mastectomy. It saves skin and lessens scarring, avoids an extra surgery, and spares reconstructed skin from radiation therapy. However, if you need radiation later, this can cause complications. Talk to your doctor.
  • Delayed reconstruction occurs some time after the mastectomy, most often because you need radiation treatment. Doctors usually recommend 6-12 months between radiation and reconstruction.