Breast reconstruction is surgery to recreate breasts after a mastectomy. There are several types of breast reconstruction. Some techniques use implants. Others use tissue from your body (such as the belly) to form a breast. Breast reconstruction can happen right after a mastectomy or much later. You may need multiple surgeries over several months.

An ideal breast reconstruction surgery candidate is a woman who has had one or both breasts removed because of cancer and wishes to restore her breast appearance. The patient can undergo the breast reconstruction at the time of her mastectomy or at a later date.
It is vital for the patient to have realistic expectations from this plastic surgery. She must be cognizant of the fact that reconstruction cannot restore breasts that appear and feel similar to natural breasts.
Regardless, this reconstructive procedure can offer the patient significant physical and emotional benefits in the long-run.
However, every woman who has undergone mastectomy is not a good candidate for breast reconstruction surgery. An ideal candidate for this procedure is a woman who:
Seeking to restore the size and shape of her breasts
Does not smoke or is willing to discontinue smoking according to the surgeon’s instructions
Has coped well with cancer therapy and mastectomy
Is cancer-free
Does not have serious hypertension or diabetes
Has clarity on her goals and realistic expectations from the procedure.
Patients with heart disease or diabetes can experience increased risks during breast reconstruction surgery. On top of this, such patients also tend to be more prone to post-op complications.

Your overall health (including issues that might affect your healing, such as smoking or certain health conditions)
The size and location of your breast cancer
Your breast size
The extent of your breast cancer surgery - if you are a candidate for lumpectomy or mastectomy, and the possibility to keep your nipple
Whether you will need cancer treatments other than surgery
The amount of tissue available for reconstruction (for example, very thin women may not have enough extra tummy tissue to use this area for breast reconstruction and having a "tummy tuck" in the past makes the tummy tissue not usable for breast reconstruction)
Whether you want reconstructive surgery on one or both breasts
Your desire to match the look of the other breast
Your insurance coverage and related costs for the unaffected breast
How quickly you want to be able to recover from surgery
Your willingness to have more than one surgery as part of the reconstruction
How different types of reconstructive surgery might affect other parts of your body

Your breast surgeon and your plastic surgeon should give you clear instructions on how to prepare for surgery. These will probably include:
Help with quitting smoking, if you smoke
Instructions to take or avoid certain vitamins, medicines, and dietary or herbal supplements for a period of time before your surgery
Instructions on eating and drinking before surgery
Plan to have someone take you home after your surgery or your stay in the hospital. You may also need them to stay and help you out for a few days or longer.

Breast reconstruction often means having more than one operation. The first creates the breast mound. This may be done at the same time as the mastectomy or later on. It’s usually done in a hospital.
Follow-up procedures such as filling expanders or creating the nipple and areola are most often done in an outpatient facility. But this decision depends on how much surgery is needed and what your surgeon prefers, so you’ll need to ask about this.

The first stage of reconstruction is almost always done using general anesthesia. This means you’ll be given drugs to make you sleep and not feel pain during the surgery.
Follow-up procedures may only need local anesthesia. This means that only the area the doctor is working on will be numbed. A sedative drug may also be used to make you feel relaxed but awake. You might feel some discomfort.

Any type of surgery has risks , and breast reconstruction may pose certain unique problems for some women. Your surgeon will go over the possible risks of reconstruction surgery with you. Be sure to ask questions if there’s anything you’re not sure about.

Infection can happen with any surgery, most often in the first couple of weeks after the operation. If you have an implant, it might have to be removed until the infection clears. A new implant can be put in later. If you have a tissue flap, surgery may be needed to clean the wound.

The most common problem with breast implants is capsular contracture. A scar (or capsule) can form around the soft implant. As it tightens, it can start to squeeze the implant, making the breast feel hard and look distorted. Capsular contracture can be treated. Sometimes surgery can remove the scar tissue, or the implant can be removed or replaced

You’re likely to feel tired and sore for a week or 2 after implant surgery, or longer after a flap procedure (which will leave you with 2 surgical wounds). Your doctor will give you medicines to help control pain and other discomfort.
Depending on the type of surgery you have, you will most likely be able to go home from the hospital within a few days. You may be discharged with one or more drains in place. A drain is a small tube that’s put in the wound to remove extra fluid from the surgery site while it heals. In most cases, fluid drains into a little hollow ball that you’ll learn how to empty before you leave the hospital. The doctor will decide when the drains can be safely removed depending on how much fluid is collecting each day. Follow your doctor’s instructions on wound and drain care. Also be sure to ask what kind of support garments you should wear. If you have any concerns or questions, ask someone on your cancer care team.

Most women can start to get back to normal activities within 6 to 8 weeks. If implants are used without flaps, your recovery time may be shorter. Some things to keep in mind:
Certain types of reconstruction surgery do not restore normal feeling to your breast, but in other types some feeling might return over time.
It may take up to about 8 weeks for bruising and swelling to go away. Try to be patient as you wait to see the final result.
It may take as long as 1 to 2 years for tissues to heal fully and scars to fade (the scars never go away completely).
Ask when you can wear regular bras. Talk with your surgeon about the type of bra to wear – sometimes it will depend on the type of surgery you had. After you heal, underwires and lace in your bra might feel uncomfortable if they press on scars or rub your skin.
Follow your surgeon’s advice on when to begin stretching exercises and normal activities, because it’s different with different types of reconstruction. As a basic rule, you’ll want to avoid overhead lifting, strenuous sports, and some sexual activities for 4 to 6 weeks after reconstruction. Check with your surgeon for specific guidance.
Women who have reconstruction months or years after a mastectomy may go through a period of emotional adjustment once they’ve had their breast reconstructed. Just as it takes time to get used to the loss of a breast, it takes time to start thinking of the reconstructed breast as your own. Talking with other women who have had breast reconstruction might be helpful. Talking with a mental health professional might also help you deal with anxiety and other distressing feelings.
Silicone gel implants can open up or leak inside the breast without causing symptoms. Surgeons usually recommend getting regular magnetic resonance imaging (MRI) of implants to make sure they aren’t leaking. (This isn’t needed with saline implants.) You’ll likely have your first MRI 1 to 3 years after your implant surgery and every 2 years from then on, although it may vary by implant. Your insurance might not cover this. Be sure to talk to your doctor about long-term follow-up.
Call your doctor right away if you notice any new skin changes, swelling, lumps, pain, or fluid leaking from the breast, armpit, or flap donor site, or if you have other symptoms that concern you.

Women who have had a mastectomy to treat breast cancer generally do not need routine screening mammograms on the side that was affected by cancer (although they still need them on the other breast). There isn’t enough tissue remaining after a mastectomy to do a mammogram. Cancer can come back in the skin or chest wall on that side, but if this happens it’s more likely to be found on a physical exam.
It’s possible for women with reconstructed breasts to get mammograms, but experts agree that women who have breast reconstruction after a mastectomy don’t need routine mammograms. Still, if an area of concern is found during a physical exam, a diagnostic mammogram may be done. (Ultrasound or MRI may also be used to look at the area closely.)
If you’re not sure what type of mastectomy you had or if you need to have mammograms, ask your doctor.