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Breast Reconstruction after a Mastectomy or Lumpectomy

You can have breast reconstruction, regardless of whether you had a lumpectomy or mastectomy 20 days ago or 20 years ago.

More than 70 percent of women who forgo reconstruction at the time of their breast surgery don't know it's an option or are focused and worried about managing their diagnosis, says Gedge Rosson, director of breast reconstruction at Johns Hopkins.

Rosson and his colleague Michele Manahan, both renowned experts in the field of breast reconstruction, share some insights that most people may not be aware of about delayed breast reconstruction:
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  • David Rosson, MD

    Nov 30th, 2024
    Dr. Gedge Rosson is an associate professor of plastic and reconstructive surgery and oncology at the Johns Hopkins University School of Medicine. He specializes in complex peripheral nerve surgery and microvascular perforator flap breast reconstructions, such as the DIEP (deep inferior epigastric artery perforator flap), the SIEA (superficial inferior epigastric artery flap), the SGAP (superior gluteal artery perforator flap), the TUG (transverse upper gracilis flap) and the PAP (Profunda Artery Perforator flap). He was the first surgeon in the United States to widely implement pre-operative mapping of the abdominal perforators using 64-slice multidetector 3-D CT scan angiograms, and he is one of the first to now regularly connect nerves to improve breast reconstruction.

    He was the first surgeon in the United States to widely implement pre-operative mapping of the abdominal perforators using 64-slice multidetector 3-D CT scan angiograms, and he is one of the first to now regularly connect nerves to improve breast reconstruction. Dr. Rosson serves as the director of breast reconstruction and Microsurgery Fellowship program director. He is also chair of the Compliance Committee of the Office of Johns Hopkins Physicians, chair of the Risk Management Committee of the Johns Hopkins Hospital and chair of the Special Credentialing Review Committee of Johns Hopkins Health Care.

The vast majority of breast cancer survivors are good candidates.
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While every patient is different and approaches to reconstruction may vary, nearly every breast cancer survivor who is interested in breast reconstruction is a candidate.

Breast reconstruction significantly enhances your quality of life, both physically and emotionally. "Some patients may not see reconstruction as a priority when they first face breast cancer," says Manahan, "but it empowers them and enhances their journey toward healing and self-acceptance, offering hope for a better life.”
Rosson and Manahan led studies that compared quality-of-life assessments for women before and after breast reconstruction. They found that immediate or delayed reconstruction can significantly improve a woman's sense of wholeness and well-being, providing comfort to those navigating the complexities of breast cancer treatment.

Breast reconstruction can help reduce pain and tightness in the chest that often result from radiation therapy. Additionally, it may enhance nipple sensitivity in some patients.
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  • Michele Manahan MD

    Dr. Michele Manahan is a plastic and reconstructive surgeon in Johns Hopkins Department of Plastic and Reconstructive Surgery. She specializes in breast reconstruction after cancer. Breast reconstruction, plastic and reconstructive surgeon, plastic surgeon, Johns Hopkins Hospital, microsurgery, oncologic reconstruction, breast reconstruction, reconstructive transplantation, plastic surgery, Johns Hopkins Hospital, breast reconstruction surgeon, microsurgery, oncologic reconstruction, peripheral nerve surgery, breast plastic surgery, free flap reconstruction, breast implants, breast reconstruction, flap reconstruction, microvascular reconstruction, breast tissue expander, plastic surgery, delayed breast reconstruction. Microsurgery, oncologic reconstruction, peripheral nerve surgery, breast plastic surgery, free flap reconstruction, breast implants, breast reconstruction, flap reconstruction, microvascular reconstruction, breast tissue expander, plastic surgery, delayed breast reconstruction.

Prostheses can be challenging to use and may lead to skin allergies.
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Patients who opt for prostheses often find them heavy and challenging to fit with clothing. Moreover, prostheses require regular replacement; in my case, they have caused painful skin allergies. On the other hand, breast reconstruction offers a permanent solution for restoring the natural shape and size of the breasts.
You don't have to live with jagged, indented scars.

Over the last decade, innovations in breast reconstruction surgery have significantly improved appearance, including reducing the number of indentations and appearance of scars.

Watch this animated video to learn more about delayed reconstruction using tissue from the abdomen.

In many cases, your reconstructed breast will look just as good whether you had reconstruction during your mastectomy or after.
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"We do believe it's never too late," says Manahan. "You can wait and put it off, and when you're ready, there will be many good choices for you."

Even if you were counseled against breast reconstruction at the time of your treatment, advances in reconstructive techniques will qualify you for the procedure. 


You can pick an option that fits your lifestyle.
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Your surgeon can work with you to create a customized treatment plan to suit your preferences. For example, you can choose between breaking up breast reconstruction into one longer surgery or several shorter and less invasive ones.

You'll also have the choice to have your breast reconstructed using the tissue from your belly, thighs, buttocks, or back. Additionally, you can select reconstruction using implants made of saline or silicone.

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