What is breast reconstruction?
Breast reconstruction is a surgical procedure that recreates the shape of a breast lost to surgical removal or injury, or that was never fully developed. Unlike aesthetic augmentation, here the goal is to restore something that is missing and to return symmetry and balance to the body.
Reconstruction is most often performed in women who have undergone a mastectomy for breast cancer, but also after partial tissue removal, following serious injuries or burns, and in cases of pronounced congenital asymmetry. Reconstruction of the nipple and areola is also an option, as a final step that completes a natural appearance.
There are several approaches: reconstruction with a silicone implant, reconstruction using the patient's own tissue (a flap of skin, fat and, if needed, muscle) or a combination of the two. Which approach is best depends on the type of previous surgery, the quality and amount of tissue, general health and the patient's wishes.
Reconstruction can be done at the same time as removal of the breast (immediate reconstruction) or later, after oncological treatment is completed (delayed reconstruction). The decision on timing and type is made in agreement with the oncology team and the plastic surgeon, always with the patient's safety first.
Who is breast reconstruction for
Breast reconstruction is for women who have lost one or both breasts, part of a breast, or whose breast shape is not balanced for other reasons. For many patients this is an important step in regaining a sense of wholeness after treatment.
Reconstruction is considered in the following situations:
- after complete removal of the breast (mastectomy) due to cancer
- after partial tissue removal when the breast shape is significantly changed
- in cases of pronounced asymmetry following previous breast surgery
- after severe injuries or burns that have damaged the breast tissue
- in cases of congenital underdevelopment or absence of a breast
- when the patient wishes to have the nipple and areola reconstructed as a final step
- when oncological treatment and general health allow a safe procedure
How breast reconstruction is performed — types
Reconstruction is performed in several ways, and the choice depends on the condition of the tissue and the treatment plan. In implant reconstruction, a temporary expander is first placed if needed, which is gradually filled to stretch the skin, and is then replaced in a second stage with a permanent silicone implant. Sometimes the implant can be placed immediately, if conditions allow.
In reconstruction with the patient's own tissue, a flap of skin, subcutaneous fat and, if needed, muscle — most often from the abdomen or back — is used to shape a new breast. This kind of reconstruction gives a softer, more natural result, but it is technically more demanding and leaves an additional scar at the site from which the tissue was taken.
Reconstruction of the nipple and areola is done as a separate, smaller procedure after the main breast shape has settled, and the colour of the areola can be completed with medical tattooing. This completes the natural appearance of the reconstructed breast.
The plan is always made individually, in agreement with the patient and, when needed, with the oncology team. At Medical Time every option is explained in detail, with all its advantages and limitations, so that the decision is calm and informed.
Preparing for breast reconstruction
Preparation begins with a thorough consultation at which the surgeon assesses the condition of the tissue, reviews earlier findings and chooses the most suitable type of reconstruction with the patient. When reconstruction is linked to oncological treatment, the plan is coordinated with the oncology team.
The following is usually requested before surgery, with the exact scope tailored to your health:
An open conversation about your health, previous therapies and expectations is key both to safety and to a realistic picture of the result.
- laboratory blood tests, including clotting parameters
- an ECG and, if needed, an examination by an internist or anaesthesiologist
- review of oncological records and findings from previous surgeries and therapies
- a list of medications you take, especially blood thinners
- stopping smoking before and after surgery, as it significantly slows healing
- information about chronic conditions, allergies and previous procedures
- arranged escort and help at home during the first days of recovery
The procedure, anaesthesia and duration
Breast reconstruction is performed under general anaesthesia, so the patient is asleep and feels nothing during the procedure. The course and duration depend on the chosen type of reconstruction.
Reconstruction with an implant or expander is usually shorter, while reconstruction with the patient's own tissue takes longer, as it involves carefully harvesting and shaping the flap and connecting blood vessels. The surgeon shapes the new breast while attending to symmetry with the other side, and the wounds are sutured in layers with drains placed.
Because of the extent of the procedure, the hospital stay is longer with own-tissue reconstruction, while it is most often shorter with implant reconstruction. After surgery the patient wakes in the recovery room, under constant monitoring.
Throughout the operation the anaesthesiologist monitors vital functions, and the team pays particular attention to the blood supply of the reconstructed tissue. The final shape is sometimes achieved over several stages, which are planned in advance and about which the patient is informed.
Recovery after reconstruction — realistic, phase by phase
Recovery depends on the type of reconstruction and is generally gradual. In the first days there is swelling, a feeling of tightness and moderate pain controlled with medication, and with own-tissue reconstruction the recovery is longer because of the wound at the site from which the tissue was taken.
In the first weeks, exertion, lifting and raising the arms are avoided, and a recommended support bra or dressings are worn. If an expander has been placed, it is gradually filled at follow-up appointments over several weeks, until the skin is stretched enough for a permanent implant.
Swelling subsides gradually, and the final shape and softness of the reconstructed breast are seen only after several months, often after additional, smaller corrections and nipple reconstruction. Scars are permanent, more prominent at first, and fade over time.
Realistic expectations and patience are especially important in reconstruction, as it is a process rather than a single event. At Medical Time, follow-up appointments monitor recovery, track the condition of the tissue and plan the next steps, with the team's support.
- first days: swelling, tightness and moderate pain, controlled with medication
- with an expander: gradual filling at check-ups over several weeks
- avoiding exertion and lifting in the first weeks
- possible additional, smaller corrections and nipple reconstruction later
- final shape and maturing of the scars over several months
Risks and possible side effects
Breast reconstruction is a more complex procedure than aesthetic operations, so it carries corresponding risks that are discussed openly before deciding. With an experienced team and careful planning, most patients go through recovery without serious complications.
Possible side effects and risks include:
Following the instructions, stopping smoking and attending regular check-ups significantly reduce the risks. In reconstruction, cooperation with the oncology team is especially important to keep the whole process safe.
- swelling, bruising and a temporary change in skin sensitivity
- infection, bleeding or fluid collection that may require an additional intervention
- reduced blood supply or partial flap loss in own-tissue reconstruction
- capsular contracture or implant displacement in implant reconstruction
- visible scars on the breast and at the site from which the tissue was taken
- the need for additional, corrective procedures to achieve symmetry
- general risks associated with anaesthesia and a longer procedure, assessed in advance
Why have your breast reconstruction at Medical Time
Breast reconstruction is a sensitive and important step, often after demanding treatment. At the Medical Time hospital in Belgrade we approach it with expertise and understanding, with an experienced team of plastic surgeons and a plan tailored to each patient individually.
Through all phases — from the consultation, through the choice of reconstruction type, to check-ups and final corrections — the patient has the team's support. Diagnostics, preparation and follow-up are carried out in one place, with clear information and a warm approach.
- an experienced team of plastic surgeons and an individual reconstruction plan
- coordination with oncological treatment when needed
- a choice between implant and own-tissue reconstruction
- modern equipment and high standards of safety
- constant supervision by the anaesthesiologist and careful monitoring of the tissue
- team support and regular check-ups throughout the recovery process
Cost
The cost of breast reconstruction depends on the chosen type of procedure, the number of stages and the complexity of the individual case, so it is set after a consultation and examination; see the plastic surgery services in the price list.
- Breast reconstruction with an implant or expander
- Breast reconstruction with the patient's own tissue
- Nipple and areola reconstruction
- Corrective procedure for symmetry
For an assessment and an appointment, call 062-399-888.
Frequently asked questions about breast reconstruction
Reconstruction can be done at the same time as removal of the breast (immediate) or later, once oncological treatment is completed (delayed). The decision is made in agreement with the plastic surgeon and the oncology team, according to the condition of the tissue and the treatment plan.
Both options exist, as does a combination of them. Implant reconstruction is most often shorter, while own-tissue reconstruction gives a softer, more natural result but is more demanding. Which approach is best is assessed individually.
Yes. Reconstruction of the nipple and areola is done as a separate, smaller procedure after the breast shape has settled, and the colour of the areola can be completed with medical tattooing. It is the final step that completes a natural appearance.
Recovery depends on the type of reconstruction. It is shorter with implant reconstruction and longer with own-tissue reconstruction, because there is also a wound at the site from which the tissue was taken. The final shape is seen only after several months.
An expander is a temporary implant that is gradually filled at follow-up appointments to stretch the skin, preparing space for a permanent silicone implant. Once the skin is sufficiently stretched, the expander is replaced with a permanent implant in a second stage.
Yes, scars are permanent and are located on the breast, and with own-tissue reconstruction also at the site from which the tissue was taken. They are more prominent at first and fade over the months. Their appearance also depends on the skin's tendency to scar.
In reconstruction, additional, smaller corrective procedures are often needed to achieve symmetry and to reconstruct the nipple. The whole process is planned in advance, in stages, about which you are informed before starting.
The price depends on the type of reconstruction, the number of stages and the complexity of the case, so it is set after a consultation and examination. For an assessment and an appointment, call 062-399-888.