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Breast Reconstruction

Breast Reconstruction

Mr Nakul Patel offers a personalised and sensitive approach to breast reconstruction in Leicester, Nottingham, and across the East Midlands, working closely with the breast oncology and multidisciplinary teams to plan and time your reconstruction to support, never compromise, your cancer treatment.

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Varies by Technique
Procedure Time
2 to 7 Nights
Hospital Stay
2 to 8 Weeks
Time Off Work
Varies by Technique
Driving
As Advised
Support Bra
Varies by Technique
Exercise
Overview

Restoring the breast after mastectomy

Breast reconstruction is surgery to rebuild a breast that has been removed (mastectomy), most commonly as part of treatment for breast cancer, or as a risk-reducing procedure in women carrying a BRCA gene mutation. It is one of the most personally significant operations in plastic surgery, and the decision of whether to reconstruct, when, and which method to use is entirely individual. There is no right or wrong answer, and the decision should be made without pressure, with full information, and with time to consider all the options. This page provides an overview of the main approaches to breast reconstruction; it is intended as a starting point for your understanding, not a substitute for a detailed personal consultation.

Mr Nakul Patel during a patient consultation
The Procedure

Approaches to Breast Reconstruction

The most suitable approach depends on your anatomy, your cancer treatment, your general health, your lifestyle, and your personal preferences.

There are two main categories of breast reconstruction: implant-based reconstruction, using a breast implant, and autologous reconstruction, using your own tissue. Implant-based reconstruction is often performed in two stages: a tissue expander is placed beneath the chest wall muscle at the time of mastectomy and gradually inflated with saline over several weeks to create space, before being exchanged for a permanent silicone implant in a shorter second operation. In some patients, particularly where skin-sparing mastectomy has preserved a good skin envelope, a direct-to-implant reconstruction in a single operation may be possible.

Autologous reconstruction uses tissue taken from elsewhere on the body, most commonly the abdomen (a DIEP flap) or the back (a latissimus dorsi flap), to create a new breast mound. Because the tissue is your own, autologous reconstructions generally feel more natural than implant-based results, age more naturally over time, and are more resilient to the effects of radiotherapy, though they involve a second scar on the donor area and a longer initial recovery.

Implant-based reconstruction can produce excellent results in carefully selected patients, but long-term results can be affected by radiotherapy to the chest wall, which may cause firmness, changes in the overlying skin, and a less natural feel over time. This is an important consideration Mr Patel will discuss with you as part of your planning.

★★★★★
“He is an excellent doctor, an excellent plastic surgeon and an excellent human. He is kind and compassionate to his patients who are going through the worst time of their lives.”
Patient · DIEP Flap Breast Reconstruction
Benefits

Benefits of Breast Reconstruction

Reconstruction can offer physical, psychological, and quality-of-life benefits. Mr Patel will discuss these in the context of your individual diagnosis, treatment and goals.

Restoration of Breast Shape

A reconstructed breast restores physical symmetry and eliminates the need for an external prosthesis.

Natural Feel Over Time

Autologous reconstruction in particular provides a soft, natural result that ages with your body.

Improved Body Balance

Restoring breast symmetry can improve posture, comfort, and the fit of clothing.

Reconstruction is not right for every woman, and living with a flat chest, temporarily or permanently, is an equally valid choice. Mr Patel will support whatever decision feels right for you.

Suitability

Are You Suitable for Breast Reconstruction?

There is no right or wrong answer, and the decision should be made without pressure, with full information, and with time to consider all the options. Mr Patel works closely with the breast oncology and multidisciplinary teams to ensure your reconstruction is planned and timed to support, never compromise, your cancer treatment.

  • Have had, or are due to have, a mastectomy as part of breast cancer treatment or as a risk-reducing procedure for a BRCA gene mutation
  • Want to restore breast shape and eliminate the need for an external prosthesis
  • Are prepared to coordinate reconstruction planning closely with your breast oncology team
  • Understand that outcomes and recovery vary considerably depending on the technique used
  • Have realistic expectations and want time to consider the options fully, without pressure
  • Radiotherapy to the chest wall is planned, which can affect the healing and long-term outcome of some reconstruction techniques
  • You are still completing chemotherapy and need time to recover before elective reconstruction
  • You need more time to consider your options before deciding
  • Immediate reconstruction at the time of mastectomy is not your preference

Delayed reconstruction: there is no time limit, and it can be performed many years after a mastectomy once you are ready.

Living with a flat chest: many women choose this, whether temporarily or permanently, and it is an equally valid choice.

External breast prosthesis: worn inside a bra as a non-surgical alternative to reconstruction.

Techniques

Reconstruction Techniques at a Glance

There is no single approach that suits every patient. The most suitable technique depends on your anatomy, your cancer treatment, your general health, your lifestyle, and your personal preferences.

Implant-Based Techniques

Technique Best For Key Features Scars Outcome Goals
Tissue Expander (Stage 1) Two-stage implant-based reconstruction Temporary expander gradually inflated with saline to stretch skin and muscle Mastectomy scar Create space for a permanent implant
Implant Exchange (Stage 2) Completing two-stage implant-based reconstruction Expander replaced with a permanent silicone implant once expansion and any adjuvant treatment are complete Mastectomy scar reused Final implant-based breast shape
Direct-to-Implant Skin-sparing mastectomy with a well-preserved skin envelope Permanent implant placed in a single operation Mastectomy scar Implant-based reconstruction without a second stage

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Autologous Techniques

Technique Best For Key Features Scars Outcome Goals
DIEP Flap Patients with enough abdominal tissue who wish to avoid a permanent implant Microsurgical transfer of skin and fat from the lower abdomen; underlying muscle is preserved Lower abdominal scar, similar to a tummy tuck Natural, long-lasting autologous result
Latissimus Dorsi (LD) Flap Patients not suitable for a DIEP flap, or preferring a shorter, less complex procedure Back muscle, skin and fat tunnelled to the chest on their original blood supply; often combined with an implant Diagonal scar across the back, usually within the bra strap line Reliable, well-established autologous option

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★★★★★
“I was listened to and given clear choices. Mr Patel, his team and the breast surgeon ensured that my operation and recovery were carried out and managed to the highest standard.”
Patient · Stacked DIEP Flap Reconstruction
Your Journey

From First Consultation to Recovery

Sixteen steps, four phases, one continuous path: click any step to read Mr Patel's full guidance.

Phase 1 of 4

Consultation

1
Key Milestone

First Consultation

The first consultation is an unhurried and wide-ranging discussion covering your diagnosis, your treatment history or plan, your health, and your personal goals and preferences. Mr Patel will explain the available options in the context of your individual anatomy and treatment plan, and give you a clear and honest assessment of what each approach can achieve.

Because reconstruction planning is often intertwined with oncology treatment, Mr Patel works closely with the breast surgery and oncology teams to ensure the plan is coordinated. If you are considering immediate reconstruction, this planning typically happens before your mastectomy date.

Patient Consultation

Cooling-Off Period

Time built into the process wherever the oncology timeline allows, so there is no pressure to decide quickly.

There is no pressure to make decisions quickly. Mr Patel strongly believes in giving women adequate time to consider their options, and a cooling-off period is built into the process wherever the oncology timeline allows.

Second Consultation

Confirming the surgical plan and addressing all outstanding questions, often coordinated closely with your breast surgeon.

The second consultation confirms the surgical plan, addresses all outstanding questions, and ensures you are fully prepared for surgery. For immediate reconstruction, this is often close to your mastectomy date, coordinated with your breast surgeon.

Phase 2 of 4

Preparing for Surgery

Medicines & Supplements

A complete list of your medications, supplements and herbal products helps your team plan safely.

Provide a complete list of all medications, supplements and herbal products you are taking, so these can be reviewed ahead of your surgery.

Smoking & Nicotine

Stopping all nicotine use before surgery is particularly important in reconstruction, where wound healing and flap survival are critical.

Stop smoking and all nicotine products before surgery. This is particularly important in reconstruction, where wound healing and flap survival are critical.

General Health & Fitness

Optimising your general health, nutrition and fitness where possible supports a smoother recovery.

Optimise your general health, nutrition and fitness before surgery where possible.

Treatment Timing & Support at Home

Ensuring chemotherapy has settled beforehand, and arranging practical support at home, especially for autologous reconstruction.

  • Ensure any adjuvant treatment (chemotherapy) has adequately settled before elective reconstruction.
  • Arrange practical support at home for the recovery period: this is more involved for autologous reconstruction.
Phase 3 of 4

Hospital Journey

Admission

Meeting the nursing team, reconfirming consent with Mr Patel, surgical markings, and a briefing from your anaesthetist.

On arrival at the hospital, you will be welcomed by the nursing team and shown to your room. Mr Patel will visit you to reconfirm consent and review your reconstruction plan, coordinated with your breast surgery team where relevant. Your anaesthetist will also review your history and discuss the anaesthetic plan.

Going to Theatre

Performed under general anaesthetic; operating time varies considerably, from a shorter implant-based procedure to a longer microsurgical flap operation.

The procedure is performed under general anaesthetic. Operating time varies considerably depending on the approach, from a shorter implant-based procedure to a longer microsurgical flap operation. Your hospital stay will typically be 2 to 7 nights, depending on the technique used.

10
Key Milestone

The Operation

The sequence in theatre depends on the agreed approach. For implant-based reconstruction, a tissue expander (or, in selected patients, a permanent implant) is placed beneath the chest wall muscle. For autologous reconstruction, tissue is transferred from the abdomen (DIEP flap) or back (LD flap); a DIEP flap requires the blood vessels supplying the tissue to be carefully joined to blood vessels in the chest under a microscope, while an LD flap remains attached to its original blood supply as it is tunnelled to the front of the chest. Wounds are closed in layers before dressings are applied.

Operating Theatre

Recovery & Discharge

Closely monitored while you wake, with a hospital stay of 2 to 7 nights depending on the approach used.

You will wake in the recovery area and return to the ward once comfortable, where the team will monitor you closely, particularly if you have had a flap procedure. Before discharge you will receive written aftercare instructions, advice on dressings, medication, and contact details for any urgent concerns. Your hospital stay will typically be 2 to 7 nights, depending on the approach used.

Phase 4 of 4

Recovery After Breast Reconstruction

Recovery varies significantly by technique. Mr Patel will provide detailed personalised recovery guidance for your specific procedure and circumstances.

12
Key Milestone

Week 1: Early Recovery

  • Expect swelling, bruising and tightness across the treated area.
  • If you have had a flap procedure, the team will monitor the blood supply to the reconstructed tissue closely in the first few days.
  • Gentle walking as advised helps reduce the risk of blood clots.

Weeks 2 to 6: Returning to Work

Implant-based patients often return to a desk-based role within 1 to 2 weeks; LD flap patients typically need 4 to 6 weeks.

  • Implant-based (tissue expander): 1 to 2 weeks off work for a desk-based role; avoid upper-body exercise for 4 to 6 weeks, with expansion appointments every 1 to 2 weeks thereafter.
  • Implant exchange: 1 to 2 weeks off work; 4 to 6 weeks before exercise.
  • LD flap: 4 to 6 weeks off work.

6 to 12 Weeks: DIEP and LD Flap Recovery

DIEP flap patients need 6 to 8 weeks off work; full recovery from an LD flap is typically 8 to 12 weeks.

  • DIEP flap: 6 to 8 weeks off work.
  • LD flap: full recovery 8 to 12 weeks.
  • Nipple reconstruction or areola tattooing, where performed, usually needs only 1 to 2 days off work.

3 to 4 Months: Settling Phase

Full recovery from a DIEP flap is typically 3 to 4 months; nipple and areola reconstruction can usually follow from this point.

  • Full recovery from a DIEP flap is typically 3 to 4 months.
  • Nipple and areola reconstruction, if wanted, is usually timed at least 3 to 6 months after the breast mound has settled.
16
Key Milestone

Up to 12 Months: Final Outcome

  • Full recovery varies considerably by technique, from around 3 months up to 12 months.
  • Further procedures, such as nipple reconstruction, areola tattooing, or symmetrisation of the opposite breast, can follow once the reconstruction has settled.
★★★★★
“Five days post-op I was experiencing post-op blues and Mr Patel called me out of working hours to speak to me for at least 40 minutes and reassured me that what I was feeling was completely normal.”
Verified Patient · Tummy Tuck & Breast Surgery
Scar Care

Mr Patel's Approach to Scar Optimisation

Mr Patel uses careful surgical technique and meticulous wound closure to optimise scar quality, whether working with a mastectomy scar or a donor-site scar.

During Surgery

Where possible, the existing mastectomy scar is reused for implant-based reconstruction; for autologous flaps, the donor-site incision is closed with equal care.

Early Healing

Micropore tape or specialised dressings are typically used in the early stages, at both the reconstructed breast and any donor site.

Longer-Term Care

Silicone gel or strips are used as healing progresses, alongside gentle massage and sun protection.

Informed Consent

Risks & Complications

Breast reconstruction is major surgery and carries risks that vary significantly by technique. Mr Patel will discuss all risks relevant to your individual plan in detail.

  • Capsular contracture: hardening around the implant, more common after radiotherapy
  • Implant infection, which may require removal
  • Implant failure or rupture requiring replacement
  • Asymmetry or poor cosmetic result
  • BIA-ALCL: very rare lymphoma associated with textured implants
  • Partial or complete flap loss due to impaired blood supply: the most serious risk of microsurgical reconstruction
  • Donor site complications: wound healing, seroma, hernia (rare with DIEP), or weakness
  • Fat necrosis: firm areas within the reconstructed breast
  • Extended recovery
  • Infection, haematoma, seroma, or wound healing delays
  • Asymmetry or the need for revision procedures
  • Blood clots (DVT/PE): risk higher with longer operations
  • Anaesthetic complications

Mr Patel takes a careful, personalised approach to risk reduction, including thorough pre-operative assessment, meticulous surgical technique, appropriate measures to reduce blood-clot risk, and close postoperative follow-up.

Explore Further

You May Also Be Interested In

Breast Enlargement Surgery

Implant techniques used in implant-based reconstruction.

Learn More →

Breast Uplift Surgery (Mastopexy)

For symmetrisation of the opposite breast.

Learn More →

Breast Reduction Surgery

For symmetrisation of the opposite breast.

Learn More →

Breast Implant Replacement

For revision of implant-based reconstructions.

Learn More →
Questions

Frequently Asked

Both immediate and delayed reconstruction are valid options, and the right timing depends on your cancer treatment plan, your general health, and your personal preferences. Immediate reconstruction, performed at the same time as the mastectomy, avoids a second general anaesthetic and preserves the skin envelope. Delayed reconstruction, performed months or years later, may be preferable if radiotherapy is planned, if you need time to recover from other treatment, or if you simply want more time to consider your options. Mr Patel works closely with your breast oncology team to ensure the timing supports, never compromises, your cancer treatment.

Implant-based reconstruction uses a silicone implant to recreate the breast mound and is often performed in two stages, with a tissue expander placed first and replaced with a permanent implant once expansion is complete. Autologous reconstruction uses your own tissue, most commonly from the abdomen (DIEP flap) or back (LD flap), to create a new breast. Autologous results generally feel more natural, age with your body, and are more resilient to the effects of radiotherapy, but involve a longer operation, a longer initial recovery, and a scar at the donor site.

Yes, radiotherapy is an important consideration. If radiotherapy to the chest wall is planned or has already been given, implant-based reconstruction carries a higher risk of complications including capsular contracture, firmness, and changes to the overlying skin. Autologous reconstruction using your own tissue is generally more resilient to radiotherapy and may be the preferred option in this context. Mr Patel will discuss the implications of your treatment plan in detail during your consultation.

Autologous reconstruction, particularly with a DIEP flap, tends to feel soft and natural because it uses your own skin and fat. The tissue also changes with your body weight over time in the same way as a natural breast. Implant-based reconstruction can produce excellent results in carefully selected patients, but the feel may be firmer, particularly if radiotherapy has been given. Mr Patel will give you an honest account of what to expect based on the technique that is most appropriate for you.

Yes. Nipple and areola reconstruction are typically performed as a separate, smaller procedure once the reconstructed breast has settled, usually from around three to four months after the main reconstruction. Areola tattooing can be used to add colour and detail. Mr Patel will discuss the options and timing as part of your overall reconstruction plan.

Further procedures are sometimes needed to refine the result, address asymmetry, or correct complications. For implant-based reconstruction, the implant may eventually need replacing. For flap reconstruction, fat transfer or minor revisions may be used to improve contour and symmetry once the initial result has settled. Mr Patel will discuss the likelihood of secondary procedures as part of your informed consent.

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