Breast reconstruction is a deeply personal choice that can help restore breast shape after a mastectomy, lumpectomy, breast cancer treatment, trauma, or another medical concern. At Forsyth Plastic Surgery in Winston-Salem, our fully trained plastic surgeons offer personalized breast reconstruction options based on each patient’s health, anatomy, treatment needs, and goals.
For some patients, reconstruction becomes an important part of physical and emotional recovery. Others decide not to undergo additional surgery and may choose to go flat or use an external prosthesis. There is no single right decision.
Breast reconstruction surgery may involve an implant, a patient’s own tissue, or a staged approach. It may begin at the time of the mastectomy or months or years later. Understanding the options can make the decision-making process feel more manageable.
Medically reviewed by George A. Lawson III, M.D., F.A.C.S
Board-Certified Plastic Surgeon, Forsyth Plastic Surgery
Last medically reviewed: September 2026
What Is Breast Reconstruction Surgery?
Breast reconstruction surgery is reconstructive plastic surgery used to restore breast shape and contour after breast tissue has been removed or altered.
Reconstruction does not recreate the exact breast that existed before surgery. Instead, the goal is to create a breast shape that fits the patient’s anatomy and preferences while taking their overall medical treatment into account.
Forsyth Plastic Surgery offers implant-based and flap-based reconstruction, with the timing and technique determined through consultation with your plastic surgeon and, when appropriate, your oncology team.
When Can Breast Reconstruction Be Performed?
Breast reconstruction after mastectomy may begin during the same operation as the mastectomy or be performed later.
Timing can depend on:
- Cancer treatment plans
- Radiation or chemotherapy
- Overall health
- Previous breast surgery
- Available skin and tissue
- Healing considerations
- Personal preference
Patients don’t necessarily need to decide immediately. Delayed reconstruction can remain an option months or even years after mastectomy.
What Are the Main Types of Breast Reconstruction?
The main types of breast reconstruction include implant reconstruction and reconstruction using the patient’s own tissue. Some reconstruction plans involve more than one stage.
Implant-Based Reconstruction
Implant-based breast reconstruction uses a breast implant to restore breast volume and shape. Depending on the surgical plan, reconstruction may involve placing an implant directly or using a temporary tissue expander before placement of the permanent implant.
Implants are medical devices and may require monitoring or additional surgery in the future. Complications such as capsular contracture or implant rupture may sometimes make revision or breast implant removal necessary.
Tissue Expander Reconstruction
A tissue expander is a temporary device used to gradually create space beneath the breast skin for a permanent implant.
The expander is gradually filled over time as the surrounding skin and tissue adapt. Once the desired expansion has been achieved and healing is appropriate, the tissue expander may be exchanged for a permanent breast implant.
Flap-Based Reconstruction
Flap-based breast reconstruction, also called autologous breast reconstruction, uses the patient’s own tissue from another area of the body to reconstruct the breast.
A flap procedure may use skin, fat, and sometimes muscle from another location. Because there is both a breast surgical site and a donor site, flap reconstruction generally involves a more involved operation and recovery than implant reconstruction.
Forsyth Plastic Surgery offers autologous, or flap-based, reconstruction as one of its breast reconstruction approaches.
Immediate vs. Delayed Breast Reconstruction
Immediate breast reconstruction begins at the time of mastectomy. For appropriate patients, this allows breast reconstruction to begin during the same surgical experience.
Delayed breast reconstruction is performed after the mastectomy has healed. It may be recommended because of radiation, other breast cancer treatment, health considerations, or simply because the patient wants more time before deciding.
Neither approach is automatically better. The appropriate timing depends on the individual treatment plan.
Can Breast Reconstruction Be Performed After a Lumpectomy?
Breast reconstruction is not limited to patients who have had a mastectomy. Some patients who undergo a lumpectomy may experience changes in breast shape, size, or contour that can be addressed with reconstructive surgery.
The appropriate approach depends on factors such as the amount and location of tissue removed, previous or planned radiation treatment, breast size and shape, and the patient’s goals. Your plastic surgeon can discuss whether reconstructive surgery may be appropriate as part of your breast cancer treatment or after healing.
Who Is a Good Candidate for Breast Reconstruction?
A potential candidate for breast reconstruction is generally healthy enough for surgery, understands the potential benefits and limitations of reconstruction, and has realistic expectations about the results and recovery.
Factors that may influence the recommended approach include previous surgery, radiation, scar tissue, medical conditions, smoking, the amount of available tissue, and the quality of the surrounding skin.
The patient’s priorities matter too. Some people want to begin reconstruction immediately. Others prefer delayed reconstruction or choose not to reconstruct at all.
Can You Have Breast Reconstruction After Radiation?
Yes. Breast reconstruction may be possible after radiation therapy, but radiation can affect the skin and underlying tissues and may influence which reconstruction options are appropriate.
The timing and technique depend on the patient’s cancer treatment, tissue quality, overall health, and previous surgeries. Patients who have received or expect to receive radiation should discuss the potential effects on reconstruction with both their oncology team and plastic surgeon.
What to Expect Before, During, and After Reconstruction Surgery
Before Surgery
Your consultation should include a review of your medical history, cancer treatment, previous procedures, anatomy, and personal goals.
Your surgeon can explain which types of breast reconstruction may be appropriate, whether surgery may require multiple stages, where scars may be located, and what recovery could involve.
At Forsyth Plastic Surgery, breast reconstruction planning can also be coordinated with a patient’s oncology providers.
During Surgery
The procedure depends on the chosen reconstruction method. Some reconstructions can be completed in one surgery, while others involve several stages.
After Surgery
Swelling, bruising, tightness, tenderness, and fatigue are common during early healing.
Patients receive individualized instructions for incision care, activity, medications, and follow-up appointments. Recovery should progress at the pace recommended by the surgical team rather than according to a fixed timeline.
Breast Reconstruction Recovery
Recovery varies considerably by procedure. Implant-based reconstruction typically has a different recovery process than flap reconstruction because flap surgery also requires healing at the area where tissue was taken.
Patients should expect swelling, bruising, soreness, tightness, and fatigue during the early stages of recovery. The length and pace of recovery depend on the reconstruction technique, whether the procedure is performed in stages, the patient’s overall health, and any additional cancer treatment. Your surgical team will provide specific instructions about activity, lifting, exercise, wound care, and follow-up.
Most patients gradually return to normal daily activities as healing progresses. Strenuous exercise and heavy lifting may be limited for a period of time.
Additional procedures may be performed later to improve symmetry, revise scars, or address other aspects of reconstruction.
Scarring and Sensation After Breast Reconstruction
Breast reconstruction involves permanent scars. The size, position, and appearance of scars depend on the mastectomy, reconstruction technique, and individual healing response. Some people are more prone to developing a raised hypertrophic scar or keloid scar. Scar treatment may be discussed if healing becomes a cosmetic or physical concern.
Sensation changes are also common after a mastectomy because nerves may be affected during surgery. Some feeling may return over time, but normal breast sensation cannot be guaranteed.
Nipple Reconstruction and Revision Procedures
Nipple reconstruction is optional. Depending on the treatment plan, patients may choose surgical nipple reconstruction, tattooing, a combination of approaches, or no additional procedure.
Revision surgery may also be considered later to improve breast symmetry, contour, scars, or an implant-related concern.
Risks and Possible Complications
As with any surgery, breast reconstruction carries potential risks. These can include infection, bleeding, delayed healing, scarring, asymmetry, changes in sensation, or the possibility of additional surgery.
Implant reconstruction also carries implant-specific risks, including capsular contracture and implant rupture. Flap procedures involve additional considerations because both the reconstructed breast and donor site must heal. Your surgeon should explain the risks specific to the reconstruction being considered.
How Much Does Breast Reconstruction Surgery Cost?
Breast reconstruction surgery costs vary from patient to patient. The total cost can depend on the reconstruction technique, number of surgical stages, surgeon’s fees, surgical facility, anesthesia, medications, medical testing, imaging, postoperative care, and any later revision procedures.
Because reconstruction can involve more than one procedure, patients should ask which services are included in their surgical estimate and whether additional procedures may result in separate costs.
For patients using health insurance, the amount billed is not necessarily the same as the amount paid out of pocket. Deductibles, copays, coinsurance, network status, and individual plan benefits can all affect patient responsibility.
Does Insurance Cover Breast Reconstruction?
Many health insurance plans provide coverage for breast reconstruction following a mastectomy, but coverage requirements and patient costs vary by plan. Patients should verify the details of their policy before surgery.
Federal protections require many group health plans that provide mastectomy benefits also to provide certain breast reconstruction and other post-mastectomy benefits. However, not every health plan is subject to the same rules, and covered patients may still have deductibles, copays, coinsurance, or other out-of-pocket expenses.
Ask your insurance company about coverage requirements, prior authorization, network status, and expected out-of-pocket expenses before your procedure. You can also ask your plastic surgeon’s office which insurance plans they accept and whether their team can help you understand the pre-authorization or billing process.
The Emotional Side of Breast Reconstruction
Breast reconstruction is about more than surgery. Breast cancer, mastectomy, and changes in the body can affect how patients feel about appearance, identity, intimacy, and recovery. Some people feel strongly about restoring breast shape. Others feel equally certain that they do not want additional surgery.
It is also normal to be unsure. Patients deserve time, clear information, and support while deciding what feels right for their health and their body.
Choosing a Plastic Surgeon for Breast Reconstruction
Experience with breast reconstruction, clear communication, and trust are important when choosing a plastic surgeon for reconstruction. Your surgeon should explain the available options, limitations, expected scars, recovery, potential complications, and whether additional procedures may be necessary.
Forsyth Plastic Surgery provides breast reconstruction through fully trained plastic surgeons and coordinates care with patients’ oncology teams. Surgery and recovery plans are personalized based on the reconstruction technique and individual patient needs.
Frequently Asked Questions
How long is the recovery after breast reconstruction?
Recovery depends on the type and extent of surgery. Implant-based reconstruction and flap reconstruction have different healing timelines, and some patients undergo reconstruction in multiple stages.
Does breast reconstruction leave scars?
Yes. All breast reconstruction procedures involve incisions and scars. Their location and appearance depend on the surgery performed and the patient’s individual healing response.
Will I have feeling after breast reconstruction?
Changes or loss of sensation are common after mastectomy and reconstruction. Some sensation may return over time, but complete restoration of normal feeling cannot be guaranteed.
Is nipple reconstruction optional?
Yes. Nipple reconstruction is a personal choice. Patients may choose surgical reconstruction, tattooing, both, or neither.
How much does breast reconstruction surgery cost?
Cost depends on the reconstruction method, surgical complexity, facility, anesthesia charges, follow-up care, and insurance benefits. Patients should review both expected costs and coverage before surgery.
Is breast reconstruction covered by insurance?
Many health plans cover breast reconstruction after mastectomy, and federal law provides reconstruction protections for many group health plans that cover mastectomy. Coverage details and out-of-pocket expenses vary, so patients should verify benefits directly with their health insurer.
Do I have to have breast reconstruction after a mastectomy?
No. Breast reconstruction is optional. Some patients choose reconstruction, while others choose to go flat or use an external prosthesis. The right decision is the one that best fits your health, priorities, and comfort.
Considering Breast Reconstruction Surgery?
Considering breast reconstruction surgery and unsure which option is right for you? Schedule a consultation with Forsyth Plastic Surgery in Winston-Salem to discuss your goals, review your options, and create a personalized treatment plan with compassionate, experienced care.
