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Breast Reconstruction

Breast reconstruction is a surgical procedure designed to restore the shape, symmetry, and contour of the breasts following a mastectomy, lumpectomy, or injury. This procedure helps individuals regain a natural breast appearance, often improving confidence and body image.

Breast reconstruction can be performed immediately after breast removal (immediate reconstruction) or at a later stage (delayed reconstruction). Several techniques are available, including implant-based reconstruction and autologous (flap) reconstruction, allowing customisation based on individual needs and medical history.

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Dr Terence Goh

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breast reconstruction breast reconstruction

Indications and Benefits

Breast reconstruction is considered for individuals seeking to restore breast shape, symmetry, and confidence following surgery, trauma, or congenital conditions.

  • Post-Mastectomy or Lumpectomy Restoration

    Patients who have undergone a mastectomy or lumpectomy may choose reconstruction to restore breast shape, symmetry, and volume, helping them regain a natural breast contour.

  • Correction of Trauma or Congenital Breast Deformities

    Reconstruction is an option for individuals with breast deformities due to congenital conditions or trauma, restoring a balanced and proportional breast appearance.

  • Achieving Breast Symmetry

    For patients who have had one breast removed or altered, reconstruction can help restore balance between both breasts, ensuring proportional symmetry with or without surgery on the unaffected breast.

  • Alternative to External Prostheses

    Some individuals prefer a long-term reconstructive solution instead of external breast prostheses, providing a more natural look and feel without the need for removable inserts.

Breast Reconstruction Techniques

Implant-Based Breast Reconstruction
Breast Reconstruction

This method involves rebuilding the breast with silicone or saline implants. It is commonly performed in two stages, where a tissue expander is first placed to gradually create space before the final implant is inserted. In some cases, direct-to-implant reconstruction can be performed in a single stage.

Autologous (Flap) Reconstruction
Breast Reconstruction

This technique uses a patient’s own tissue, taken from areas such as the abdomen (DIEP or TRAM flap), thigh, or back (latissimus dorsi flap) to reconstruct the breast. This method provides a more natural feel but requires a longer recovery time.

Hybrid Breast Reconstruction

A combination of implants and autologous tissue is used to achieve a more natural contour, particularly for those with insufficient tissue for full flap reconstruction or who require added volume and shape definition.

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Preparing for the Procedure

Consultation and Surgical Planning

A detailed consultation assesses breast size, skin condition, overall health, and medical history to determine the most suitable reconstruction method. The procedure is tailored to individual needs and may involve a staged approach depending on the complexity.

Pre-Surgical Guidelines

To support healing and reduce the risk of complications, avoid blood-thinning medications such as aspirin, ibuprofen, and certain herbal supplements for at least two weeks before surgery. Smoking should also be stopped at least two weeks in advance, as it can impair circulation and slow healing.

Step-by-Step Procedure

1. Anaesthesia Administration

Breast reconstruction is performed under general anaesthesia, ensuring comfort throughout the procedure.

2. Incision Placement and Reconstruction

In implant-based reconstruction, a temporary tissue expander is usually placed beneath the chest muscle or remaining breast tissue and gradually filled with saline over several weeks to create space for the final implant. In some cases, direct-to-implant reconstruction is possible, eliminating the need for an expander. In flap reconstruction, tissue from the abdomen, back, or thigh is transferred to reconstruct the breast, providing a more natural look and feel.

3. Shaping and Symmetry Adjustments

The breast is shaped to create a natural contour, and adjustments may be made to achieve symmetry with the opposite breast.

4. Incision Closure

Surgical incisions are closed with dissolvable sutures or external stitches, depending on the technique used.

Post-Procedure Care and Recovery

Immediate Care

Swelling, bruising, and tightness are expected in the first few days to weeks. Pain medication and compression garments help reduce discomfort and support healing. In some cases, drains may be placed under the skin to remove excess fluid, and patients may be required to wear an elastic support bandage or specialised bra for additional support.

Recovery Timeline

Swelling and tightness improve within two weeks, though flap reconstruction patients may have donor site soreness. By four to six weeks, light activities can resume, but lifting and high-impact exercises should be avoided. Over three to six months, the breast shape settles, scars fade, and final contours form, with flap donor sites healing over six months.

Aftercare Recommendations

To support healing, wear a supportive bra as advised, avoid heavy lifting or strenuous movement for at least four to six weeks, and follow wound care instructions carefully to reduce the risk of infection and ensure proper healing.

Potential Risks and Complications

Breast reconstruction is a well-established procedure, but risks include swelling, bruising, tightness, scarring, implant rupture, capsular contracture, and potential flap loss or delayed healing. Asymmetry may require revision surgery. Rare complications of implant-based reconstruction include BIA-ALCL and BIA-SCC, primarily linked to textured implants, while some individuals report systemic symptoms known as breast implant illness (BII), such as fatigue, joint pain, and cognitive issues.

Frequently Asked Questions (FAQ)

Can breast reconstruction be done years after a mastectomy?

Yes, breast reconstruction can be performed years or even decades after a mastectomy, depending on overall health, skin condition, and personal preference. Delayed reconstruction is an option for individuals who did not initially undergo reconstruction or who wish to revise a previous procedure.

Will I be able to feel my reconstructed breast?

Most reconstructed breasts have little to no sensation since nerves are removed or damaged during mastectomy. Some nerve regeneration may occur over time, but full sensation rarely returns.

How long do breast implants last in reconstruction?

While they can last 10–20 years, factors like implant rupture, capsular contracture (scar tissue tightening around the implant), or aesthetic changes may require replacement or revision surgery. Regular monitoring is recommended to assess implant integrity.

Can I breastfeed after breast reconstruction?

If one breast remains intact, breastfeeding may still be possible. However, reconstructed breasts do not produce milk, as the glandular tissue is removed during mastectomy.

Will my reconstructed breast change over time?

Yes, reconstructed breasts age naturally, but factors like weight fluctuations, gravity, and skin elasticity may cause changes in shape or firmness over time. Implant-based reconstructions may require future revision or implant replacement, while flap reconstructions can also be affected by age-related tissue changes.

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Dr Terence Goh

Choosing to combine the intricate skills of microsurgery with aesthetic surgery, Dr Goh specialises in gynaecomastia, surgery of the Asian face, particularly Asian eyelid surgery and rhinoplasty.

Blending the precision of microsurgery with the artistry of aesthetic surgery, Dr Goh has a special interest in gynaecomastia, facial procedures, including ptosis and eyelid surgery, as well as rhinoplasty.

He also offers a full range of body contouring procedures such as mummy makeovers, breast augmentation, liposuction, and body sculpting—designed to help patients feel more confident and comfortable in their own skin.

Beyond aesthetics, Dr Goh remains active in reconstructive microsurgery, with expertise in breast reconstruction, head and neck reconstruction, and lower limb salvage—restoring both form and function where it’s needed most.

  • Bachelor of Medicine, Bachelor of Surgery, National University of Singapore
  • Master of Medicine, National University of Singapore
  • Member of the Royal College of Surgeons
  • Fellow of the Academy of Medicine, Singapore (Plastic Surgery)
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