Breast reconstruction is a procedure to create a new breast after mastectomy or lumpectomy. There are several breast reconstruction procedures your surgeon can use. Some feature saline or silicone breast implants, while others use a tissue flap from your abdomen to make a new breast.

Breast reconstruction can be done during your breast cancer surgery or months or even years later. Some patients have breast reconstruction on both breasts, so they match. Or, the surgeon can replace one breast and make it match the other as closely as possible. Some patients need this along with breast implant explant surgery.

If you are considering breast reconstruction, you probably have many questions, including whether you need to wear a bra after the procedure. Continue reading below to learn more.

Breast Reconstruction With Implants

Breast implants are commonly used for breast augmentation and sometimes with a breast lift. They also can be used for breast reconstruction. If you decide to have breast reconstruction with an implant, it will be inserted under the skin or muscle after the mastectomy.

The breast implant will usually be placed in a two-step procedure:

First, the surgeon will use a tissue expander under the skin that remains after the mastectomy. Then, the tissue expander will be slowly filled with saline over a few months.
Second, the expander will be removed and replaced with a breast implant after the chest tissue has expanded. The chest tissue should be ready for an implant after three to six months.

Sometimes the surgeon can place the breast implant in the chest right after mastectomy, which means a tissue expander isn’t needed. But this varies from patient to patient.

Surgeons often use a new material called acellular dermal matrix to support breast implants and tissue expanders. This mesh is made from pig or human skin that has been processed and sterilized to reduce infections.

Breast Reconstruction With Skin Flap

In the skin flap procedure, the surgeon takes a piece of skin and other tissue from your body and uses it to rebuild the breast.

Different parts of the body can be used for the skin flap procedure. Most often, the surgeon will remove tissue from the abdomen or back. But the buttock and leg are sometimes used, as well.

Depending on where the skin is taken from, the tissue can be free or attached (pedicled):

When the skin flap is pedicled, the tissue and blood vessels are moved through your body to the breast. The blood supply from the donor site is intact, so no blood vessels need to be reconnected.
The tissue is removed from the blood supply and reattached to the breast with a free flap. The surgeon must reconnect the blood vessels with microsurgery.

The surgeon may be able to do breast reconstruction with both an implant and tissue flap. For example, they may use a skin flap to cover the breast implant when there isn’t enough tissue left after cancer surgery.

Regarding the nipple and areola, the surgeon can use one of several techniques. First, a new nipple may be made from small pieces of skin from the rebuilt breast. A few months after the nipple is reconstructed, the surgeon can create a new areola with tattoo ink. Finally, the surgeon may use skin grafts to make the new areola in other cases.

The plastic surgeon will review your breast reconstruction options and help you decide which procedure is best for you.

Bras And Breast Reconstruction

Immediately after breast construction, the surgeon may have you wear a surgical bra. This special bra provides gentle compression and support for the healing tissues. The surgical bra will have thick straps and a front zipper that makes it easy to take on and off.

Whether you need to wear a surgical bra after breast reconstruction depends on the type of surgery. It also depends on what your plastic surgeon prefers. A surgical bra helps some patients, but others may not require them.

Your surgeon will also provide instructions about the best things to wear. It’s important to review these instructions before returning to regular bras.

Which Bra To Wear After Breast Reconstruction

After you recover from breast reconstruction, wearing a bra is usually a matter of personal taste. However, many patients decide to wear a bra to offer more support to the new breast and reduce the chances of sagging.

Remember that your old bras may not fit your new shape. Once the surgeon clears you to wear regular bras after recovery, you will probably need to buy new ones.

It may help to have a professional bra fitting to ensure you find the best bra for your needs. However, you can still wear many bra styles, and there are many patterns and colors available.

Keep in mind that wireless and seamless bras will be the most comfortable; bras with seams and wires may irritate scarred or radiated skin.

Additional tips for bra fitting after breast reconstruction include:

Bra cups: Should be fitted to the reconstructed breast without bulging or gapping. If one breast is larger than the other, make sure the bra is fitted to the biggest one.
Shoulder straps: They should fit snugly to the body but not so close that they hurt the shoulders.
Band: Should be snug around the body but not so tight that it’s uncomfortable.

Once you find a bra that works for your new contours, buy a few in different colors and patterns. Have fun with it!

For many women, breast reconstruction is an essential part of recovering from cancer. Talk to your plastic surgeon about your breast reconstruction options today.

Request a Houston Breast Reconstruction Consultation

Are you considering breast reconstruction in Houston? Please set up a consultation with Dr. Ashley Steinberg today. She’ll talk to you about the benefits and risks of breast reconstruction to determine if it’s a fit for your needs and goals.

References

Breast Reconstruction Overview. (n.d.). Accessed at https://www.pennmedicine.org/cancer/about/focus-on-cancer/2019/october/what-to-expect-after-breast-reconstruction

Breast Reconstruction Overview. (n.d.). Accessed at https://my.clevelandclinic.org/health/treatments/16809-breast-reconstruction