Many people who have a mastectomy choose to have breast reconstruction to help restore the look of the breast. The procedure is performed by a plastic surgeon and can be done at the same time as the mastectomy, which is called immediate reconstruction, or at a later time, which is called delayed reconstruction. The timing depends on your overall health and your treatment plan.

Although a reconstructed breast won’t exactly match the look or feel of your natural breast, breast reconstruction may help you feel more comfortable about how you look after a mastectomy. You may also need a cosmetic procedure on your other breast to create a more balanced appearance. The good news is that this area of plastic surgery continues to improve.

Breast reconstruction can be done with implants, or with your own tissue from other parts of your body, such as muscle, fat and skin, or a combination of these methods. Each person is unique, and there’s no breast reconstruction method that works best for everyone. The type of treatment you have, as well as your body type and lifestyle factors may affect your reconstruction options.

It’s important to discuss the pros and cons of all your options with your plastic surgeon. Take your time and make a thoughtful, informed decision that works best for you. Although this decision may seem overwhelming, it may help to know that most people who have breast reconstruction don’t regret the method they chose.

Breasts implants are made of a silicone shell that’s filled with either saline or silicone gel. Inserting the implant requires several steps.

First, the surgeon inserts a tissue expander between the skin and the chest muscle to form a skin-muscle envelope. The tissue expander is a saline implant with a valve that allows more saline to be added over a period of 4 to 6 months, until the envelope reaches the desired size. This expander is later replaced with a permanent implant in an outpatient surgical procedure.

Reconstruction using your own tissue, which are called natural tissue flap procedures, can look and feel more natural, but they involve more complex surgery and longer recovery.

Flap procedures usually require a longer hospital stay, since they also require surgery to the donor site, which is where the tissue for the reconstruction was taken from. This surgery leaves scars at the donor site, and in some procedures, an entire muscle is removed, causing weakness in that part of the body.

Natural tissue procedures use tissue from the back, abdomen, buttocks or thigh to reconstruct the breast. Talk with your plastic surgeon to decide which technique is right for you.

If you’re having immediate breast reconstruction, your surgeon may perform a skin-sparing mastectomy to keep as much of your skin as possible.

A skin-sparing mastectomy includes removal of the tumor and clean margins, along with the nipple, areola, fat and other tissue that make up the breast. Much of the skin that surrounds the breast is left intact and can be used to cover a tissue flap or an implant.

A skin-sparing mastectomy that leaves the nipple and areola intact is called a nipple-sparing mastectomy. This usually improves the overall look of the reconstructed breast. Not everyone can have a nipple-sparing mastectomy, so talk with your plastic surgeon to see if it’s an option for you.

Creating the nipple and areola is the last step of breast reconstruction. While the nipple can be created from the reconstructed breast once it has healed, the areola can be created by tattooing the skin or by grafting skin from the groin.

Most people feel sore and tired for several weeks after their surgery, and should avoid overhead lifting, strenuous sports and sexual activity for 4 to 6 weeks. Most people can resume normal activity within 8 weeks. Check with your doctor first.

After reconstruction, many people experience a period of emotional adjustment, and feelings of anxiety or depression are common. It can be helpful to talk with a mental health provider, such as a social worker or counselor, or others who’ve had breast reconstruction.

It’s also important to have a realistic expectation of how your breast will look after reconstruction. Results vary and depend on the quality of the tissue left after a mastectomy, as well as your natural breast anatomy and your treatment plan. But remember, most people who’ve had breast reconstruction don’t regret the method they chose.

For more information, visit the Breast Reconstruction page in the Treatment section of komen.org.