October 20, 2026
Christopher Stewart, MD is a board-certified Plastic Surgeon with St. Peter’s Health. He earned his medical degree from the University of Wisconsin School of Medicine and Public Health.
Being diagnosed with breast cancer can be one of the scariest moments in a person's life. The road ahead often includes many doctor's visits, chemotherapy, radiation, and eventually surgery to remove part or all of the breast tissue. But what happens next? Will you ever look or feel the same again? What are the options?
As a plastic surgeon, one of the most rewarding parts of breast reconstruction is that this is the phase of treatment patients get to control. There are many reconstructive options, and there is never a "one size fits all" approach. Patients often tell me they had no idea options were even available. So, let's walk through some of the most common approaches to breast reconstruction.
Going Flat
One of the simplest choices is what's called "going flat." A growing community of patients chooses no reconstruction at all, an approach known as "aesthetic flat closure." For some, this feels liberating. Even in these cases, we still contour the chest to remove excess skin and smooth out any irregularities in the chest wall. Some patients wear a prosthesis when they want shape under clothing, and others choose tattoos as a meaningful part of their recovery.
Fat Grafting
Another option is fat grafting, where fat is taken from one part of the body and used to fill in areas of the breast or improve its shape. This approach is often used after a lumpectomy, when full breast reconstruction isn't needed. It can also be combined with other reconstructive procedures to fine-tune the results.
Breast Implants
Perhaps the most well-known method of reconstruction uses breast implants. This is typically done in two stages. First, we place something called a tissue expander, which allows us to gradually shape the breast and help decide on the size that feels right, a choice the patient ultimately makes.
Breast implants are very safe devices, but they do have some drawbacks worth understanding. They aren't designed to last forever, so they need to be monitored and may need to be exchanged or removed at some point during a patient's lifetime. They can also rupture, become infected, or develop a thick layer of scar tissue known as capsular contracture. These issues are generally rare, but it’s important patients are aware and understand them.
Autologous Reconstruction
The last option is autologous reconstruction, which uses tissue from another part of the body to rebuild the breast. This can take several forms, but the most common today is called a "DIEP flap," which uses tissue from the abdomen. Another option is the latissimus flap, which uses tissue from the back. These procedures are more involved and have a longer initial recovery, but in the long run they generally require less monitoring than implants do and essentially are permanent.
It's Never Too Late
One final point I want to make: it is never too late for breast reconstruction. Many patients who had breast cancer surgery years ago don't realize they still have options today. These cases can present unique challenges, but there are almost always paths worth exploring.
Patients going through breast cancer treatment often feel overwhelmed by both emotion and information. I encourage every woman undergoing breast cancer treatment to seek a consultation with a plastic surgeon so she can understand the full range of options available to support her recovery.