Breast Reconstruction
(Breast Reconstruction After Breast Cancer)
Being diagnosed with and treated for breast cancer is one of the hardest experiences in a woman’s life. Losing part or all of a breast during treatment can leave a mark both on your body and on how you feel about yourself. In breast reconstruction, my aim is to create a natural-looking breast that helps you feel whole again, without interrupting your cancer treatment. We plan this process step by step together with your general surgery and oncology team.
In short: Breast reconstruction is the recreation of a breast removed because of breast cancer, using plastic surgery methods. It can be done in the same session as the cancer surgery or after treatment is complete. The method I use most often is staged reconstruction with a tissue expander: an expander is first placed under the skin, gradually inflated over a few months, and then replaced with a permanent implant. In the final stage, the nipple is created and, if needed, a symmetry procedure is performed on the other breast. Because breast reconstruction is part of cancer treatment, it is often covered by health insurance.
Who Is Breast Reconstruction For?
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Women who have had their whole breast removed because of breast cancer (mastectomy)
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Women who will have a preventive mastectomy because of a genetic risk (such as BRCA)
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Women left with a noticeable deformity or asymmetry after breast-conserving surgery
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Women who had a mastectomy years ago and are now considering reconstruction
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It is never “too late” for breast reconstruction. Even if your treatment ended years ago, reconstruction can still be planned.
When Is Breast Reconstruction Done?
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Immediate reconstruction
The first stage of reconstruction is done in the same session as the cancer surgery. In this case, a tissue expander or implant is placed while the breast tissue is removed. When you wake up from surgery, your chest is not completely flat. For many women, this is a great psychological relief.
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Delayed reconstruction
This is done after chemotherapy and radiotherapy are complete and the tissues have healed. If you have had radiotherapy, I usually plan reconstruction at least 6 months after the end of treatment, so that the effects of radiation on the tissues have settled.
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We decide together with your general surgeon and oncologist which timing is right for you, according to your cancer treatment plan.
Breast Reconstruction with a Tissue Expander
This is the breast reconstruction method I use most often. After a mastectomy, the skin on the chest wall is usually not wide or elastic enough to hold a permanent implant right away. A tissue expander slowly stretches the skin and the underlying tissue over a few months, preparing a suitable space for the implant.
What is a tissue expander?
A tissue expander is a temporary silicone balloon that is placed empty. It has a small filling point (port) that can be located under the skin. Through this port, the expander is inflated with saline using a fine needle at the clinic, without the need for surgery.
Stages of Tissue Expander Reconstruction
1.Placing the expander
The expander is placed under or over the chest muscle, either in the same surgery as the mastectomy or in a separate surgery later. The surgery is performed under general anesthesia, and you usually stay 1–2 nights in hospital.
2. Expansion period
After the wound has healed, from about the 2nd–3rd week, the expander is inflated at the clinic every 1–2 weeks. Each session takes a few minutes. You may feel tightness or mild pressure in your chest for a few days after each inflation; this is normal. Reaching the desired size usually takes 2–3 months. If you are receiving chemotherapy, we plan the inflation sessions around your treatment.
3. Exchange for a permanent implant
Once expansion is complete and the tissues have settled, usually within a few months, the expander is removed and replaced with a permanent silicone implant. This second surgery is shorter than the first, and recovery is faster. In the same surgery, the breast fold can be adjusted if needed, and the breast contour can be softened with fat grafting.
4. Nipple and symmetry
In the final stage, the nipple is created and, if needed, a symmetry procedure is performed on the other breast.
Advantages of this method
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Because no tissue is taken from another part of the body, there is no extra incision or scar.
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The surgeries are shorter, and recovery is faster.
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The breast size is decided together with you, gradually, during the expansion period.
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It can be used for one-sided or two-sided reconstruction.
Who is it less suitable for?
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People who have had or will have radiotherapy to the chest. Radiation reduces skin elasticity and increases the risk of infection, implant exposure and capsular contracture. In this case, adding a flap of your own tissue to the expander, or reconstruction with your own tissue alone, may be safer.
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People whose skin is very thin or has a poor blood supply after mastectomy
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Smokers (smoking is one of the most important causes of wound healing problems)
Other Reconstruction Methods
Single-stage implant reconstruction
If the skin is sufficient and healthy after mastectomy, a permanent implant can be placed directly, without an expander, in suitable patients. This is usually possible with mastectomies that preserve the nipple and most of the skin, and with small to medium-sized breasts.
Fat grafting
Fat taken from your body with liposuction is injected into the reconstructed breast to correct contour irregularities and make the breast look more natural. It is usually used to complement other methods. It can also be used on its own for small dents left after breast-conserving surgery.
Reconstruction with your own tissue
The breast can be recreated using skin, fat and muscle taken from another part of your body:
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Back muscle (latissimus dorsi) flap: Muscle and skin taken from the back are moved to the chest while keeping their blood vessels intact. It is often used together with an implant and is preferred especially in patients who have had radiotherapy.
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Abdominal tissue (DIEP, TRAM) flaps: Skin and fat from the lower abdomen are moved to the chest using microsurgical techniques. No implant is needed, a natural breast is created, and the abdomen is also tightened.
Reconstruction with your own tissue can give a more natural and longer-lasting result. However, the surgeries take longer, recovery takes longer, and an extra scar remains where the tissue was taken.
Recovery
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Hospital stay: Usually 1–2 nights.
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Drains: The drains placed in the surgical area are removed when the amount of fluid decreases, usually within 1–2 weeks.
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Arm movements: In the first weeks, you should not raise your arm above shoulder level or lift heavy objects. We increase your movements gradually.
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Return to daily life: You return to light daily activities within 2–3 weeks.
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Exercise: You gradually start intense exercise after 6 weeks.
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Bra: In the first weeks, a supportive, wire-free, front-closing bra is recommended.
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If you are coming from abroad, plan to stay in Türkiye for about 2 weeks after the first surgery, until your drains are removed and your first check-ups are complete. Because the expansion period requires regular clinic visits, we plan the whole process with you in advance.
Follow-up After Reconstruction
Breast reconstruction does not interfere with your cancer follow-up. You continue your oncology check-ups regularly. Mammography and ultrasound of your healthy breast also continue as usual. After implant reconstruction, I recommend ultrasound or MRI at regular intervals to check the condition of the implant.
Risks
As with any surgery, breast reconstruction has risks:
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Infection
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Seroma (fluid collection) and hematoma (blood collection)
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Wound healing problems and reduced blood supply to the skin
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Exposure of the expander or implant, or the need to remove it
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Capsular contracture (hardening around the implant)
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Asymmetry and the need for additional corrective surgery
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With reconstruction using your own tissue, flap loss and a scar or weakness where the tissue was taken
Radiotherapy and smoking significantly increase these risks. To keep the risks as low as possible, I choose the reconstruction method and timing according to your treatment plan.
Frequently Asked Questions
Does breast reconstruction hide a cancer recurrence?
No. Breast reconstruction does not increase the risk of cancer recurrence and does not prevent a recurrence from being detected. Your oncology follow-up continues regularly after reconstruction.
Is inflating the tissue expander painful?
Inflation is done at the clinic with a fine needle in a few minutes. Because sensation in the chest skin is reduced after mastectomy, the needle is usually barely felt. You may feel tightness or pressure for a few days after inflation; this is normal and goes away on its own.
How many surgeries does tissue expander reconstruction require?
Usually two surgeries are needed: the first to place the expander, and the second to exchange it for a permanent implant. Nipple reconstruction is a small additional procedure under local anesthesia. Some patients may need an additional procedure for symmetry or fat grafting.
I had a mastectomy years ago. Can I have reconstruction now?
Yes. There is no time limit for breast reconstruction. Even if years have passed since your cancer treatment ended, we can decide together at the consultation which method is right for you.
Is breast reconstruction covered by insurance?
Breast reconstruction after breast cancer is considered part of the treatment, not an aesthetic procedure, so it is often covered by health insurance. Coverage depends on your policy; if you have insurance in your home country, check with your insurer before the surgery whether your policy covers this treatment in Türkiye.
Breast Reconstruction Cost in Türkiye
The cost of breast reconstruction depends on the method used (tissue expander, implant or reconstruction with your own tissue), whether one or both breasts are reconstructed, the number of surgeries needed, the type of implant and expander used, and the length of the hospital stay. Because breast reconstruction is part of cancer treatment, it is often covered by insurance, so the amount you pay yourself depends on your policy. Once your treatment plan is clear after the consultation, we explain both the cost and the insurance process to you in detail.
Information and Booking
If you are considering breast reconstruction during or after breast cancer treatment, I would like you to make this decision without rushing, knowing all your options. At the consultation, I evaluate your cancer treatment plan, your body type and your expectations together with you. I explain clearly which method suits you, how many stages it will take and what recovery will involve. If needed, we make a joint plan together with your general surgeon and oncologist. If you have them, bringing your pathology report, surgery notes and treatment plan to the consultation makes the evaluation easier. If you live abroad, this also helps us plan your trip and your stay in Türkiye.
Bu sayfa Op. Dr. Nurgül Altuntaş tarafından hazırlanmış ve kontrol edilmiştir.
Son güncelleme: Kasım 2026