Breast reconstruction after breast cancer is a key step in restoring body image, silhouette, and self-confidence. This procedure can follow a mastectomy (complete removal of the breast) or a lumpectomy (breast-conserving surgery), and outcomes depend on the technique used. Reconstruction is available to women who wish to regain an aesthetically and functionally complete breast after cancer treatment.
When to Have Breast Reconstruction After Breast Cancer
Immediate Breast Reconstruction
Breast reconstruction may be performed immediately at the time of the mastectomy (immediate reconstruction) or at a later time (delayed reconstruction). In our practice, we prioritize immediate reconstruction whenever possible, including in patients scheduled for additional therapies like chemotherapy or radiotherapy. Thanks to refined techniques and optimized patient care, over 95% of patients are eligible for this approach.
Immediate reconstruction offers numerous advantages:
- It restores breast shape and symmetry right away
- Reduces the emotional impact of breast loss
- Maintains body proportions and silhouette
Delayed Breast Reconstruction
Each patient’s journey is unique. For those who have already undergone mastectomy or lumpectomy, delayed reconstruction remains a viable option. This personalized approach allows us to adapt to medical history, body type, and patient preferences.
Breast Reconstruction After Mastectomy: What Are Your Options?
There are several techniques available depending on:
- Your expectations and body morphology
- The type of surgery performed
- Whether or not you’ll undergo radiotherapy or chemotherapy
Reconstruction with Breast Implants
This is the most common method in France and involves inserting an implant beneath the pectoral muscle. It can be used in both immediate and delayed reconstruction. However, implants can present challenges:
- Poor tolerance of radiotherapy
- Not a permanent solution—may require replacement or additional fat grafting
Flap Reconstruction (Using Your Own Tissue)
This technique uses autologous tissue (your own fat and skin) taken from areas like the abdomen, under the buttocks, or back. It offers a natural feel, adjusts with body weight changes, and is well tolerated during radiotherapy.
Benefits:
- Lifelong result, no need for replacement
- Warmer, more natural texture
- Evolves with your body
Limitations:
- Requires harvesting tissue from another body site
- Additional scars (though often discreet)
Flap Techniques Offered by Our Team
DIEP/SIEA Flap (Abdomen)
Best suited for women with abdominal skin excess (often post-pregnancy). The reconstruction uses skin and fat only, preserving muscle integrity. Scarring is hidden under the bikini line.
Although it requires microsurgery to reconnect blood vessels, DIEP is considered the gold standard in breast reconstruction.
PAP Flap (Under the Buttocks)
Ideal for slimmer patients lacking abdominal tissue. Tissue is taken from beneath the buttock crease. It’s less voluminous than DIEP and best for women with B or C cups.
TDAP (Back Fold Flap)
Used when microsurgery isn’t possible or there’s significant back tissue. Unlike the older latissimus dorsi flap, it preserves muscle and causes less discomfort. However, the fat volume is limited, often requiring complementary lipofilling.
Lipofilling and Complementary Procedures
Breast Lipomodelling (Fat Grafting)
Fat is harvested from the body (abdomen, flanks, thighs) and injected into the reconstructed breast. It improves shape, volume, and texture. Full reconstruction with fat alone is possible but requires 3–5 sessions, spaced over several months.
Breast Harmonization
To achieve symmetry, the opposite (unaffected) breast may be reduced, lifted, or reshaped—either at the time of reconstruction or later.
Breast Reconstruction After Lumpectomy
When tissue remains post-lumpectomy, reconstruction can be achieved through implants or lipofilling. Symmetry procedures may be required to ensure a natural look. Technique choice depends on tissue availability and patient goals.
Breast Reconstruction Procedure: What to Expect
Surgical Phases:
- Preparation (removal of remaining tissue or fat harvesting)
- Implant placement or flap tissue positioning
- Symmetrization if necessary
- Nipple and areola reconstruction (tattoo or surgical techniques), performed later
The procedure can last between 2 and 8 hours, depending on complexity. Multiple surgeries spaced several months apart may be needed for the final results.
Recovery and Post-Operative Care
- Hospitalization: generally a few days
- Pain: moderate and well-managed with medication
- Recovery time: 6 to 8 weeks
- Activity restriction: avoid strenuous activity for several months
- Follow-up: regular visits with your surgeon to monitor healing
Cost and Reimbursement
Breast reconstruction is covered 100% by Assurance Maladie, including secondary procedures such as nipple reconstruction or breast symmetrization.
However, if your surgeon charges over the standard rate (sector II), your health insurance may cover the difference, depending on your policy.
Please refer to our price list or contact our team for an individualized estimate.
Breast Reconstruction for Congenital or Acquired Malformations
In addition to post-cancer reconstruction, surgery can correct congenital or post-operative breast deformities using autologous techniques such as fat grafting. These include:
- Breast asymmetry: correction by enlarging the smaller or reducing the larger breast
- Tuberous breasts: corrected through fat injections and possibly implants
- Poland Syndrome: involves fat transfer or implant to compensate for absent muscle/breast
- Inverted nipples: treated medically or surgically
- Surgical after-effects: deformities from benign tumor removal, abscesses, or implant complications can often be treated with lipofilling
Areola and Nipple ReconstructionThe final step in complete breast reconstruction is nipple and areola creation, which we perform using an innovative method that avoids harvesting grafts from the thigh. Medical tattooing may also be used for realistic results.