Breast reconstruction (implant)

What is implant-based breast reconstruction?

Breast reconstruction rebuilds a breast shape after a mastectomy. This guide covers implant-based reconstruction, which uses a silicone or saline implant to recreate the breast, sometimes after a tissue expander has first stretched the skin.

It can be done at the same time as the mastectomy (immediate) or months or years later (delayed). It may be done in one stage, or in two stages using an expander that is gradually filled before being swapped for a permanent implant. A piece of supportive material (a mesh or matrix) is sometimes used to hold the implant in place.

The other main way to rebuild a breast is to use your own tissue (a flap), such as a DIEP flap from the tummy. Implants involve a simpler, quicker operation with no second surgical site, but the result can feel firmer and colder, may show rippling, and is more likely to need further surgery over time. Implants are not lifelong devices.

Reconstruction restores a shape but does not restore normal breast sensation, and the reconstructed breast will not behave exactly like a natural one. Radiotherapy makes implant problems more likely, so the plan and timing are decided together with your cancer treatment.

Types & techniques

There isn't one single operation. The right approach depends on you — which is something to discuss with your surgeon.

Implant vs own-tissue (flap) reconstruction

Neither is 'best' for everyone. The right choice depends on your body, cancer treatment, radiotherapy and preferences.

Preparing for your surgery

• Discuss implant versus own-tissue reconstruction, and immediate versus delayed timing, before deciding.
• Ask how radiotherapy — given or planned — affects which reconstruction is advisable and when.
• Talk through one-stage versus two-stage (expander) approaches and what each involves.
• Ask about the type of implant, any supportive mesh, and the chance of needing further surgery later.
• Stop smoking well beforehand, as it raises wound-healing and reconstruction risks.
• Tell the team about all medicines and supplements, especially blood thinners, and follow fasting instructions.
• Arrange several weeks of help at home and a lift, as you should not drive after a general anaesthetic.

What happens

Implant reconstruction is done under general anaesthetic. After the breast tissue is removed (at the same operation for immediate reconstruction, or earlier for delayed), the surgeon places either a permanent implant or a tissue expander, usually under or in front of the chest muscle, often with a supportive mesh or matrix.

If an expander is used, it is partly filled at surgery and then topped up with fluid through a valve over several visits, gradually stretching the skin. A second, smaller operation later swaps it for a permanent implant.

Thin drains are often left to remove fluid. You will usually stay one or more nights. Later refinements, such as fat transfer, nipple reconstruction or surgery to the other breast for symmetry, are often planned as separate steps once everything has settled.

Is this operation right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

Anaesthetic choices

The safest option depends on the operation, your health, the facility and your surgeon/anaesthetist. Ask what is planned and why.

The issues most specific to implants are capsular contracture, the chance of needing the implant replaced over time, and the higher rate of problems if you have had or will have radiotherapy. Rare implant-associated cancers (such as BIA-ALCL) are important to know about. Ask your surgeon about implant type, their own complication and replacement rates, and what they do if an infection occurs.

Published figures to discuss

Complication rates vary with the technique, smoking, body weight, diabetes and especially radiotherapy, which substantially increases implant problems. Studies define and follow complications differently, so figures vary; many people will need further implant surgery over their lifetime. The numbers below are cautious general ranges, not your personal risk.

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

Recovery — what to expect, and when

Recovery from implant reconstruction is usually shorter than from own-tissue reconstruction because there is no donor site. If an expander is used, the breast shape is built up gradually over weeks of fills, with a second operation later.

• Soreness and tightness across the chest that eases over weeks
• Numbness of the breast skin, which is usually long-lasting
• A firm, high or swollen reconstruction that softens and settles over months
• Temporary tightness during expander fills
• Tiredness and the emotional impact of surgery

Aftercare

• Follow instructions on caring for wounds, drains and the reconstruction.
• Wear the support garment or bra you are advised to.
• Avoid heavy lifting and overhead activity early; build up gradually as advised.
• Watch for signs of infection or skin problems and report them, as implants can be lost to infection.
• Attend expander filling appointments if you are having a two-stage reconstruction.
• Avoid smoking completely, as it threatens healing and the reconstruction.
• Keep follow-up appointments and use your breast care nurse for support.

• A supportive, non-wired bra or recommended garment
• Front-opening tops that avoid reaching overhead
• Help at home for the first weeks, especially with lifting
• Pain relief at home as advised
• A lift home and someone to stay the first night
• Expander filling appointments noted (if two-stage)
• Breast care nurse and clinic out-of-hours numbers saved

Scars and how they heal

Scars are usually on the breast, often where the mastectomy scar is. Their position depends on the mastectomy and whether the nipple was kept. If a back flap is combined with the implant, there is also a scar on the back. Scars are firm and pink at first and usually soften and fade over many months.

⚠ Get urgent help if…

• Spreading redness, heat, increasing pain or pus around the implant (possible infection)
• The wound opening or the skin over the implant breaking down
• A rapidly growing, tense swelling (possible bleeding)
• Fever or feeling generally unwell after surgery
• Sudden change in the size, shape or firmness of the reconstruction
• A hot, swollen calf, or breathlessness or chest pain (possible clot) — seek urgent help

Who to contact: your surgeon or clinic first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your surgeon gives you.

Results & realistic expectations

A good result is a reconstructed breast that gives a natural-looking shape in clothing and a reasonable match to the other side, achieved safely. Implant reconstructions can look very good, especially in smaller or medium breasts, but they feel firmer and cooler than a natural breast and do not restore normal sensation.

The final result settles over months and often needs refinement, such as fat transfer, nipple reconstruction or surgery to the other breast for symmetry. A good surgeon is honest about what an implant can and cannot achieve for you, particularly if you have had radiotherapy.

Implants are not lifelong devices. Over the years they can harden, change shape, ripple, leak or rupture, and many people will need at least one further operation to revise or replace the implant during their life. Radiotherapy increases these problems. Own-tissue reconstructions generally last longer. Ongoing follow-up and being aware of changes in the reconstruction are important.

Combining with other procedures

Implant reconstruction is often combined with other steps: a supportive mesh, fat transfer to refine the shape, nipple reconstruction or tattooing, and surgery to the other breast for symmetry. It may be combined with a back flap for extra cover, especially after radiotherapy. It is planned alongside your wider cancer treatment.

Follow-up & long-term care

You will be seen to check healing, carry out expander fills if needed, and plan any further stages. Longer-term, you should know how to have the reconstruction reviewed and when to seek advice about implant problems. You should have a named contact, usually a breast care nurse, for concerns.

• Be aware that implants may need replacing and can develop problems over time
• Report any new pain, swelling, lumps or change in shape of the reconstruction
• Attend any recommended reviews of the reconstruction
• Ask your team about awareness of rare implant-associated cancers and what to look out for

Revision and secondary surgery reality

• Many implant reconstructions need at least one further operation over time, for example to replace or revise the implant.
• Two-stage reconstructions always involve a second operation to swap the expander for a permanent implant.
• Refinements such as fat transfer, nipple reconstruction or symmetry surgery are commonly planned as separate steps.
• Radiotherapy increases the chance of needing revision or switching to own-tissue reconstruction.

Ask your surgeon for their own revision rate, what counts as a revision, and what is included in the written aftercare policy.

What good aftercare looks like

• Clear advice on wound and garment care and on spotting infection early.
• Organised expander filling appointments and clearly planned later stages.
• A named contact and route to be seen quickly if the implant looks infected or the skin breaks down.
• Long-term awareness of implant problems and rare implant-associated cancers, with a plan for review.
• Honest discussion of symmetry surgery and refinements as part of the overall plan.

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

• Whether reconstruction is immediate or delayed, and one-stage or two-stage (with an expander)
• The type and brand of implant, and any supportive mesh or matrix used
• Surgeon and anaesthetist fees, theatre time and length of stay
• Expander filling visits, and later refinements such as fat transfer or nipple reconstruction
• Surgery to the other breast for symmetry, if chosen
• Follow-up and management of any complications, including implant replacement over time

• The surgeon's and anaesthetist's fees and theatre/facility costs
• The cost of the implant, any expander and supportive mesh
• Whether expander fills and later stages are included or charged separately
• Follow-up appointments and breast care nurse support
• Any surgery to the other breast for symmetry
• What happens — and what it costs — if the implant becomes infected, hardens, leaks or needs replacing

On the NHS? Breast reconstruction after cancer surgery, including immediate or delayed implant reconstruction, is available on the NHS; private care may be chosen for choice or speed but should meet the same standards.

You're entitled to your total cost in writing — including aftercare and any revision — before you decide.

Consent traps and marketing red flags

These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.

Choosing a surgeon safely

• Check your surgeon is on the GMC Specialist Register for this area.
• Make sure they practise at a CQC-registered location, and look for membership of bodies like BAAPS or BAPRAS.
• You're entitled to a two-stage consent process with time to reflect (a cooling-off period). The surgeon who will operate must consent you — not a salesperson.
• Be wary of pressure: time-limited offers, discounts or deposits taken before you've had time to think are red flags, not bargains.
• You're entitled to your total cost in writing — including aftercare and any revision — before you decide.

How Vuemedics verifies every consultant →

Take this to your consultation. A good surgeon will welcome every one of these.

• For me, what are the pros and cons of an implant versus using my own tissue?
• Given my radiotherapy plan, what reconstruction and timing do you recommend?
• Will this be one operation or two (with an expander), and what does each involve?
• What are your own rates of capsular contracture, infection and needing the implant replaced?
• How likely am I to need further surgery in the future, and what would that involve?
• What should I watch for, including rare implant-associated cancers, and who do I contact?
• Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
• Will you be the surgeon who carries out my operation, and who looks after me afterwards?
• What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
• What does a realistic result look like — and what can this operation not achieve?
• What are my options, including waiting, doing nothing for now, or choosing a different approach?
• Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
• What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Find a verified surgeon for breast reconstruction (implant)

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How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: BAPRAS — Breast reconstruction patient guide Cancer Research UK — Types of breast reconstruction Breast Cancer Now — Types of breast reconstruction Systematic review of implant-based breast reconstruction complications — PMC MHRA — Breast implants and anaplastic large-cell lymphoma Association of Breast Surgery — BIA-ALCL patient information

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.