Breast Reconstruction After Mastectomy

Our Approach In Managing Breast Reconstruction

Your body. Your choice. Our expertise.

Breast reconstruction after mastectomy is deeply personal  timing, technique, and outcome must be aligned with the patient's cancer treatment, body type, and wishes. We offer the full spectrum of reconstructive options  implant-based and autologous  and always ensure the decision is the patient's.

1. Oncoplastic Planning & Multidisciplinary Coordination

Reconstruction is planned before mastectomy, not after:

• Multidisciplinary tumour board review  oncologist, breast surgeon, plastic surgeon, and radiologist
• Oncological staging assessment to determine whether radiotherapy is planned post-mastectomy critical for implant vs. flap decision
• Skin-sparing or nipple-sparing mastectomy coordination with the breast surgical team
• Discussion of immediate vs. delayed reconstruction and patient preference

2. Immediate vs. Delayed Reconstruction

Timing of reconstruction is a clinically important decision:

• Immediate reconstruction : performed at the same operative session as mastectomy; superior aesthetic outcomes and single anaesthetic event
• Delayed reconstruction : performed months to years after mastectomy; appropriate when radiotherapy is planned or patient preference dictates staging
• Delayed-immediate reconstruction : tissue expander placed at mastectomy; converted to final implant or flap after adjuvant treatment

3. Implant-Based Breast Reconstruction

The most commonly chosen pathway, particularly for patients with smaller natural breast size:

• Implant based breast reconstruction :direct-to-implant (DTI) or two-stage tissue expander followed by permanent implant
• Acellular dermal matrix (ADM) supports the lower pole of the implant for a more natural contour
• Sub-pectoral or pre-pectoral implant placement choice depends on tissue thickness and body habitus
• Available as immediate or delayed procedure; bilateral options for patients choosing prophylactic or contralateral mastectomy

4. DIEP Flap — Autologous Breast Reconstruction

The gold standard for natural, long-lasting breast reconstruction using the patient's own tissue:

• DIEP flap breast reconstruction Mumbai : Deep Inferior Epigastric Perforator free flap using abdominal skin and fat
• Blood supply preserved to the perforator vessels  no sacrifice of abdominal muscle (unlike TRAM flap)
• Creates a warm, natural breast that changes with body weight over time
• Simultaneous abdominoplasty (tummy tuck) effect  a secondary benefit at the donor site

5. Alternative Autologous Options

For patients who are not candidates for DIEP flap:

• Latissimus Dorsi (LD) flap : muscle and skin from the back; frequently combined with implant for adequate volume
• SGAP / IGAP flap  gluteal artery perforator flaps using buttock tissue
• TUG flap (transverse upper gracilis)  inner thigh tissue for smaller breast reconstruction
• Mastectomy recovery and reconstruction planning always considers donor site morbidity, patient lifestyle, and recovery tolerance

6. Nipple & Areola Reconstruction

The final step in completing the reconstructed breast:

• Nipple reconstruction using local flap techniques (skate flap, arrow flap, C-V flap)
• Performed as a day-case procedure 3–6 months after the breast mound is established
• Areolar tattooing : medical tattooing to recreate pigmentation and 3D illusion of projection
• Option of silicone nipple prosthesis for patients not wishing further surgery

7. Symmetrisation & Long-Term Aesthetic Refinement

Achieving symmetry with the opposite breast is a critical component of the overall outcome:

• Contralateral breast reduction or uplift (mastopexy) to match the reconstructed side
• Fat grafting for contour refinement, scar improvement, and volume fine-tuning
• Implant exchange for optimal size, shape, or position adjustment if required
• Post mastectomy breast reconstruction specialist in Mumbai India follow-up maintained for 2–5 years post-surgery