Breast Reconstruction
Rebuilding Confidence, One Step at a Time
Breast reconstruction is a personalized surgical procedure designed to restore the shape, volume, and symmetry of the breast following mastectomy or breast-conserving surgery. Depending on medical needs and personal preferences, reconstruction can be performed immediately after breast removal or at a later stage, using implants, autologous tissue (flaps), a combination of both, or with your own fat through lipofilling. Since 2024, these AFT (Autogenous Fat Transplantation) treatments have been fully covered by health insurance in the Netherlands.
Why Consider Reconstruction?
Rediscover your shape
Recreate the natural curves and contours of your breast, supporting both your body and sense of self.
Support emotional well-being
Reconstruction can ease the emotional impact of mastectomy and help restore confidence.
Personalized approach
Procedures are adapted to your anatomy, goals, and lifestyle, combining safety, aesthetics, and comfort.
When reconstruction may be recommended
After Total or Partial Mastectomy
Immediate reconstruction during surgery or delayed once your body has recovered.
- Immediate reconstruction during mastectomy surgery
- Delayed reconstruction after recovery and treatments
Revision or Symmetry Procedures
To refine shape, improve contour, or balance breasts after previous surgery.
- Correction of asymmetry between breasts
- Improvement of contour and natural appearance
Techniques
Modern breast reconstruction offers several advanced approaches
Implant Based Reconstruction
Implants provide shape and volume, often supported with muscle coverage, tissue matrices, or specialized membranes for optimal results.
Direct-to-Implant
One-step procedure where the final implant is placed immediately after mastectomy.
Two-Stage with Tissue Expander
Gradual skin expansion followed by placement of a permanent implant, ideal when tissue is tight or thin. Mainly used in irradiated patients.
Exashape
A soft, biocompatible bovine pericardium membrane that wraps the implant, encourages tissue integration, and provides gentle support and natural contour.
Lightweight Implants (B-Lite)
Reduce pressure on tissues, minimize sagging over time, and improve comfort and mobility.
Considerations
- Implant choice depends on body type, chest wall dimensions, and desired outcome.
- Implant based reconstruction can be combined with fat grafting for improved contour and natural softness.
Autologous Tissue Reconstruction (Flaps)
Using your own tissue creates a natural, long-lasting breast.
DIEP Flap
Skin and fat from the lower abdomen, muscles preserved. Ideal for fuller volume and soft feel.
Latissimus Dorsi Flap
Muscle, fat, and skin from the back, sometimes combined with an implant for additional projection.
PAP Flap
Tissue from the back of the thigh, suitable when abdominal tissue is insufficient.
Complete reconstruction with own fat (AFT)
Combined with the EVE system, the skin is first stretched and new blood vessels are created, so the fat cells will survive better after lipofilling.
Advantages:
- Natural movement and softness.
- Reduced risk of implant-related complications.
- Can be combined with lipofilling to refine contour.
Considerations:
- Deep flap reconstruction is a significant procedure and creates a large abdominal scar.
- There is a risk of the flap dying due to poor blood flow.
Hybrid and Combined Approaches
Merges the benefits of implants and autologous tissue to maximize both projection and natural appearance.
Hybrid Reconstruction
Smaller flaps combined with implants (e.g., B-Lite) for optimal volume and natural feel.
Lipofilling Enhancement
Fat grafting smooths edges, improves symmetry, and enhances a lifelike appearance.
Staged Approach
Begin with implants and later integrate autologous tissue if needed, adapting to evolving goals and healing.
The Reconstruction Journey
Understanding the timeline and process of breast reconstruction
Consultation
Open discussion of your goals, questions, and options, ensuring a plan that feels right for you.
Surgical Planning
Coordination with your medical team, selecting the best approach, timing, and materials (implants, flaps, matrices).
Reconstruction Surgery
Immediate or delayed, with techniques chosen to match your anatomy and desired outcome.
Recovery
Gentle healing phase; may include tissue expansion if an expander is used. Timeframes vary by procedure and patient.
Refinement Procedures
Optional touch-ups for symmetry, nipple-areola reconstruction, or contour enhancement.
Postoperative Considerations
- Pain and swelling are normal; early mobility exercises may be recommended.
- Scarring and changes in sensation are part of the healing process but usually improve over time.
- Regular follow-up ensures optimal outcomes and addresses any concerns early.
Key Takeaways
- Reconstruction is highly personalized: implants, flaps, hybrid approaches, and fat grafting can be combined for natural and lasting results.
- Modern materials like B-Lite implants, Polytech and Evebra matrices, and Exashape membranes enhance comfort, support, and aesthetics.
- The process is a journey, physical, emotional, and empowering, where each step is guided with care and attention.
Want to discover more?
Explore our Luna Stories to see pictures, videos and behind-the-scenes content, hear professionals talk about procedures, and read insightful articles.