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What factors can affect the choice of breast reconstruction method?
Source: Breast Reconstruction After Mastectomy, National Cancer Institute.
Source updated: December 2, 2025 · Captured 2026-09-09.
Selected source text with whitespace normalised. This Triangle page is not an NCI PDQ summary. Independent clinical review is pending.
NCI patient treatment article for this disease Exact source article; not a clinically reviewed indication or current-standard recommendation.
Context: Breast Reconstruction After Mastectomy
What factors can affect the choice of breast reconstruction method?
Several factors can influence the type of reconstructive surgery a woman chooses. These include the size and shape of the breast that is being rebuilt, the woman’s age and health, her history of past surgeries, her risk factors for complications after surgery (for example, smoking history and obesity), the availability of autologous tissue, and the location of the tumor in the breast (2, 6). Women who have had past abdominal surgery may not be candidates for an abdominally based flap reconstruction.
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Each type of reconstruction has factors that a woman should think about before making a decision. Some of the more common considerations are listed below.
Reconstruction with Implants
Surgery and recovery
Enough skin and muscle must remain after mastectomy to cover the implant
Shorter surgical procedure than for reconstruction with autologous tissue; little blood loss
Recovery period may be shorter than with autologous reconstruction
Many follow-up visits may be needed to inflate the expander and insert the implant
Possible complications
Infection
Accumulation of clear fluid causing a mass or lump (seroma) within the reconstructed breast (7)
Pooling of blood (hematoma) within the reconstructed breast
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Blood clots
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Extrusion of the implant (the implant breaks through the skin)
Implant rupture (the implant breaks open and saline or silicone leaks into the surrounding tissue)
Formation of hard scar tissue around the implant (known as a contracture)
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Obesity, diabetes, and smoking may increase the rate of complications
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Very small risk of developing a very rare form of immune system cancer called breast implant associated–anaplastic large cell lymphoma, particularly with textured implants
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A small number of squamous cell carcinomas and various lymphomas in the scar tissue around implants have been reported, but they are very rare
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Other considerations
May not be an option for patients who have previously undergone radiation therapy to the chest
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May not be adequate for women with very large breasts
Will not last a lifetime; the longer a woman has implants, the more likely she is to have complications and to need to have her implants removed or replaced
Silicone implants may feel more natural than saline implants to the touch
The Food and Drug Administration (FDA) recommends that women with silicone implants undergo periodic MRI screenings to detect possible “silent” rupture of the implants
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More information about implants can be found on FDA’s Breast Implants page.
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Reconstruction with Autologous Tissue
Surgery and recovery
Longer surgical procedure than for implants
The initial recovery period may be longer than for implants
Pedicle flap reconstruction is usually a shorter operation than free flap reconstruction and usually requires a shorter hospitalization
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Free flap reconstruction is a highly technical operation that requires a surgeon who has experience with microsurgery to reattach blood vessels.
Possible complications
Necrosis (death) of the transferred tissue
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The risk of bleeding and blood clots is higher with autologous reconstruction than with implants
Pain and weakness at the site from which the donor tissue was taken
Obesity, diabetes, and smoking may increase the rate of complications
Other considerations
May provide a more natural breast shape than implants
May feel softer and more natural to the touch than implants
Leaves a scar at the site from which the donor tissue was taken
Can be used to replace tissue that has been damaged by radiation therapy
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All women who undergo mastectomy for breast cancer experience varying degrees of numbness and loss of feeling in the breast because nerves that provide sensation to the breast are cut when breast tissue is removed during surgery. However, some breast sensation may be regained as the severed nerves grow and regenerate, and breast surgeons continue to make technical advances that can spare or repair damage to nerves.
Any type of breast reconstruction can fail if healing does not occur properly. In these cases, the implant or flap will have to be removed. If an implant reconstruction fails, a woman can usually have a second reconstruction using an alternative approach.
Publication references
Read the original reference and check its publication notices.
- PubMed 26835456 · Not captured locally · Original source
- PubMed 27018665 · Not captured locally · Original source
Preserved source evidence · Independent clinical review pending · Not medical advice