When a mastectomy or lumpectomy is a part of your breast cancer treatment, you may also consider breast reconstruction surgery.
Penn is the most active breast reconstruction center in the nation. Our high volume means we are experts in all stages of the breast reconstruction process, from consultation to recovery. We also respect and treat each patient with exceptional care. Learn what our patients say about personalized care at Penn.
What to Expect from the Breast Reconstruction Process
It's important to know that each breast reconstruction journey is different. Our skilled team guides you through your personal breast reconstruction process with compassionate care.
Throughout your breast reconstruction journey, you can access expert information with our Penn Breast Reconstruction Advocate (PennBRA) online portal. You can also reach out to your providers through MyChart by myPennMedicine.
Breast Reconstruction Consultation
If you are considering breast reconstruction surgery, your oncologist refers you to our breast reconstruction team. You can meet with one of our plastic surgeons to discuss your goals and the types of breast reconstruction options available to you. We also discuss the risks, potential complications and likely outcomes. Together we choose the breast reconstruction surgery procedure that is in line with your health situation and preferences.
When you choose which type of breast reconstruction surgery to have, we can pair you with a patient who has had the same kind of surgery. In our Peer-to-Peer Telephone Program you can learn insights about the breast reconstruction process from someone who's been there.
At this time, we take specialized images of your chest and arrange your pre-operative workup.
The Day of Breast Reconstruction
The breast reconstruction surgery process depends on the type of surgery you have. Another factor is when you have breast reconstruction — either immediately after mastectomy or delayed reconstruction, which can be years after a mastectomy.
On the day of your breast reconstruction surgery, you will arrive and check in at our facility. We prepare you for surgery, including giving you general anesthesia to keep you comfortable.
Implant reconstruction immediately after a mastectomy usually requires two surgeries several months apart. In the first surgery, your reconstructive plastic surgeon places an expander under the skin of your chest and either under or on top of the chest wall muscles. Your surgeon may insert drains to help remove fluid from the surgical sites. Surgery can take one to two hours. You can expect to be in the hospital for one to two days.
Free-flap breast reconstruction surgery is also a two-part surgery, but the procedures happen on the same day. After your mastectomy, your reconstructive plastic surgeon removes tissues from your lower abdomen, buttocks or thigh and inserts them into your chest. Your surgeon may insert drains to help remove fluid from the surgical sites. Surgery can take four to eight hours for one side (unilateral) and longer for two sides (bilateral). You can expect to be in the hospital for three days.
After surgery, we move you to an intermediate care floor, a level of care between a regular surgical unit and an intensive care unit. A nurse checks on you every hour for the first 48 hours and then every two hours for the remainder of your hospital stay.
Since Penn is an academic institution, we have many resident physicians in the hospital at all times. That means, in addition to your plastic surgeon, you have 24/7 access to highly trained experts after surgery.
Breast Reconstruction Recovery
Before you go home, we teach you how to care for your drains and incisions and take your medications. We also tell you about any activity restrictions. We connect you with Penn Medicine Home Health and our visiting care nurses.
Once you get home, you can continue to rely on Penn for expert care. We see you for follow-up care frequently, typically at two weeks, three weeks, four weeks, eight weeks, three months, six months and one year after surgery. During this time, your doctor may recommend physical therapy, and we can connect you accordingly.
You can always reach a Penn provider by phone, either in the clinic during office hours or the plastic surgery resident on call after clinic hours. You can also send questions at any time through MyChart by myPennMedicine.
For implant reconstruction, including mastectomy and placement of tissue expanders, most patients take four weeks off work. Recovery from the second stage surgery (removal of tissue expanders and placement of the permanent implant) is usually one to two weeks.
For free-flap reconstruction following a mastectomy, patients are typically away from work for six to eight weeks.
Nipple Reconstruction and Nipple Tattooing
After your new breasts have had time to heal, you may consider nipple reconstruction, nipple and areola tattooing or both. A plastic surgeon can build a new nipple in an outpatient procedure. The new nipple will not have sensation or react to touch and temperature in the way that a natural nipple would.
3D Nipple Tattooing treatment is a form of micropigmentation. Learn more about nipple and 3D areola tattooing.
Breast Reconstruction Process: Why Choose Penn Medicine
Our highly skilled team, advanced technologies and individualized care result in excellent outcomes for our patients. When you trust Penn for breast reconstruction surgery, you can expect:
- Experts in all aspects of the breast reconstruction process: Penn completes more breast reconstruction procedures than any other health care system in the nation. We have the experience and skills that lead to the best possible results.
- Compassionate care from a skilled team: Our experts are with you at every stage of breast reconstruction. We coordinate all efforts to streamline your care.
- Comprehensive education: We ensure you and your family know what to expect before, during and after breast reconstruction surgery. In addition to individualized guidance from our team, our Penn Breast Reconstruction Advocate (PennBRA) online portal is a unique resource with extensive information about breast reconstruction.
- Modern pain management protocols: We are leaders in procedures that reduce pain using minimal or no narcotics, resulting in a reduced risk of opioid abuse or opioid use disorder. Reduced pain helps our patients go home faster.
- Nipple reconstruction and 3D nipple tattooing: To complete the reconstruction process, some patients opt for nipple reconstruction or 3D nipple tattooing. We work with micropigmentation specialists who are leaders in their field.
- Peer support: We match you with a volunteer who experienced the same type of breast reconstruction. You can connect over the phone to share your experiences and get a peer's perspective on your upcoming surgery and recovery process.
- Coordination for care at home: Before you go home, we coordinate home care from Penn Medicine Home Health. Our visiting nurses are experts in post-surgical care. Also, with our telemedicine portal, sometimes you can have post-operative appointments from home.
Request an Appointment
Call 215-662-7300 or request an appointment online.