Breast Plastic & Reconstructive Surgery

Our approach to breast reconstruction after mastectomy or lumpectomy

We encourage you to discuss breast reconstruction with your breast surgeon and a plastic and reconstructive surgeon before you have a mastectomy or lumpectomy. They can help you select the best procedure based on your unique needs and desires.

We consider many factors when recommending reconstruction, including:

• The type, stage and location of the tumor

• Whether you need radiation therapy or chemotherapy after surgery

• Your breast size, body type and overall health

Immediate vs. delayed breast reconstruction

Many people choose to have immediate reconstruction, which happens at the same time as their mastectomy or lumpectomy. Our plastic and reconstructive surgeons can also perform reconstruction months or even years after your mastectomy – called delayed reconstruction. We explain the risks and benefits of each approach and what you can expect during recovery.

Types of breast reconstruction

There are two types of breast reconstruction:

• Implant reconstruction. This procedure uses an expander to create space for a permanent breast implant.

• Autologous (free flap) reconstruction. Surgeons use tissue from another area of your body to rebuild your breast.

DIEP flap reconstruction

Plastic and reconstructive surgeons at UCSF Health specialize in microvascular tissue transfer to perform free flap reconstruction. We take skin, fat and blood vessels from your lower belly to reconstruct your breast. We leave abdominal muscles intact, so you have an easier recovery and lower risk of complications. This approach, called DIEP (deep inferior epigastric perforator) flap, is the gold standard in breast reconstruction and delivers superior cosmetic results.

Additional areas of expertise

Our plastic and reconstructive surgeons also specialize in:

• Aesthetic flat closure. We can take steps to flatten the scar and create a smoother chest contour if you choose not to reconstruct your breast.

• Nipple reconstruction. Our surgeons use local tissue flaps (usually from the reconstructed breast) to construct nipples and improve breast symmetry.

• Skin-sparing and nipple-sparing mastectomy. We preserve as much healthy tissue as possible for patients undergoing a prophylactic (risk-reducing) mastectomy or those with early-stage tumors who are having immediate reconstruction.