Breast Reconstruction for Breast Cancer

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If you will be having surgery for breast cancer and you are interested in breast reconstruction, your first step is to meet with one of our breast reconstructive plastic surgeons. 

The surgeon will go over a range of options with you and explain the timeline for reconstruction so you have all the information to make a decision that meets your goals.  

Breast Cancer Care Tailored to You

You and your family are our top priority. At Fred Hutch Cancer Center, we offer comprehensive and compassionate care — personalized to you. You'll have access to the latest treatment options, clinical trials and supportive care services. 

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Deciding on Breast Reconstruction

At Fred Hutch Cancer Center, your first visit about reconstruction will typically happen after your cancer care team makes your treatment plan. This gives you a chance to think about the plan and then decide the next step. We will schedule your reconstruction visit to meet your needs.

It is normal for your first consultation to be just the start. Patients often have more than one visit with their surgeon to talk about and think through all their choices.

Watch this video with Dr. Shannon Colohan to learn about the breast reconstructive process.

Types of Breast Reconstruction Surgery 

Based on your needs and wishes, we may be able to offer the first step of breast reconstruction surgery at the same time as your cancer surgery. We use many advanced techniques to get the best outcomes. This includes complex options for people with different body types or health concerns and people who want breast reduction.

If you decide not to have reconstruction (also known as “going flat” or aesthetic flat closure done by the breast surgeon without the need for a reconstructive surgeon), we support you in making the choice that is right for you.

Oncoplastic Surgery

If you are having a lumpectomy, your surgeons may be able to remove your cancer and also reshape one or both breasts.

One option is a breast reduction or breast lift, done at the same time as your lumpectomy, to adjust your remaining breast tissue and give you a natural breast shape and symmetry. Another option is using tissue from the side of your chest wall to fill the space left by the lumpectomy (lateral intercostal artery perforator, or LICAP, flap). This is also known as volume-replacement surgery.

Implants

A saline or silicone implant is another option. Your surgeon can explain the differences and show you samples during a consultation. 

To make room for an implant, and if women want to be reconstructed to a different size than their current breast size, many patients need a tissue expander inserted first. This is a balloon-like device. It goes under your skin and is slowly filled with saline over several weeks to months, which stretches your skin. It can be put in the same day as your mastectomy or weeks, months or years later. When the skin has stretched enough, your surgeon will remove the expander and put in your implant. Some women can have an implant (generally silicone) placed at the same time as the mastectomy if they want their breast reconstructed to the same size as their natural breast and the skin and nipple appear healthy enough to do so in surgery.

Natural Tissue

After mastectomy, many patients have their breast restored using skin and fat from their own body. The abdomen is the most natural match and is also the most common area to have extra tissue. The name for this method is deep inferior epigastric perforator (DIEP) flap. It is also called tummy-tuck reconstruction. 

There are other options, too. We can use tissue from your upper buttock (superior gluteal artery perforator, or SGAP, flap), your inner thigh (transverse upper gracilis, or TUG, flap), or your back (latissimus flap).

Tissue reconstruction may involve using a tissue expander, like for implants, or it may be done later without needing an expander. 

Wearing a Prothesis or "Going Flat" or Aesthetic Flat Closure

Keep in mind that many people choose not to have reconstructive surgery. Instead, some people decide to wear a breast form, or breast prosthesis. Others decide to “go flat” and get used to their new chest. This is a personal choice, and only you will know what is right for you. We support whatever you decide.

If you are interested, the American Cancer Society has resources about breast prostheses. Shine, Fred Hutch’s retail store in South Lake Union, has breast prostheses and can do mastectomy fittings (to fit you for a prosthesis and related garments). 

Dr. Shannon Colohan
Dr. Shannon Colohan is a reconstructive surgeon whose primary focus is on breast reconstruction for people with cancer.

Why Choose Fred Hutch for Breast Reconstruction

Our plastic surgeons are all UW Medicine physicians. They are highly skilled in both ways to restore your breast — with either implants or natural tissue. Implants use synthetic materials (like saline or silicone) to reconstruct the breast. Natural-tissue methods restore your breast using tissue from your own body.

Learn More About Reconstruction Surgery

Breast Cancer Reconstructive Surgery FAQ

If you need radiation therapy as part of your treatment plan, you may need to wait for breast reconstruction or at most have a temporary reconstruction (ie. tissue expander). Some people also decide to wait to get reconstructive surgery for personal reasons or to have more time to recover from their mastectomy. 

People do not typically get mammograms after breast reconstruction following a double mastectomy. Physical exams are done instead to check for cancer recurrence (see if the cancer has come back). If you had a single mastectomy, you will get a mammogram on the other breast.