Display Patient Information Leaflets

Mastectomy and Implant Reconstruction

Posted Monday, 22 September 2025

Date issued: September 2025

For review: September 2027

Ref: A-686/SJL/Breast Care/Mastectomy and Implant Reconstruction

PDF: Mastectomy and Implant Reconstruction.pdf[pdf] 340KB

Implant reconstruction is performed following a mastectomy, where the breast tissue is removed. An implant is then inserted under the skin to replace the volume that has been removed and to create a breast mound.

The use of mesh

A surgical mesh may be used during breast reconstruction to support the breast implant. It’s attached to the chest muscle to create a pocket that holds the implant in place. This helps create a natural droop, shape and contour.

ADM (acellular dermal matrix) is a type of mesh made from animal tissue, usually pig or cow tissue.

If you don’t want your surgeon to use products made from animal, talk to them about possible synthetic alternatives.

Considerations of breast implant reconstruction surgery

Implants are made from medically tested silicone and come in either round or teardrop shape. They can be either smooth or textured on the surface.
The reconstructed breast will feel heavier and colder than your natural breast. If you lose or gain weight, this will affect the natural breast but not the reconstructed breast, causing a difference in shape and size.
They do not have a predicted expiry date, but revision surgery may be needed over the years. However, you do not need to have your implant removed unless there are any problems.
You may notice a reduction in breast skin sensation and therefore the breast will feel different
You may notice some asymmetry after surgery. This can be discussed with your consultant as to whether symmetrising surgery can be offered to the other breast.

Breast implant registry

Your details and details of the implant will be uploaded onto a national database. This is to ensure data is stored appropriately and patients are supported if they have any concerns with their implants in the future. If you have any further questions about this then please ask your breast care team.

General complications of surgery

Haematoma: Swelling due to bleeding and clot formation around the implant. Often requires return to theatre to evacuate the blood and clots and stop the bleeding. Removal of the implant +/- replacement may be necessary.
Wound infection.
Delayed wound healing: Some areas of the scar are more vulnerable, healing to these areas may require more frequent dressings changes and this can take months.
Blood clots (you can reduce the risk with early mobilisation and staying hydrated)
Complications may result in a delay in adjuvant treatments if radiotherapy or chemotherapy are required.
Seroma: Collection of clear fluid around the implants. This happens in almost all patients but to a varying degree. Most often, the body reabsorbs the fluid without any consequences. Occasionally the collection becomes uncomfortable and requires draining with the guidance of an ultrasound scan. Infected fluid collection requires another operation to drain the collection and remove the implant, usually temporarily.

Potential complications of a breast implant reconstruction

Implant loss: this is more common in the early post operative period due to skin loss, tissue necrosis, infection or bleeding. This will lead to more surgery and likely removal of the implant.
Implant rupture: the shell of the implant can be damaged through injury or generally over time. This can lead to silicone being released from the implant. If this happens, it might mean that the implant needs removing/replacing.
Capsular contraction: this is the formation of hard tissue around the implant. This is unpredictable and does not occur in all patients. A capsule is much more likely to occur if radiotherapy is given and in smokers. Capsular contracture can lead to a hard and painful breast. This may require replacement or removal of the implant.
Nipple complications:

Impaired blood supply, 1 in 100 people approximately. The operation by its nature partially disrupts the blood supply to the nipple. There is a risk of nipple loss (necrosis) from the type of surgery, either total or partial or the nipple may be disconnected at the time of surgery and reattached.
Altered nipple sensation, 1 in 5 people approximately. The operation disrupts some of the sensory nerves to the nipple. This can be in the form of reduced nipple sensation and reaction to cold or stimulation, numbness, or heightened nipple sensation.

Rotation or movement of the implant
Breast implant associated illness: This is a term used by some patients who experience a variety of symptoms that they feel are directly connected to their silicone breast implants.
Breast implant associated anaplastic large cell lymphoma (BIA- ALCL): Affects 1 in 24,000 to 1:12,000. This is a cancer that arises in the breast implant capsule. The most common symptom is swelling around the implant due to collection of fluid.
Breast implant associated squamous cell carcinoma- very rare, approximately only 20 cases reported worldwide.

If you notice any swelling to the breast, redness, discharge from the wound, or increased pain, fever, or vomiting, you should contact the breast care nurses for a review ASAP. For out of hours please contact 111 or attend the emergency department.

What to expect after the operation

You will need to take regular over the counter painkillers (Paracetamol and Ibuprofen) following surgery.
You will be given a 7-day course of antibiotics- it is important to take these to reduce the risk of infection
You will go home with a drain in situ (the team will educate you on how to look after it at home)
You will have a dressing in place, and we will arrange an appointment for this to be removed either after a week or when the drain is reviewed. The surgeon may decide to use a PICO dressing. This is a dressing with a small battery pump which provides suction to the wound to promote wound healing.
The stitches are dissolvable and do not need to be removed.
It is important to look after yourself in the post operative period to aid wound healing. This can be achieved by adopting a healthy diet of protein and vitamin C. Also, by ensuring you are achieving good quality sleep.

Resuming normal activities

Please only do your first 6 exercises from the exercise leaflet and avoid raising your arms above 90 degrees until the team are happy for you to progress.
The length of time you need to take off work depends on the nature of your job but will need at least 4-6 weeks.
You are advised to avoid strenuous exercise for a minimum of 6 weeks; then ask your nurses before progressing to any kind of exercise (avoid high impact)
You are advised not to drive for up to 4 weeks following surgery and only re-start when you can safely perform an emergency stop (car insurance might need to be informed of recent surgery)
Avoid heavy lifting, like hoovering and carrying heavy shopping

Post operative supportive bras

You need to wear a supportive, front fastening, non-wired bra immediately after the operation, for at least 6 weeks post-op, day and night. This supports the weight of the implant and helps it settling in place.

Please ask your nurses for advice on where to find the right bra.

Follow up treatment

You will be seen 1 week after your operation with a breast care nurse to remove your dressing and review the wound and drain.
You will be seen on the Primrose Unit in approx. 3-4 weeks after your surgery to review the wounds, discuss results and additional treatment.
You will receive a follow up appointment in our oncoplastic clinic (up to a year after surgery, depending on your progress)

If you have any concerns, you can contact the breast care nurses on 01752 431898 and they can arrange an appointment if needed. This includes if you have cosmetic concerns, or you would like to be seen by your breast surgeon again for consideration of symmetrising breast surgery.