Breast reconstruction after breast cancer

Breast reconstruction is a surgical procedure in which the breast is reshaped or completely rebuilt after removal – usually as part of breast cancer treatment.  

The reconstructive surgery can be performed at the same time as your breast cancer operation or at a later date. This depends on your treatment plan and what feels right for you.

Reconstruction is not necessary after every breast cancer operation. Thanks to cutting-edge screening techniques, many tumours today are so small that the breast can be preserved during surgery, in which case reconstruction is then not usually necessary.  

The decision to have breast reconstruction is yours and yours alone. Some women feel comfortable with a breast prosthesis or make a conscious decision not to have their breast reconstructed. However, if you are considering reconstruction, there are various options available, regardless of your age.

The options suitable for you depend on several factors:  

• Type of breast cancer surgery: Was the breast completely removed or was breast-conserving surgery performed? Was it possible to preserve the skin in the process?
• Further treatments: For example, will you need radiotherapy afterwards?
• Timing of reconstruction: Should reconstruction take place immediately during cancer surgery or later?  

Our reconstruction plastic surgeons are by your side from the very beginning:  

At Affidea brustCare, your breast cancer surgery will be carefully planned together with an experienced reconstruction plastic surgeon. This allows oncological and reconstructive aspects to be optimally coordinated. Before treatment, we will discuss all the options with you in calm surroundings so that you can make a decision that feels right for you. 

We offer a comprehensive range of proven, evidence-based breast reconstruction techniques. Our specialist surgeons work closely with you to achieve a result that meets your wishes and restores the most natural breast shape possible. Your treatment team will discuss each of the individual options with you, as well as their benefits and risks.

The following options are available for breast reconstruction:  

• Implants or expanders – In implant reconstruction, the breast is reconstructed using silicone implants. In many cases, an expander is inserted first to stretch the tissue before the implant is inserted later. In some cases, the implant can be inserted straight away.
• Autologous (flap) reconstruction – This involves transplanting the patient's own tissue, e.g. from the abdomen, thigh or buttocks. This microsurgical technique is considered particularly natural, as the shape and feel of the breast are very close to the original.
• Additional procedures for symmetry and shape correction – In order to achieve a harmonious overall appearance, corrections to the other breast (e.g. a lift or reduction), revision surgery to improve results, or reconstruction of the nipple and areola may be appropriate. The latter usually takes place at a later date – surgically and/or through medical tattooing.

Our leading surgeons include specialists in microsurgical procedures. These highly technical procedures enable innovative tissue transfers for breast reconstruction and are available exclusively in specialised clinics.  

Both implant-based and tissue-based reconstruction can be performed immediately during cancer surgery or at a later date. The optimal time may depend on whether or not you require radiotherapy. During your initial consultation, we will discuss your options and further procedures.   

The decision whether or not to have breast reconstruction is entirely up to you. Your surgeon will provide you with comprehensive advice on the possible procedures, their benefits and risks, and the right timing for reconstruction – either immediately after breast surgery or at a later date.  

Things to consider:  

Breast reconstruction has no influence on whether the cancer returns. This risk depends on the type of tumour, its spread and other factors beyond your control – not on the reconstruction method chosen.

What you should consider when making your decision:  

• Recovery time: If the breast reconstruction takes place at the same time as cancer surgery, the procedure is usually longer and the recovery time may also take a little longer.
• Scarring: Reconstruction with implants leaves scars on the breast. Using your own tissue also results in scars at the donor site.
• Natural feel: Reconstruction using your own tissue (e.g. from the abdomen) usually feels softer and more natural.
• Long-term outcome: Implants require monitoring and may need to be replaced after a few years. Reconstruction using the patient's own tissue is permanent.
• Family planning: Speak with the treatment team if you plan to have children. Both methods of reconstruction are possible and safe in this case.
• Further treatments: If radiotherapy is necessary after reconstruction, this may affect the look and feel of the breast. Hardening of the implant (fibrosis) is also possible.  

The exact procedure for your operation depends on the type of surgery and the timing. Reconstruction can still be performed months or even years after your initial breast cancer surgery. Immediate reconstruction takes place during the same procedure.  

Before the operation

The surgical team (breast surgery and plastic surgery) will plan your operation. Together, they consider how best to remove the tumour, preserve healthy tissue and restore the breast to as natural an appearance as possible.  

They will discuss your options with you. Common questions include:  

• How long does recovery take?  
• What are the risks associated with each method?
• What will my new breast look and feel like?  
• Where will the scars be after the operation?  
• How does reconstruction impact on other treatments that are necessary?  
• What operations will I have to undergo in the future?  

During the operation  

The operation is performed under general anaesthetic. Depending on the procedure and the type of reconstruction requested, the operation may take several hours.  

After the operation, you will stay in hospital to recover. A two-day stay is standard after an expander/implant reconstruction, and up to five days after autologous tissue transfer.  

After the operation

Once you are discharged from hospital, you will continue your recovery at home. Side effects are possible while recovering from breast reconstruction. These include bruising, swelling and pain, which are easily managed.

Before you even leave the hospital, your follow-up appointments will be arranged for outpatient aftercare to check your wounds and discuss the results with you. The majority of patients can resume their normal daily activities after two weeks. 

In Switzerland, the costs of breast reconstruction after breast cancer or mastectomy are usually covered by your health insurance provider. This also includes:  

• Repeated operations to correct complications, such as hardening of a breast implant after breast cancer surgery
• A corrective procedure on the healthy breast to restore symmetry  
• Risk-reducing mastectomy and reconstruction for individuals with high-risk genes, such as BRCA1, BRCA2, PALB2, TP53, PTEN, CDH1 and STK11

A separate cost approval is required for certain procedures. Your treatment team will assist you through all the formalities.