Breast reconstruction

Breast reconstruction recreates the shape of the breast after part or all of it has been removed — whether that is rebuilding the whole breast after a mastectomy, or restoring contour after a lumpectomy. The aim is not simply to replace volume, but to restore balance and proportion in a way that respects your anatomy, your cancer treatment and your own wishes. Reconstruction is a choice: some women have it immediately, others years later, and some decide against it. Every one of those decisions is equally valid.

Anaesthetic: General
Hospital stay: Varies with technique
Time off work: Several weeks
Final result: Usually staged over months

A general guide only — your own timeline is confirmed at consultation.

What it involves

Reconstruction may use an implant, your own tissue, or a combination. Implant reconstruction is a shorter operation and avoids additional scars elsewhere on the body. Autologous reconstruction transfers skin, fat and sometimes muscle from another site — commonly the abdomen or back — and the reconstructed breast then changes naturally with weight and age. Reconstruction can be performed during the same operation as the mastectomy, or months and years afterwards. Whether radiotherapy is likely to form part of your cancer treatment is one of the most important factors in both the timing and the technique recommended.

Who it may suit

Suitability depends on the type of cancer, the planned cancer treatment, whether radiotherapy is required, your general health, and your own preferences. Not every patient is suitable for reconstruction using their own tissue. Where possible it helps to meet a plastic surgeon before your cancer surgery, so that reconstruction can be planned alongside the breast surgeon and oncology team — but if that moment has passed, delayed reconstruction remains an excellent option, and the opportunity has not been missed.

Recovery

Reconstruction is usually a sequence rather than a single operation. Depending on the technique, the pathway may include an initial procedure, a tissue expander gradually filled over several weeks before being exchanged for a permanent implant, surgery on the opposite breast to improve symmetry, nipple reconstruction, medical tattooing, and smaller refinements. This can run over a year or more. Needing a second or third stage is not a sign that something has gone wrong — for many women it is simply the safest and most predictable route to a good long-term result.

This page is a general guide. Every procedure is planned individually — the details, risks and recovery relevant to you are discussed at consultation.

Common questions

Is reconstruction covered by medical aid?

Breast cancer is a Prescribed Minimum Benefit condition in South Africa, so schemes are generally required to fund its diagnosis and treatment within the PMB framework, and reconstruction may be covered as part of that — including delayed reconstruction performed years later. The level of cover varies between schemes and benefit options and pre-authorisation is usually required, so confirm the position with your scheme before surgery is scheduled.

Will I need surgery on the other breast?

Often, yes, and it is planned rather than an afterthought. Achieving good balance may involve a lift, a reduction or an augmentation on the unaffected side. These later stages are usually much smaller procedures than the first.