What Does a Reconstructed Breast Look Like?

How close can breast reconstruction get to creating a breast that looks real? Does it largely depend on how much tissue has been removed?

Doctor Answers 36

What do Reconstructed Breasts Look Like?

This is a simple question that has anything but a simple answer. Because there are so many variables involved, there is no single answer. Some of the variables that affect the appearance of reconstructed breasts include:

  • the timing of reconstruction (immediate-at the time of mastectomy or delayed-done at a second procedure sometime after mastectomy)
  • whether or not radiation therapy has been part of a women's treatment
  • the type of mastectomy performed (e.g., traditional incision, skin-sparing mastectomy or nipple spaing mastectomy
  • method of reconstruction (implants or natural-tissue reconstruction)
  • patient age
  • patient's skin quality and thickness.

The cliché, a picture is worth a thousand words, applies here. I suggest that you consult with board-certified plastic surgeons who have significant experience with breast reconstruction. Most experienced surgeons will have have a significant number of pre and postoperative photographs that you can review to get a better sense of what the results of reconstruction actually look like.

I hope this is helpful.

Breast Reconstruction Results

The results following reconstruction today can look very close to the real thing, but they will never look quite like a real breast because it is not a breast. It is very difficult to achieve the natural ptosis (hanging) or projection of a natural breast. In the past, the goal of reconstruction has been to make you look good in clothes, but plastic surgeons today really try to make an individual look good naked.

The amount of cancerous tissue and skin that must be removed does play a role. Other factors, including whether radiation therapy is needed, can also affect the outcome. The more mastectomy skin that can be saved, such as in a skin sparing (where only the nipple-areola complex is removed) or a nipple sparing (where the nipple-areola complex is spared), the more similar the reconstruction will be to the pre-mastectomy breast. Remember, adequately removing the cancer is the main priority.

Wandra K. Miles, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 2 reviews

Cosmetic result of breast reconstruction

The result of your reconstruction has many influences.  The mastectomy surgery result, whether reconstruction is done immediately (time of mastectomy) or delayed, the role of radiation, your body habitus, and the appearance of the opposite breast amongst other things.  Also very influential is the type of reconstruction that is performed.  In most cases a reconstruction with your own abdominal tissue will provide a more natural look and feel to the breast.  However, implant based reconstructions can also look quite nice.  There are pros and cons to all surgery types that go beyond the final appearance.  Ideally your surgeon would perform all types of reconstruction and be able to guide you based on your individual situation.  

Rodger Shortt, FRCSC
Toronto Plastic Surgeon
5.0 out of 5 stars 52 reviews

Breast Reconstruction Results

Results from a Breast Reconstruction are influenced by the following:

1.  Type of mastectomy performed (traditional vs. skin sparing vs. nipple sparing) determines the skin envelope of the breast.

2.  Size/Shape of breast prior to surgery.   Breasts that have a lot of loose skin are more difficult to reconstruct than those with less skin.

3.  Previous Breast Surgery:  patients that have had previous breast reduction or breast lift, may have limited options in mastectomy skin design and nipple preservation.

4.  Need for Radiation:  After radiation, patients will require removal of damaged skin and replacement with healthy non radiated tissue (patch appearance)

5.  Choice of Tissue Reconstruction vs. Implant Reconstruction:   Depending on your anatomy and potential donor sites, your plastic surgeon will share which of these options  may be able to achieve a more natural result in your setting.

 

Bottomline,  there are several options and factors that can influence a final breast reconstruction results.   In some cases, we can achieve very natural results and even improve on the existing breast shape and size.    In others, we are limited in options based on the breast anatomy, presence of radiation, or mastectomy performed and must realistically discuss what to expect prior to surgery.


I think the most important part of breast reconstruction is establishing expectations prior to the procedure.   With the many doctor visits and different options on the table, it is often difficult to absorb what the limitations of reconstruction can be.    However, I find a good understanding of this prior to surgery, leads to a happy and well informed patient postoperatively.    I wish you a safe recovery and wonderful result.

 

Dr. Gill

Paul S. Gill, MD
Houston Plastic Surgeon
4.8 out of 5 stars 84 reviews

It Depends on the Mastectomy itself

The appearance of a reconstructed breast depends a lot on the mastectomy itself. Factors like the amount of skin and tissue that was removed and whether a nipple-sparing approach was used will affect your results. Your plastic surgeon can only work with what he or she has been given, which is one reason why it is important to include your plastic surgeon at the beginning of the process, not after the mastectomy is already completed.

That being said, women today can achieve beautiful, very natural-looking results with reconstruction, particularly with the use of flap reconstruction (using the patient’s own tissue) in combination with implants.

David N. Sayah, MD, FACS
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 7 reviews

How

Hi Eva,

Great question.

There are many factors that affect how good a breast reconstruction looks, many of which (unfortunately) are out of your plastic surgeon's hands. There are basically three components to breast reconstruction - there's the skin of the reconstructed breast, threre's the volume of the breast mound and finally there's the appearance of the nipple areolar complex.

  1. Breast skin. The best skin is breast skin - as in a skin sparing mastectomy when the reconstruction is performed at the same time as the mastectomy. If the reconstruction is "delayed" (ie you've had your mastectomy some time in the past) then new skin will be needed. This can either be created from the existing chest wall skin through tissue expansion, or can be recruited into the area in the case of a flap. Radiotherapy will cause discoloration and scarring of your chest wall skin, which makes the whole process trickier than in patients who haven't had readiotherapy.
  2. Breast mound. There are 3 ways to make a mound for a reconstructed breast. You can use an implant. You can use a flap of tissue from elsewhere in the body - usually either from the back or abdomen. Finally, you can use an implant under a flap
  3. The nipple areolar complex can be reconstructed by folding  the skin on the breast mound (sometimes with a skin graft) and then later getting it tatooed. Alternately, you can get adhesive (stick on) nipples which look very realistic.

Symmetry is the main goal of breast reconstruction. It is often easier to get good symmetry when both breasts are reconstructed in the same way at the same time. Matching a completely natural breast is not impossible - there will always be scars and slight differences - but it is a noble goal we all strive for.

Pleae check out some of the before and after photos on this and other websites.

Good luck with it all!

A reconstructed breast can look and feel almost exactly like a real breast

A breast reconstruction can look and feel almost exactly like a normal "real" breast. It does not depend on how much tissue has been removed. Rather, it depends on how the mastectomy and reconstruction was performed. Specifically, if you have a well-done nipple-sparing mastectomy and immediate natural tissue breast reconstruction, it can be almost impossible to tell that you ever had a mastectomy at all. The nipple-sparing mastectomy will preserve the skin envelope, and the natural tissue breast reconstruction will keep the breast soft, warm, and feeling like a normal breast. Even better, with natural tissue breast reconstruction it is possible to reconnect the nerves to restore sensation to your breasts. Since breasts reconstructed with natural tissue are made of living tissue, it may be difficult for other people including friends, family members, sexual partners, and even other doctors to comprehend that your breasts are actually reconstructed and not "real." That is, they  look and feel normal like regular breasts, but the reconstructed breasts contain no actual breast tissue so you don't need mammograms and you cannot breastfeed.

Constance Chen, MD, MPH, FACS
New York Plastic Surgeon

Different types of breast reconstruction yield different results

Different types of breast reconstruction include implants and autologous (your own) tissue.  Reconstructions using your own tissue, like DIEP (deep inferior epigastric perforator) flaps and free ms-TRAM flaps reconstruct the breast using warm, soft natural tissue from a site on your body that has excess skin and fat, typically the lower abdomen.  Because the breast is remade using your own tissue, it can feel and look very natural.  Implants, for certain individuals, can be an excellent option.  However, though implants can appear aesthetically pleasing, it is more challenging to achieve symmetry with a natural breast and to achieve a natural texture using an implant than natural tissue.

Aesthetic Breast Reconstruction

That is a very good question.  There are many variables to answer that.  Much of how well a breast can be reconstructed is dependent on what tissue is left over after mastectomy.  The more aggressive the mastectomy the more difficult reconstruction can be.  Depending on what is expected you Plastic Surgeon may elect to use a tissue expander and implant based reconstruction or Autologous tissue.  Autologous tissue is using part of your own body to recreate a breast.  This is typically from your abdomen or your back.  You can really have great results with either form of reconstruction from an experienced surgeon.  What's great is that there has been more and more focus on bringing concepts from aesthetic breast surgery to reconstructive surgery, and patients have benefiting greatly from this.

I hope this helps :)

John Paul Tutela, MD
Livingston Plastic Surgeon
5.0 out of 5 stars 29 reviews

Appearance of a reconstructed breast

The main goal of breast reconstruction is to give back size and form within clothing.  In turn, your plastic surgeon will try to achieve the most aesthetically-pleasing reconstructed breast.  While it is difficult to completely mimic the natural shape and ptosis (sag) of a breast, excellent results can be obtained.

 

With that being said, the answer to your question has many variables, all contributing to your overall result.  Factors such as the timing of your reconstruction (immediate or delayed), type of mastectomy performed (subcutaneous, nipple-sparing, skin-sparing, modified radical, or radical), need for post-mastectomy radiation therapy, age, body habitus, preoperative breast shape, and type of reconstruction performed (implant-based or flap-based) all will contribute to your final outcome.  Overall, studies have shown that a vast majority of women are pleased with their decision to undergo breast reconstruction and are satisfied with the results.  Consult with your plastic surgeon regarding breast reconstruction, taking into account the factors above, and make a decision together about which breast reconstruction procedure would be best for you.  Research photos and hopefully you will also get a realistic idea of what your results may be.  Thank you for the question...hope this helps.  Good luck!

Lewis Albert Andres, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 24 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.